Update: We spent our third week at the hospital in the
maternity unit, and this is by far my
favorite unit to be in. Claire says the same for herself as well. It is an
exciting unit with something always happening.
Roughly seventy percent of women in Rwanda give birth in
health centers in this country (as opposed to in their homes), and there are about
four hundred if these facilities nationwide. If a woman is high risk or is
experiencing complications, she is transferred to a district hospital, and
those are the patients that we see here.
During the week Claire and I observed quite a few births (about three per day). Compared to the US, the equipment here
is very limited, but they do their best with what they have, and the nurses’
and midwives’ education is increasing with teachers like Leslie.
Felix is the student midwife who became our designated
supervisor for the week, and he is always sure that Claire and I are not only
learning, but also practicing what we learn. There are a lot of midwifery
students on this unit so it is a good learning environment. We also sat in on
some of Leslie’s midwifery lectures which we enjoyed very much. She is a great
professor!
In the morning, we spend time with the mothers who are
laboring if they are struggling to remain calm, and we make sure to give much
attention to mothers who may be ready to deliver a stillborn child.
The labor room is small and full of beds, so it gets hot
quickly with many people in this small space, especially with no fans and no
breeze through the opened windows. Despite the heat and smell of sweat and
urine, it is good to be with these women to massage their backs or give them a
drink or hold their hand (or catch them as they are passing out, as I had to do
our second day on the unit!), since they are otherwise alone to labor in a room
full of other laboring women as families are not allowed to be with them except to bring food and water.
The nurses and midwife on duty continually do rounds to keep
check on the fetal heart rate and the progress of the mother. The first day I
was having trouble hearing the fetal heartbeat through the fetoscope, but I was
very excited the next day when I counted accurately the first time listening to
a heartbeat.
When a women is ready to give birth, she goes across the
hall to one of the three delivery rooms. It is common here in Rwanda for many
complications to occur in childbirth because there is a lack of antenatal care.
Because of this we have witnessed a variety of situations. Some things we observed
and learned how to do this week are:
d
- Under what circumstances to put the mother on oxygen during labor
- When a mother needs an episiotomy (far more episiotomies and C-sections are performed in Rwanda than necessary, so this is a point of needed education here)
- When a baby needs to be assisted in birth by a vacuum suction
- How to get a baby to start breathing if it is not doing so immediately after being born
- How to do a full infant examination after birth
- How to apply eye cream and give a vitamin K injection to the infant
- How to deliver a placenta and check that it is all in tact and no pieces have been left in the uterus
- What medicine the to give the mother to prevent and stop hemorrhaging
Highlight of the week:
Doing a lot of hands-on learning in the maternity unit this week, and
learning a lot from the students and Leslie.
Leslie took us down the street to the Rwamagana School of
Nursing and Midwifery for a tour of the campus. There are about three hundred
students, two hundred of which live on the campus. It is a beautiful place, and
they even grow their own food in big gardens, and they have cows which the milk
to make chai tea and they also sell it.
On our second to last weekend we went to lake Kivu in
Gisenyi with Emily, Shami, and Babu. It is so beautiful and relaxing there, and
it was nice to be in the fresh air and get out of the city for a day!
Our last weekend, we went to the rainforest at Nyungwe
National Park to camp overnight and go hiking. No wonder it was named one of
the top twenty places to visit in the world! Breathtakingly beautiful, high up
in the mountains, we were completely surrounded by forest for miles and miles. Sounds
of birds and chimpanzees echoed in the forest. We were so happy to have
experienced this beautiful part of Rwanda.
Challenge of the week:
Passing people on the sidewalk! I was laughing about this with Emily and
Shami, because people don’t walk on the sidewalks here the same way they drive
on the road. People tend to walk in crowds on the sidewalk and don’t move out
of the way or make a single file when people are passing in the opposite
direction. Even when one or two people are walking towards us, they usually
walk down the middle of the sidewalk or even on the correct side, but quickly
switch sides before passing. It makes for a very attentive walk anywhere, as
you are constantly dodging people at the last step or passing crowds on the
road. You’d think it would be simple enough to use the sidewalk the same way you
drive, but for some reason that doesn’t work here.
Humor of the week: Claire
and I spent our last day in Rwanda in Kigali with Babu, wandering around town
exploring and getting things that we wanted to bring home. It had been such a
successful trip with no casualties, but of course, on the last day, we lost two
important things: Claire and my iPhone. Thankfully, at least we got back the
more important one!
At the end of the day, we were taking motorbike taxies from
town back to the bus station to go home. Babu told the moto drivers that we
would stop at one store along the way, but only my driver and his heard the
message, Claire’s did not. So we stopped, and when Claire kept going, my driver
said that he told him where to take Claire (our final destination). Well that
wasn’t the case, so Claire’s driver began looking for us and finally came back to the
store where we stopped, after we had already left. When Babu and I arrived to the bus stop
and didn’t see Claire, I slightly panicked but realized that Claire had my bag
with my phone in it. Babu called her and although she was in a slight frenzy, Babu
calmed her and told her to get a moto and tell him to bring her to the Eco Bank
where we were waiting. After some confusion with which bank and six motos all
surrounding her, Claire jumped on one and hoped he would bring her to the right
one. Babu and I had a great laugh at this now that we knew she was safe. I
tried to get out all my laughter before she arrived. That didn’t work. I’m
still laughing about it.
We got on the bus, and somehow by the time we got off and
walked the rest of the way home, my iPhone was gone. It’s totally gone, and I
have no idea how. But that was our only casualty this trip, so I’d say it went
pretty well!
Claire and I are so
thankful for this experience we had in Rwanda— in Rwamagana at the hospital,
in Kigali, at Lake Kivu in Gisenyi, and in the rainforest at Nyungwe National
Park. We want to again give a special thank you to all of our friends and
family who supported us and made this trip possible. It is a time we will
never forget!
I have pictures of our last week at the hospital with Leslie and the students we worked with, but they are on Leslie's camera and I have not obtained them yet!
Shami and Emily keeping it cool at the lake
cloudy day a the lake
the library at Rwamagana School of Nursing and Midwifery
personal cellphone holder for the midwife (Felix here) when sterile or soiled gloves are on during a delivery
Outside the house with Giselle, our new Rwandese sister
Claire and I on the canopy bridge high above the rainforest!
Emily and Shami enjoying the view from the canopy bridge
