Bowl fruit for breakfast. I really had to refrain from eating the whole mass of them. I am seriously going to miss these treats when I am back in the states! But our tasty meal was interrupted by a morning emergency call from the hospital. When we got there, it turned out to be a hypotensive 70-year-old alcoholic in respiratory distress. The nurses were giving him a huge bolus of IV fluid to counteract his low blood pressure, but we had to slow it, because the increase in fluid overloaded his old heart and was giving him pulmonary edema (fluid surrounding the lungs making it hard for him to breathe). We treated him for his symptoms and kept him for monitoring, since Tabi believed this whole situation may have been caused by alcohol withdrawal.
Continuing rounds, our most extreme case was a severely malnourished TB patient in the female ward. This young lady had been a regular patient of Dr. Jean’s, and would be doing just fine on her treatment until she was sent home and refused to take it. Dr. Jean was very frustrated her for being so stubborn, and also for putting the rest of the community at risk for drug-resistant tuberculosis. I really don’t know what this girl’s deal was. I thought maybe a psychological issue was at hand, because she was literally wasting away and refusing to receive any treatment. I have never seen anyone that skinny before–not even in pictures. It was scary. Dr. Jean and Dr. Tabi decided to keep her in the hospital for a long time, since that’s the only place she gets better. Uncooperative patients are only one small part in the seemingly never-ending list of frustrations of Dr. Jean’s.
After rounds were done (we split them again, thank goodness!), Tabi and I had the exciting task of draining an injection abscess. This long-standing infection on the upper and outer quadrant of the buttock had probably been caused by a quack doctor or medicine man going around to the villages giving people injections for this and that, just to take their money. There was a raised abscess of about the size of my entire hand, and as Tabi says, “Where there’s pus, let it out!”
She palpated around for the “tracks,” or where the cavities of pus were, and made an incision on the top edge of the abscess, so that the patient would be able to sit down as it healed. I held the receiver tightly against his buttock to catch the drainage. A lot of squeezing and flushing later, and I had about 300 mL’s of pus and necrotic tissue in the basin. It was really lovely. Tabi felt around in the tracks with her finger to make sure there was nothing else there, and she said that one of the four tracks went almost all the way down to the bone. I think this man should be the one to tell every person in Saboba district not to listen to any village quack doctor!
The morning was concluded with an ultrasound scan on a woman who wasn’t quite sure how far along she was in her pregnancy. It was a pretty cool thing to show her the heartbeat of her little baby, and see her face light up. We found out that it’s almost 3 months old, and that she’s due in late October! Tabi has a really good touch for pregnant moms, and I am really enjoying watching and helping her with them.
After lunch back at the bungie, I called Brendan and we got to meet up for a less rushed goodbye than we had yesterday. I found him at the EP Church Easter Monday picnic, playing cards! I sat down right next to their group and started learning how to play Ghanaian mancala with a very nice and patient lady. It’s worlds more complicated than the mancala I learned, and I would have no idea how to explain it to you if you asked! Every turn I took was basically a guess, but I had fun! In turn, I taught her the mancala I knew, which she picked up in a flash, go figure!
After pulling a tie in mancala with my new friend, I followed Brendan to one of Pastor Baaka’s relatives, whom he was asking for a ride to Yendi/Tamale for the Peace Corps conference. He followed me to Lucy’s seamstress shop to pick up some needle and thread so I could sew up my shirt. Then I followed him to return a book to a friend, wherein I found Ephemera (sp?) from the female ward! I am still getting used to the small town feel of Saboba, especially seeing people you know literally wherever you go in town. It’s definitely new for a city girl, but I really have been liking it for the past two months!
Finally after all our errands were over, Brendan and I got to sit down at Back Home Spot and just shoot the breeze over some Alvaro and Fanta. I always enjoy our conversations, especially since Brendan is very relatable. It helps both being the same age, both from the US, both schooled in California, both serving in the same rural village in Northern Ghana! I will miss him when he goes, but thankfully we got to say a proper goodbye.
As I was walking back to the bungalow from my break, Tabi was leaving for the hospital again! I turned right back around and joined her. The tasks on the list today were just to visit David, one of our nurses admitted with pretty bad typhoid, but we got stuck with two labor cases! That’s what happens at the hospital–you go planning to check back on one or two things, and you end up staying the entire night.
We scanned both the pregnancies. One case was a very high-stress situations, so Tabi and I were slightly frantic. She sent me back to the bungalow to fetch things for her twice, and I was working up a sweat! The second time I went for her computer (drug information database on it), the first baby was delivered. Tabi caught it, and it’s apgar’s score was very good, although when the umbilical cord was clipped and cut, it sprayed poor Tabi in the eye with cord blood! That’s another one to add to her list of crazy experiences with body fluids. Prophylaxis and lab tests were duly fulfilled, and we can confirm that our doctor does not have AIDS, Hep C, or Hep B! It was a scare, but she is safe. J
We were just about to tend to the second woman in labor, when Dr. Jean came in and announced that there was a man with a right inguinal hernia that was strangulated. We didn’t want his gut to rot outside the peritoneal cavity, so Tabi went to assist in the operating room and left me with Stella the midwife to catch the baby. I was SO EXCITED! Tabi said that it was a normal delivery case on a “multip,” (multiparous, a woman who has given birth more than once), and was easy to start with, so she would let me catch it!
I was really thrilled but simultaneously terrified and nervous. I kept repeating all the steps that Tabi told me to perform when helping the baby to come out so that there would be less of a chance of doing anything wrong. Stella broke the tension when our plump mama announced that she really felt the urge to push.
“She will deliver the first twin now,” Stella announced.
“First twin? There’s only one…” I answered, confused. Then I looked, and our mama was pooping during her push. I had to laugh out loud! The poop was the “first twin,” haha!
The baby moved steadily down the canal until its head was crowning. I thought it might be at least a minute until the head was delivered, so I went to go throw away some of the “first twin” so it wouldn’t be around to infect things. When I came back, the head was already out! Later, I heard Tabi say to never leave a multip alone! The baby will be out before you know it!
I did get to deliver the rest of the baby, though–help it to turn, guide down for the top shoulder, up for the bottom shoulder, grab the arms and legs and put the baby on the mama’s stomach! I clipped the cord and cut it, and the baby was free! She was crying within a matter of seconds, and weighed 3 kg exactly. What a good girl! I wrapped her up tightly and totally forgot about delivering the placenta because I was so absorbed in the little girl. Stella handled that while I presented her to her mama, beaming the whole time. I was so happy that both the mom and the baby were fine, and that I had played a little role in the delivery.
Soon, after everything was clean and the mom was feeling ready, I walked her back to the lying-in ward, where she was able to start nursing her baby. I was so happy that I caught my first baby that I had to ask her to snap a photo with me. The photo is pretty funny. I look elated, mama looks tired, and the baby looks possessed because of the flash. I asked the mama what her name would be, and she answered that the dad would name it. I turned to him and asked again, and he said that her name would be Soraya. What a gorgeous name. J
I went home with Dr. Tabi and Dr. Jean afterward, late at night. The inguinal hernia had been repared just dandy, and we had a healthy baby. It was a successful night that we were very happy about, considering the suffering and death we endured over the weekend.
We even got to have some bowl fruit when we got home! Tabi and I sat there dipping them into sugar as an extra treat, as if fried dough wasn‘t bad enough for you! I felt complete. Thanks be to God for everything that was accomplished today. J