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Two Half Glasses

My glass is half full.

I am so excited to tell you that, finally, the OB facelift is completed!  The walls are painted a beautiful green.  The mattresses have been replaced.  All the patients have sheets and blankets.  Heaters have been purchased to keep the sick or little babies warm.  In fact, the administration of the hospital has been painting the rest of the hospital and has bought many more sheets for all the wards.

Before

After

Beanies for Ethiopian Babies.  Super catchy name that the Belcher boys came up with to get the heads of the Soddo babies covered.  They were able to collect 1,307 hats!!!  They got their church, local retirement communities and friends involved.  Little messages were tucked into most of the hats.  Some of the families kept them others left them for the other patients to enjoy.  The nurses her have been taping the messages and Bible verses to the walls or the beds.

What 1307 hats look like

Messages for the babies and moms

Cara (Viner) Dumaplin wanted to raise money to help with the pediatric ward.  Her children all go to a private school, Scottsdale Christian Academy, where they are allowed to wear jeans once a month if they pay $3.  This money goes towards an organization each month.  In September, they sponsored the pediatric ward.  A presentation was given a week prior about what the money would be going towards.  Benjamin Moyle, a third grader, with a huge heart brought his entire piggy bank.  It was $21 and all he had.  They raised over $700!!!

The Peds Ward… Thank you SCA!!!

My home church in Muskegon, Olivet Evangelical Free, raised enough money for me to bring about 15 eggs a day for the entire year to patients at the hospital!  They also paid for the next session of photos at one of the orphanages, many births, bought a surgical pelvic atlas (HUGE in teaching and learning!) and more.

Another pelvic atlas was sent (PERFECT!  One for each hospital.), breast pumps, gauze, spices (for me :-)), gloves, baby blankets, baby hats, thermometers, BP cuffs, formula, stuffed animals…  SO many wonderful things.  A huge thank you to you all!

Last week, I went and visited Tamirat, Miracle.  For those of you who don’t remember, he was 2 pounds when he

Tamirat playing with his coffee cup

was born ten months ago.  He was seizing, would forget to breath and was admitted to the hospital, I think, four different times when he was near death. I was almost afraid to go visit.  Would he be sitting, smiling, crawling?  Seizing?  Would he even be alive?  We got to his home and were welcomed by all the neighbors.  There was Tamirat.  He was all rolls and smiles.  He can sit.  Mom says he can crawl.  And after he drank two cups of coffee he peed all over me.

Abiti and Bereket are now living with Ethiopian families.  Abiti lives with his cousin, who happens to be my house helper.  He will be with her until the end of the school semester and then move home with his mom.  If he leaves now, he will not be able to be in school for the semester, so his mom wanted him to stay until the semester was over.  Abiti’s “brother” was in the hospital and is now home doing wonderful!  I have given Abiti’s mother a loan so that she can start her own business selling injera.

Abiti before his trip to Hawassa

When I look at this incomplete list of things to be thankful for, I almost feel bad writing any more.  But the second half of this post has been my heart.  I have forgotten all of the things to be thankful for.  I have felt like me being here has no purpose.  I have counted the days until I can leave.

My glass is half empty.

It has taken over 4 months to do the simple task of redoing the obstetrics and gynaecology ward.  I don’t know who I can and can’t trust.  If I ask someone to buy something for me, the price will most likely go up so they get a cut of the sale.  If I do it myself, I may not get a fair price.  But then what is a fair price?  So, I made trips to two different towns trying to find the supplies to redo the ward.  I was able to buy 33 sets of sheets.  After I brought them back to the hospital 9 sets were stolen.  I am not sure if they were stolen by staff, patients or the patients‘ families.  But they are gone.  After two months the sheets were still not on the beds.  Finally, I threaten to take the sheets back.  If they weren’t on the beds the next day, I would bring them to another hospital that would use them.  The next day, they were on the beds.

