february 3rd 2011

Each day has been so full and with its own unique stories. I don't know where to start. Maybe with yesterday at the hospital, and then I will ret to recapture some of what happened last week as well.
Well, in genereal also, life here is going really well. Running the house has been a big job. But it is going more smoothly with time, as we figure out systems that work for things. Blada and I are doing great. He is so awesome! I can't wait for all of you to meet him. He's so positive and easygoing. We have been sprouting and making kimchi (fermented cabbage and other vegetables). He loves kimchi! We eat it every day. It is so good to be able to do this. Having a real refrigerator makes so many things possible. I used to take all of this for granted. It's amazing how all of us are so used to having something like a refrigerator. Having one again is such a blessing.
The internet has been really really unreliable. Sometimes there are days and days where I can't sign into hotmail. and FB also, it doesn't let me open and respond to my messages. I guess it's too slow. But sometimes it works and that's great. Like right now.
On this past Sunday, I went to a funeral with Blada. It was so so interesting. The ceremnoy was at the big Catholic cathedral. There was some weeping and wailing there, from a couple of ladies...then, we walked in the funeral procession to the graveyard. I had seen other funeral processions but never been in one. It felt really significant to me that I was part of it--I felt like, this means that I am part of this community. Really significant. When we got to the graveyard, everyone had to walk through the weeds and over tombstones to get to the tombstone for the guy thery were burying. Here, they bury people in these cement boxes above the ground. Maybe they don't all do this, but maybe most people do. They put the coffin in the cement box thing, above the ground. The thing is though, they don't biuld a new one each time. They leave someone in there for awhile, then when they need it for someone else, they take that person's body out and burn it or bury it. So, we got to the tombstone for them to put the coffin in , and when they opened up the cement box, there was someone else's decomposing body in there. They pulled it out--it was mostly just bones--the skull and the other bones--and the clothes were still on him...I didn't realize it at first, but Blada unflinchingly pointed it out to me. Then there was some heated discussion about twhat to do with the bones of this guy--leave them there, burn them, etc--well they ended up putting them back in after the coffin. Into the cement box tombstone.
This same evening, I had another super interesting and intense cultural experience with Blada. We went down to the plaza to see Carnaval, which is starting since late January...each Sunday, a Rara band plays and everyone goes and dances in the street...so, we went, and it was CRAZY. There were so many people, and it was so so chaotic and there was all this movement...like bikes going in and out of the crowd, some cars, and a huge crowd following the Rara band around the square, everyone dancing and singing...well, after awhile, apparantly a fight broke out somewhere in the thick of the crowd, and then everyone started running...then someone started throwing ROCKS and bottles...we left. Blada was very protective of me...yet he was also amazingly calm and unflinching during the whole thing...I wish I could really describe what it was like...just a little slice of Haitian culture...also, by the way, with all of this, there is no lighting...no streetlights...
So, the hospital...busy, interesting, crazy. Yesterday I was in 3 births...the 1st, was a 4th timer who had a great birth but then had a retained placenta...we waited an hour and tried everything but then I ended up doing a manual removal of her placenta...thank god, a current MW volunteer brought a med called Katorolac...a pain med...we give it for manual removals...
Then yesterday afternoon, we arrive and there is this 1st timer in labor, with a reference from a different hospital for a CORD PROLAPSE...but she's just laying there...I ask and the staff say that it's not a cord, it's a hand, next to the head...2 people had checked her...so I say to the students: Well, the first thing for us to do RIGHT NOW is listen to fetal heart tones...we start listening and there are deep decelerations with each contraction...like from 120 BPM to 60...so we check her, and indeed yes, there is a cord right there...there is the head, a hand, and the cord...so then, I stayed inside pushing up the head off the cord, while we prepared her for a cesarean--luckily the Dr came quickly and we got her in for the c-section maybe within 1 hour (sometimes it can take 3-4 hours). The decels resolved after a little while of holding the head up off the cord. So, I went in with her for the c/s...and when we were in the OR, it seemed like everyone was getting ready and moving so slowly...it always ffeels like that with emergencies here...so, at one moment, I felt that the cord wasn't pulsing...I didn't want to squeeze it either so I just waited and then after a little while, I felt it again lightly, and I could feel it was pulsing normally...so, they got the bb out, and the bb was a little shocky and cyanotic but was fine...just needed stimulation...thank god...I brought the bb back to the delivery room, to do the weight measurements vitamin K etc, and the one of the students ran iin with this OTHER baby, who had just been born in the other room--in the antepartum room--to this lady who had been eclamptic, who Marthonie had been working on all morning...the baby was extremely premature...maybe 24 weeks, maybe more,...definetly way premature--red translucent skin, all the stuff. No way of saving this baby.
Last week, there were also alot of crazy things...there were 4 manual removals (of the placenta--you separate it with your hand--in the uterus--then come out with it)--of which I did 2--one of these was on this lady who had just birthed a stillborn baby in the cholera tents...she was like 5 months pregnant...you see more retained placentas with premature births...so, we tried for a little while and then I went ahead and did the manual removal...for some reason I always get these...Marthonie always gets eclamptic ladies...
marthonie worked the other night because she had gone and it was so crazy that she stayed to help...they had alot of births, and 3 of these ladies had severe preeclampsia. Well, one of these ladies, she died. She maybe had a heart attack. It sounds like maybe she had a heart condition, because what happened was that she just suddenly laid down and died...she never had had seizures or anything...Marthonie told me the whole story...she was really bummed...she has seen alot of people die...so she had worked the night before class, and needed to sleep, so I taught class the next morning...it was good to do it by myself...I feel like my Creole isn't really good enought to really really do a good job teaching classes and explaining physiology...but I did a pretty good job, and felt proud of myself...usually we do the classes together and kind of share the teaching and add things to eachother's teaching...
Last week also, while we had a few births and one lady who had a retained placenta, at the same time, there was this other lady who was only 10 weeks pregnant and severely anemic...her hemoglobin was 4.6...she couldn't stand up...we did her admission and did a requisition for 2 units of blood from the red cross, and....they were out of blood. Maybe out of her type of blood. They had her family looking for someone to donate blood for her.
I feel like there were other stories from the hospital last week but maybe I've highlighted some of the main ones...
Each day is so interesting...I am really enjoying living here and learning more and more Creole...the hospital is super interesting but also super frusturating...because there is nothing, often not even charts to write on...it's crazy...MWH is trying to establish a formal relationship with Zanmi Lasante (Partners in Health)--for referring people to them and also to get meds and supplies...but apparantly, this action is offensive to some people...because they don't want everyone to know the truth about the hospital...they act like they care and want to help Maternity access materials and meds, but it's all a show and I know they're just cursing us under their breath...there was a lady last week who was there for 6 days and couldn't breath because her lungs were full of fluid...she had some kind of lunf infection probably but also had had severe preeclampsia...we had done her birth...her baby was premature (maybe 32 weeks?) and did after about 1 day...anyway, she wasn't on oxygen or anything...finally, we tried to transfer her to the PIH hospital in Cange...they came and got her...she would have died if we didn't do this...well apparantly this made some people really mad, that we took it upon ourselves to refer her...
Unbelievable stuff...
Ok I love you guys...hopefully will keep being able to write every week or two...
Reina