Firstly, hooray there is another midwife from the states here! We chatted at length last night and agreed that I would go in and try to shadow her today—she has been here a whopping week and a half and assures me she has hardly got a grip on the paper work so I should not feel overwhelmed by it. That plan went to dust as they really won’t have two of us doing what one of us could be doing.
I woke up with the sun at 6 and made some tea then headed in. There had been a dozen plus births last night but it was a quiet morning so I headed up to help out at the antenatal clinic doing prenatal check-ups. The day starts with a prayer in Bislama, I caught the part about being thankful for the doctor from Papua New Guinea, the doctor from Australia, the nurse from Tanna, the midwife from America (that’s me!) and the good health of the long-term midwife from New Zealand. We then opened the doors and somewhere around 60 women came in, each holding a small card. We collected the cards and then it was my job to pull charts, in order of the cards. So even though I could see there were 16 Marie’s (charts are filed by first name), I had to pull one and then move down the list. I am kind of the queen of efficient systems and organization and it took a lot of self control not to “fix” their system!
As I was pulling charts a midwife gave an educational lecture to the women sitting in the room waiting for appointments. She gave them a big talk about birth control and then put on a video about breastfeeding. I tried to attach myself to one of the midwives for prenatals but it only lasted for one, during which she told me, in Bislama mostly, about what to write where. Then she left me alone and I was on my own doing prenatals in a language I don’t speak. This would not be such a huge problem if the mothers didn’t have anything to say but like at home, prenatals here are 80% psychological work and I listened to their stories only catching bits and pieces. The good news is that “my man done me wrong and I told him to get out but he keeps coming back and looks into my eyes and I melt into a puddle and then he does me wrong again” sounds the same whether in a country song or out of the lips of a woman deep in the South Pacific. The bad news is that the men seem to have multiple sexual partners and STDs are rampant. The women take the meds we give them but their men will not and they bring Chlamydia back to the mamas again and again and again. I personally feel that we are talking to the wrong folks and put in the request to make a giant poster of man parts ravaged by Chlamydia (not a pretty site, I assure you) and that we march around the neighborhoods with meds and other such things as might be used to prevent the spread of this disease while parading the Poster of Truth around. The midwife who I have taken on as my boss here thinks there is a strong connection between Chlamydia and Group B Strep and she is trying to collect statistics and make a care plan for addressing this vicious cycle. The powers that be are difficult at best when it comes to making system-wide changes. I think my idea might be more effective in the short term at least….I learned some new ways of measuring where the baby is at that we don’t use at home, and since the battery was gone in the Doppler I used my stethoscope and a little plastic horn to hear the heart beat.
While left alone for the prenatals, as soon as I found something concerning I was able to get the attention of doctors, midwives and nurses who converged to discuss the problem. I had a 5th time mother who was complaining of symptoms of pre-eclampsia. But her chief complaint was that she was feeling things she hadn’t felt in the first four pregnancies. I managed to convey to her the importance of this knowledge and how much I trust her sense that something is wrong. She got very animated as I continued to confirm that what she was feeling was right and true. When the team came in to evaluate her she took some of the language I had used with her and her original statement and kept saying, “I know it this is not right” and they just stared at her as if she was from mars…Yikes…am starting to feel like the folks from Star Trek might have had the right idea with the Prime Directive. Although someone did say to me, “it is never wrong to bring humanity to a person” and I am just going to use that as my guide when interacting with women and families here.
On a happier note I was able to pick up a couple of soccer balls today and I brought them to a mother on Chicken Road and asked her to give them to the children. It costs next to nothing but the kids were so so happy and having so much playing with actual inflated soccer balls. I showed them pictures of Julia and Jeffrey and told the kids the balls were from my kids which they loved so much.
I went for an afternoon swim at The Club and met the other members…which include 2 children under the age of 8, a French woman who wears very little and says even less, and the wife of an anesthesiologist at the hospital. She is a nurse and was telling me how she has emailed the hospital looking to come volunteer but she has been unsuccessful. On this I could be helpful –the mind set here with regards to the internet and email is similar to what it was in the early 90’s in America—when emails instead of phone calls might have been considered confusing at best. We had a nice little chat and I took a great walk home, that point as I come back over the top of the island and the breeze whooshes over me still makes me smile. The sun was hot even as it set and there is a lunar eclipse due tomorrow (supposedly!)…
Tomorrow it is back to the maternity ward for a long shift…