I bought paint, but the mixing of paint here is a guessing game, at best.  I had gallons of the “same color” of paint

First paint job. New sheets and old blanket.

that were all different shades of green.  The painter just painted.  Rooms would be in patches of shades of green.  I think the walls had to be painted at least 3 times before the colors were the same.  And I am not talking all the same from room to room.  I am simply saying one room, one color.  For the next month the painter found me at least once a day to ask for more money.  We had agreed on a price before he began, but afterwards he wanted more.  Very typical.  At one point, I was even accused of stealing some paint.  Seriously!?!?!?

It took four weeks for the taylor to show up to sew the bedspreads.  Each time I asked if he had appeared, the answer was he was supposed to be here ____, but never came.  Maybe tomorrow.

There is more, but I think you get the picture.

After Abiti returned from his trip to see his sister, I went with him to his mother’s home.  I learned how Abiti ended up on the streets…. His family lives in housing that is subsidized.  They pay just over $1 a month for housing.  This housing is reserved for the poor in the community.   It is made of mud and has a tin roof.  The floors are dirt.  There is no running water and no electricity.  Both of his parents do day labor.  As in, if there is work, they do it.  One of his sister’s had died just after child-birth two years ago.  His mom took her grandson in, Abiti’s brother.  A few months ago, he became sick.  He constantly had diarrhea.  Abiti’s mom had to stay home from work to take care of him.  Suddenly, they didn’t have enough food for everyone, so Abiti was put out on the streets to survive.  I came into the picture about 3 weeks or a month after Abiti was on the streets.  About a month later, he moved in with me.  Then we went to his house.  His brother had kwashiorkor, protein malnourishment.  He was SICK.  His body was swollen up like a balloon.  He could no longer walk or sit.  He had bed ulcers from laying down in his diarrhea for so long.  His main nourishment was grandma’s milk supply, which had mostly dried up.

I love these boys!

One of the other street boys was also brought to his home.  On the way to his house, he saw his older brother, who is also living on the streets.  Their house was falling down.  The roof had as many holes as not.  Only his grandmother was there.  She begged that he be returned to the city were he would be able to live.  She said they had no food.  The neighbors said it wasn’t safe because his father drinks heavily and beats them when he is home.  He isn’t a candidate for an orphanage or for adoption because both of his parents are living.  I am still trying to figure out what is best for him.  He is living with a family here in Soddo for now.

It is a constant struggle to get the family members of patients to donate blood.  We don’t have a blood bank, so it can mean the difference between life and death.  I cannot begin to tell you how frustrating it is!  The excuses range from, “I am just a friend” and “I had malaria this year” to “If I give, it will kill me.”  I have tried educating patients families and talking to them until I am blue in the face, but somehow it just doesn’t work.  So one day, I asked a mother, “Why are you so selfish?  You would rather let your daughter die than give a unit of blood?”  The mother agreed to give blood and left for the blood bank.  She came back some time later wailing because she had the wrong blood type and now her daughter was going to die.  All I could think was there goes my mouth again!  We were able to find blood for her.  What I find even sadder than the families not being willing to give, is the fear of those in the medical field to give.  Two weeks ago, I had a mother who was in heart failure from her anemia (Hg 2.4).  No one would give.  I asked about 20 students to give and they all refused.  The next day she died.

Only 5 of the 12 street boys are still in school.  Their teachers have all asked for money and threatened to kick them out of school if they don’t pay.  The school is a government school, so it is free, but since there is a white face behind these boys being in school it is one more opportunity for them to get money.  I went to the school to ask about the fees and suddenly there were none.  The kids still are asked for money.  Six have been arrested for stealing.  I still have lunches on Tuesdays for all of them.  They get to shower and get clean clothes.  Things in my house, small things, but still things, have gone missing.  I wish I knew how to be a better influence on them.   How can they learn that lying and stealing is wrong when that is all that goes on around them?

