22nd February 2012

At Ganji Health centre today, a woman arrived having been in labour for 12 hours before her contractions stopped. Thankfully Jeremy was at the clinic as well and so was able to start her on some Oxytocin to get the contractions going again. The staff in the health centres are not allowed to give Oxytocin to start contractions as there is a risk that the woman would have strong contractions but a stuck baby. After an hour of ‘malo, malo (please, please), and no analgesia, the woman pushed out a healthy baby boy. Well it was healthy after a bit of suction - using what looks like a turkey baster - to remove the plug of mucus firmly stuck in his throat.

It really is quite remarkable the way that babies are delivered here with such little equipment. The narrow delivery bed will either be just ¾ long, allowing the woman to place her feet at the bottom of the bed in order to balance her bent up legs, or as was the case today, it will have a large hole just below where the bottom goes, presumably to allow fluids to drain away underneath. Thankfully there was a bowl in the hole, which I think would prevent the new born baby form falling to the floor. There are no pillows, no sheets, and very little that can be used to mop up any fluid expelled during the delivery process – and boy, there is a lot of fluid swishing around (enough said on that matter for now). In the UK, it is perfectly acceptable to grab masses of blue tissue paper to mop up even the smallest of spillages.

Women don’t get any analgesia – there’s not a huge amount on offer even if they did ask for it – and surprisingly enough, they don’t make very much noise. When she cries out  malo, malo, you can be pretty sure that the baby will arrive within the next 30 minutes.

The woman remains in what is probably her only dress and by the time the baby has arrived, it will be rather soaked with all manner of fluids that are mentioned above. She remains in this dress and walks home with her baby wearing it, although it may be a bit drier by then. The nurse will have gloves for the delivery and there is a set of forceps and scissors for dealing with the cord. The cord is tied with string that has been soaked in an antiseptic solution. Once out in the big wide world, the baby is wrapped in the mother’s shawl, which absorbs much of the surrounding fluid. There is no oxygen, no proper suction and no facilities to warm the baby. Yet, thankfully, many babies do survive. Yes, the neonatal mortality rate is unacceptably high, as is the maternal mortality rate. But I am constantly amazed at what people do manage to achieve with such little equipment. Have we in the West all become just a little too reliant on technology?

Changed landscape 2 months before the rainy seasons starts

What are the chances of our bananas remaining on the tree and not being eaten by monkeys?!?!