The oppression here is overwhelming.  Nine times out of ten I am dealing with a half empty glass or at least it feels that way.  I know that God has placed me here for a purpose, I just don’t know how long He wants me to be here.  So many days I feel blinded by the half empty glass.  I don’t even see that the glass is half full.  I just see the emptiness.  I do not tell you this for pity.  This is just life here.  I know I can’t change it, but I can make small differences in some peoples’ lives.  I knew when I signed up for this job it would be difficult.  I just didn’t realize what the difficulties would be.  Please keep my patients, the street boys and all whose paths I cross in your prayers.  I will be going back to the states for 3 weeks in January.  I pray this will be a time of rejuvenation for me and adjustment to my glasses.

These boys may have a glass half empty life, but they look like they are living a glass half full life

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Life on the Streets

It all started about 3 months ago. I was walking home from the hospital and two young boys said they were hungry and wanted food. I didn’t have any with me, so I invited them over for dinner. They were filthy, so I offered them a shower while I warmed up dinner. They came out of the bathroom dripping wet with their clothes back on. They had never used a towel and didn’t know what to do with the one I gave them, so it sat folded on the floor. A few days later, two women on the street asked for food, so I brought them home with me. It was pretty interesting. I don’t think they had been in anything but a hut before. They were not comfortable coming into my house or sitting at the table, so we sat on the cement floor next to the table and ate. I felt so blessed by these people I started looking for them.

One night on my way home, I came across some of the street boys, six to be exact. I invited them over for dinner. I didn’t have dinner ready, so I started cooking. One of the boys had been over previously and he asked if they could all shower. Next thing I know, all 6 boys are in the shower. I offered to wash their clothes, so we threw them in the washing machine. I obviously wasn’t thinking too far in advance, because I do NOT have a dryer…. and it was the rainy season. So, they all got to wear, yep, my clothes. Now for those of you that do not know me, I am not exactly petite.  And these boys were all 9-12 or so years old. I wish I had taken a picture of them all. Scrubs, sweat pants, sweaters, t-shirts to their ankles, bare shoulders from the neck of a sweat shirt… They were quite the site.

When they finished with their showers, I put in a movie for them to watch. We all got on the couches and I attempted to translate part of the movie into Amharic and then one of the boys that spoke Amharic would translate it to Wollaitina. We eventually ate dinner and did the laundry. In this time, I found out bits and pieces of their lives. It is hard when their primary language is Wollaitina. I just don’t know enough to be able to talk to them.  I cannot tell you how hard it was to send these kids back to the street that night.

Then next day, I was checking to see if their clothes were dry and I noticed they all had a bunch of “fuzzies” on them. With closer inspection I realized that they were completely infested with body lice. I spent the next few hours picking the lice off their clothes. I finally just gave up. The clothes were INFESTED, thousands of bugs. I decided to shower and got the heebie geebies when I found the lice crawling on my clothes. I took a deep breath, read some about body lice and decided I was bigger than body lice and could get over it. In my reading, it said that if you have access to washing your clothes once a week, you should not be infested with lice, so the weekly dinners began.

Most weeks there are 10 or 12 boys and I am learning more and more about them. Every week starts with showers and clean clothes; then we eat, play games, watch movies or just talk, “aka stare at each other and try to say things”.  Some of the boys come back from week to week. This week I only knew one of the ten. Most of them have one set of clothes. I have done some shopping in town, so now when they come over they don’t leave in my clothes. Well, that isn’t entirely true. I haven’t found enough clothes for all of them, so some of them wear my clothes. But the rules are: you come in with one set of clothes, so you leave with one set of clothes. The next week they can get their clean, lice free, dry clothes back.

Now, I would like to introduce you to some of my new friends. Abiti is 11 years old. His mom left. He doesn’t know where she went, but says she went a long ways away. He hasn’t seen her in years. His dad and only sister both died. He lived in a small village outside of here, so he came to Soddo for a better life. And he says it is much better because “there is food”. He is wearing a sweater that has been sewn to pseudo fit him and is falling apart. He got a t-shirt from me that goes down to his ankles. And his pants only go down to his calves. His smile is amazing! Just today I saw him on my way to work and he ran to me and gave me a big smile and hug. He then showed me where he sleeps.

Ezekiel is 10. His mother died and his father remarried. He said life with his new mom was very hard. Everything I have ever heard about step children here

An example of where the kids sleep at night

is that they essentially become the slaves to the family. He has three siblings and he is the oldest. He said that living in the country was hard. He said there was no food, so he came to Soddo. He told me he begs or works and is able to make about 25-35 cents a day. He pays a family six cents a night so he can sleep on their porch. And then the rest he can use to buy food.

Everyone of their stories has common threads. They sleep on the streets.  They find medians during the day if they don’t get enough sleep at night.  At night, they sleep under overhangs of buildings.  During the day they go to the market

This is how you get “ambushed” at the market with “helpers”. I don’t know anyone in this picture.

and offer to carry things for people to make some money. They all beg. Some have families.  Some don’t.  One of the boys told me he wanted to go home for New Year to see his family, but would come back because life is too hard at home. I just cannot imagine having a ten year old and knowing that they would be better on the streets, so letting them go. I don’t think any of them are in school. School is free, but if they aren’t working they can’t afford food. And they can’t afford notebooks, pencils, pens and clothes that fit. I do not know how many street boys there are, but if I had to guess… several hundred

Today, I am asking for you to pray for these boys.   I would like to help them get into school. Their is a church that has a ministry for the street boys, so I am going to contact them. Hopefully, they have something set up. My house helper has taken over the duties of cooking and clothes washing. I don’t know the best way to help these boys, but I am going to love them, feed them, let them shower and wash their clothes.

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Baby Boy No Name

“Baby Boy No Name” has been my patient for the last month and I sent him home, probably to die.  I have mentioned that things are tough.  This is a perfect example.  From beginning to end, the frustration never ended.

No Name’s mom was admitted to the hospital because her bag of water broke and the baby’s leg was hanging out.  She had no idea how far along she was, but guessed around 7-8 months.  Without doing an ultrasound, it was decided to just induce her and “get it over with”.  I was checking on patients and happened to come across her.  I immediately stopped the induction, started her on antibiotics, and gave steroids.  The one person with the only key to the ultrasound room was nowhere to be found.  My hope was to keep the patient pregnant at least long enough for the baby to benefit from the steroids (lung development) and to keep her from getting an infection.  She stayed pregnant for another 5 days and then went into labor.  On day 5, I finally had access to the ultrasound.  No Name was about 30 weeks–or 2 months early.  Here babies do not live before 28 weeks, so this baby had a chance.

Since No Name was trying to come out foot first I felt that the best option was to do a c-section.  So we went to surgery.  Mom and No Name did great. After birth, I placed a tube in No Name’s nose to feed him.  I instructed mom to express milk.  She complained of hurting too badly from surgery and was not motivated to do so. So we started No Name on formula. The family literally spent their entire life savings ($9) on one small can of formula.

About two days after surgery, I went into the room to find mom burning with a fever and baby freezing cold.  Vital signs are never taken on babies.  When I had them take No Name’s temp he was hypothermic.  Both mother and No Name were started on antibiotics… or so I thought.  The mother was febrile for two days before I found out that the family was not buying antibiotics for the mother because of the cost (90 cents a day).  So, I started paying for the antibiotics.  No Name has developed some sort of skin rash, but was now able to stay warm.

The nurses help each other out and as a group take care of all the patients. No one is assigned to patients.  No Name was supposed to be getting fed every 2-3 hours.  It isn’t expected to write things in the chart, so I would get nervous never knowing if he was fed or not. When I would ask about expressing milk they would just ask the mom is she was doing it.  She would say yes.  I would then ask, “How many times a day?”    Mom would say once or twice….

Now let me tell you about the breast pumps here.  They take a 20 cc syringe and cut off the end of it.  It is a one size fits most nipples pump.  They then put the rough, cut edges of the syringe on the nipple and pull on the plunger.  Talk about uncomfortable!!!  Melodie Stocks, an Obstetrician from the states had sent a breast pump, so I brought it to the mother.  Most of the midwives were not convinced it was “strong” enough.  I can understand why they would think that, compared to their “breast pump”.

The next day, mom’s incision opened up and was pouring out pus.  The hospital was out of gauze (there is a shortage in the entire country), so I went on a hunt to see if any of the nurses had some stashed away.  I was able to find a few in the operating room.  We don’t have the proper soaps to clean out the incisions, so we used bleach water and then put the few gauze I could find in the wound.  With her being sick, her motivation to express milk was greatly decreased.  I wanted mom to express milk and then supplement with formula.  No Name just got formula.

It was a constant battle every day.  Many days, I would go between surgeries or at the end of my day to help the mom pump for an hour to make sure it was at least happening once a day.

When No Name was about two weeks old we had a big scare.  I was just popping my head into rooms to ask how everyone was.  Mom and dad were asleep and No Name was blue and not breathing.  I stimulated him and did mouth to mouth.  It was just an episode of apnea, but another medication was added to his list.

With time, both mom and No Name were improving.  No Name had gone from 1.5 kilograms at birth to 1.7 kilos about two and a half weeks after birth.   Mom reported No Name was sucking really well and she demonstrated it to me.  I was reluctant to do so, but I pulled the nasogastric tube and told her to breast feed.  The next day No Name was a little dehydrated.  Mom didn’t have much milk in and they weren’t supplementing with formula, so I told them to combine the two. The next day, No Name was even more dehydrated.

Both mom and dad were crying and begging to go home. Dad was literally on the ground begging me to let them go home. They are farmers and have 4 kids at home. No one has been caring for them. They were afraid that if they do not go home the whole family will starve to death. And if they can’t farm the fields it will affect them not just for a short time, but for the entire year. They had no money, so they couldn’t pay their bill and leave. Patients are just kept in the hospital until they pay up. There was no way to keep No Name in the hospital without a parent. I volunteered to take No Name home for a week or two, but was told I couldn’t because of the possible consequences if something went wrong. I paid their hospital bill, gave them another can of formula and money to get home and buy some food. In the reality of this world they had to go home. They chose survival for the ones that had the best chance. I don’t think No Name will ever get a name, but I hope that the No Name’s brothers and sisters will be able to survive.

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Meskerem

Today, I buried one of my patients.  Her name was Meskerem.  She grew up in Shone, a village about 70 kilometers away.  She probably lived in either a grass or mud hut.  I don’t know how old she was.  Her brother said she was seven, but my guess is she was at least 16.  He said he was 10, but he is probably in his twenties.  Their parents had died “many years ago” and he had finished raising his sister.  She had married, but during the pregnancy her husband left her.

I met Meskerem and her brother yesterday.  I think his name is Etenabalu, but it is long and hard to say, so sadly, I don’t know.  His worn clothes were falling off of his skinny body.  His shoes were lacking soles.  Lou, a medical student from Britain has been working with me this week at Otona.  We had gone to work and Meskerem had just arrived.  She had been in labor for three or four days.  She was in shock.  Her baby had died and was rotting in her pelvis.  The stench was horrible.

Her brother had gone around their village and asked people to give him money to help bring his sister to the hospital.  It wasn’t enough.  The government hospital doesn’t take care of patients unless they have money or they have a letter from their village saying they are poor.  Her brother only had 53 birr left (just over $3).  SInce the hospital wouldn’t do anything without a letter, I decided to bring her to the Christian Hospital.  They found the keys to the ambulance, but couldn’t find the driver.  I offered to drive, but they wouldn’t hand over the keys, so I found a bajaj.  When we left she was half dead.

Once we arrived things moved fast.  We have three visitors for a little over a month and all three of them have the same blood type as the patient, so if they weren’t helping with Meskerem, they were giving blood.

Carrying Meskerem to the Grave Yard. Her brother is the one in the back

Do not read this paragraph if you don’t want to know the nastiest part of my job.  When a woman is in labor and the baby is stuck it is safer to do a destructive delivery for the patient, so that is what I did.  I had to crush the skull of the baby and then pull the head out in pieces.  Once the head is out the baby can fit through.  As the mother was screaming, the nurses held buckets for me to vomit into.

We thought that her uterus ruptured in the process, so we had to bring her to the operating room.  We opened her to find a dead uterus, so she got a hysterectomy.  About eight hours later she died.  The infection, the insult of surgery and the exhaustion from a four day labor had been too much for her body to handle.

After I got home I was talking to a friend.  I had left her brother up at the hospital.  He only had a blanket and had been sleeping on the sidewalk outside the ICU.  People sleep out there every night.  I don’t know when he had last eaten.  I couldn’t save his sister, but I could feed him and give him a couch to sleep on.  Thank you Danny for encouraging me and telling me to take care of him, when I didn’t think I had the energy to do so.

Today, was a day like none I have had here.  An Ethiopian friend, the gardener at the hospital, Etenabalu and I planned a funeral.  We bought a wooden box, got permission from a church to bury his sister, hired grave diggers and talked to the authorities about burying her.  Then we went to the grave yard.

The Grave Yard

The grave yard is on the side of a hill.  There are no grave markers, but hundreds of graves.  The grave diggers had dug a hole for Meskerem and found that the grave had been previously used, so they asked about where some of the bones go in the body and kept digging.  There were only about ten people there.  The only one that new her was her brother.  The men lowered her wooden box with a cross on it into the

Meskerem’s Casket

ground.  They then put plants over the casket.  From what they explained it is saying that she is now in God’s hands.  We said a prayer and then the men started covering her casket with dirt.  When they were at about 2-3 feet below ground they threw in a lot of thorny branches in.  This is to keep the hyenas out.  They filled the hole the rest of the way.   Etenabalu pushed the dirt down with his feet and put a plant at each end of the grave.  Traditionally, the family stomps the dirt down.  Etenabalu was all she had and all I could think was who will stomp on his grave when he dies?

My heart is broken today.  I am so grateful to know that this is not the end.

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Just Another Day

You know those jitters you get when you start something new?  The excitement.  The nervousness.  Well, my stomach was a little unsure of itself as I walked into Otona Hospital.  My first day at the new hospital.  Three patients had just had babies in the

Babies aren’t delivered by storks. Look at how Massive this stork is!

last hour, we had about 30 patients to round on, five uteruses to remove along with putting female parts back inside, two normal deliveries and a c-section.  There are also about 20 nursing students and 25 health officer students that are on the service that you teach when you have chance.  My day ended with sectioning a woman for fetal distress.  The baby died because of congenital anomalies within minutes of birth.  And that is a normal day.

Here is the rest of the story….  There was no running water for the first three cases, so you take water out of a bucket that has a small layer of grime on it to scrub before cases.  There is not a single thermometer in the entire hospital.  You ask the patients if they feel like they have a fever and touch them to see if you can feel one.  There are two blood pressure cuffs in the entire hospital, about 200 beds.  Probably 10% of the patients have no shoes.

Trying to find pics for this post…. No Shoes

The nurses had never seen a doppler or heard the heart beat of a baby through one.  I had to show them how to use it.  The employee bathroom wreaks of urine and the floor is always wet.  There is a bath tub they fill with water, when it is running, so you can flush the toilet and wash your hands.  One patient I saw had been in the hospital for 3 weeks.  One vital sign taken the entire time she was in the hospital and it was abnormal.  It is amazing what they are able to accomplish with the lack of resources

Now let me tell you about my Thursday.  Surgery was supposed to start at 8 am.  We had seven major cases lined up for the day.  They had not one single clean gown or set of instruments, so surgery was delayed until the afternoon.  We decided to round.  While rounding a patient was brought in seizing.  She was 18 years old and pregnant with her first baby.  She had started having headaches a few days back and then started seizing.  It took the family four hours to get to the hospital.  Her tongue was swollen from biting it and impeding her airway.  We induced the pregnancy because mom was for sure going to die if we didn’t.  We treated her for eclampsia, cerebral malaria and meningitis.  We also gave her on oxygen, but all we have are nasal cannulas.  No masks.  No ventilators.  On oxygen she was hypoxic (32-76%.  I never saw it higher than 76%).  She continued to seize through out the entire day despite everything that we were trying.

Girl at the Market

We had other patients to see, so we kept working our way through them.  A septic abortion… a “ovarian mass” that was really a bowel cancer that had to be resected by the OB because there was no general surgeon and now her incision was infected… a destructive delivery…. obstructed labor… a woman with a placenta previa… hyperemesis….  pregnant patient with typhoid… a post operative infection… 2 mothers with HIV…

Side note.  Dr. A’s stomach had a nice loud growl.  I asked if he was hungry.  He said no, so I must have giardia or worms again.

After rounding I went to the labor ward and helped with two deliveries.   Each time I thought I could sneak out for lunch I was called back in to help.  Then, it was time to start our seven surgical cases.  As we were getting ready to start our cases, a woman with a ruptured uterus came in.  We preceded with two hysterectomies and pelvic reconstruction and THEN did the ruptured uterus.  The baby had tried to come out forehead first.  It would have had six brothers and sisters, but he died in the birthing process.  We removed him from her abdomen and then took her uterus out. During the case the electricity went out, but the sun was still up, so we could see.  Her family refused to give any blood and refused to even pay to have her blood typed so we could give her some.  The doctor, “Dr A”, I am working with went to the “blood bank”.  A patient for surgery the next day had blood available so he took hers, O positive, and transfused it hoping that she wouldn’t react.  When she left the OR she had no pulses in her arms or legs.

Another woman came in and needed a c-section and Dr. A had clinic, so I did the c-section.  We still didn’t have any electricity and the sun was going down.   When the electricity goes out you call the man that lives in the house next to the generator for the hospital to turn it on.  The generator was broken.  Thank you Walmart for the

Women at work

head flashlight.  In the middle of the case, one of the midwives came in to let me know that we had a woman who came in with the umbilical cord and the arm of a baby hanging out.  The baby was dead.   I went to OB to evaluate her.  The halls were pitch black.  I was glad I had a flashlight so I wouldn’t step on patients or their families sleeping in the halls.  I noticed a new scent in the hospital, candles.  The patients that could afford candles put them on the ends of the beds so they would have light in their rooms/hall.

We sent the family to the pharmacy to get all the supplies (IV, IV fluids, antibiotics, etc). Forty five minutes later they returned to let us know they had been waiting at the hospital pharmacy, but the pharmacist was gone.  Maybe he wanted some tea.  I had no way to reach the pharmacist.  We brought the patient to the OR and the staff had left so we had no supplies AND were waiting for the night staff to arrive.  We decided to attempt a destructive delivery.  In the process her uterus ruptured.  They had found a big OR battery operated light, so we weren’t relying on my little head lamp any longer.  The general practitioner and I opened her and started her hysterectomy.  Her bladder had also ruptured.  We had no ureteral catheters, so we used feeding tubes.

Dr. A returned during the case to help with the intensions of doing three more cases that we hadn’t been able to do during the day.  It was about 10pm by this time.  We had only done 2 of the seven scheduled cases.  Since we still had no electricity he opted to wait until the next day.

Woman on the side of the road.

After the case, I went to check on the patient that was seizing.  Now keep in mind no electricity means no oxygen.  She was blue and was coughing up yellow gunk.  You could hear her breathing down the hall.  She was no longer responding to stimuli.  Thankfully, the baby was ready to come out.  So I delivered the baby and then went home.  There was nothing I could do but pray for her.

I had only been there for 16 hours.  I had delivered three dead babies, done a surgery twice that I had never done and was almost certain I would show up the next morning to two more dead patient.  Thank God I was wrong.  The next morning both patients were alive and the seizing patient was actually responding.  The hospital still didn’t have electricity or running water, but another day started.

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