Thursday, May 16, 2013

Haiti-Day 5

Day 5- Monday
I woke up early as usual and took a shower, a real one the power was on, and it was cold but in Haiti that is a marvelous thing. I was trying not to wake up my late riser roommates but I was unsuccessful. Breakfast was delicious French toast with peanut butter and syrup and bananas. Ironically a banana in Creole is "Pini" and a pineapple in "anana". As far as my Creole is coming I feel like the only words I can remember are foods and labor words like push, shower, baby and urinate. :) Midwife meeting at 8 we talked about who would be doing initial prenatals for moms coming for the first time to the clinic and who would be on call for births. I was going to be doing prenatals and be second for Martha who was going to do her first catch in Haiti. I was very excited for her!  

At 9 am Marie started the prenatal classes at 9 explaining about how the baby grows, nutrition, body parts and labor. At 10 prenatals began. We had to do a full initial exam and questionnaire so it took a lot longer especially through an interpreter. I got mostly through with one when Mary came and told me a laboring mom, Sebine, was here and her bulging bag was hanging between her legs. I finished up quickly. Almost every mom complained of a UTI and vaginal itching. Haitian people are very clean but UTI's are common due to not drinking enough water and not having toilet paper.  They go home with probiotics and cranberry pills. About half were married, another 25% in a relationship and the rest the dad split when the pregnancy was announced. These statistics are about the same as the clients I serve at home. Even in a conservative state like Utah. When asked if they ever felt sad as part of a depression screening all but one of the 12 I interviewed said yes. When asked why, the answer was usually "I look at my life and the status of Haiti and feel sad". One said she felt sad because she couldn't return to school pregnant and other was sad because her mother wouldn't stop yelling at her about getting pregnant. The interesting thing is that I get similar answers from many of my moms in the United States. Unhappy about the relationship with the father, unhappy about the state of the country. So are people just generally unhappy even if hey have enough food to eat??? 

When I finished the one prenatal I joined Mary and Martha in the birth room. Sure enough mom was on the bed with a softball sized bag of waters between her legs. Mary ruptured it with an amnicot and checked mom to find her complete but baby was still high. She walked stairs for the next 3 hours while we finished prenatals. After a while she felt like pushing and Martha got into position with Mary and I guiding her she delivered the baby. I did pit, charting, mom care and baby APGAR. Mary left right after the birth to check on another labor so I showed Martha how to do gentle fundal massage to expel clots and do a newborn exam. The baby was beautiful. Dressed in a cute white and blue dress.

A sister for her big brother. We moved her to postpartum. All moms stay at least 4 hours but if we have the beds they often stay overnight. They are in a clean environment away from other children and they are fed three meals a day.  Lunch was beans and millet with sauce. I almost always skip the sauce which has a mismatch of different foods in it usually onions and peppers plus some sort of meat or fish or crab. It would be heaven for my husband who loves spicy, highly flavored foods and a surprise. Harder for me who eats almost the same thing every day. The food is always delicious though and there is always enough.

 Another labor came in the middle of the day. A 5th time mom who was 29 weeks was complaining that she had been having contractions for 24 hours and she felt like she needed to push. Mary did an exam and found her closed at -3 station. She continued to have contraction like pain. After some discussion she claimed she had not had any food for 3 days since she had none, she had 4 children to feed and her husband had left her. She complained of being dizzy with no energy. We gave her some food and kept her to monitor for several hours. She still complained of pain. We suspected a UTI so we did an IV to hydrate her well and cranberry and kept her overnight and fed her, and fed her, and fed her.

 Martha and I walked to the gas station a few blocks away for some ice cream. It was heaven! I am drinking 4-5 quarts of water a day. I fill it up and I swear someone else is drinking my water. When sweat runs down my face into my mouth, which is all the time, it just tastes like water. I constantly carry a washcloth with me to wipe my face other wise I drip on the patients. It is actually embarrassing  I am used to heat. Where I live it is always above 100 degrees in the summer often 110, but we have 0% humidity. Haiti is hot and humid which is why it is so beautifully green contrasted to the amazing red desert I come from. After a birth it is the worst. I am dripping sweat everywhere and the native staff midwife always jokes that I had "douche" shower, in my "rad" clothes. And she was right, that is exactly what I looked like. As soon as clinic was over every day I would change out of my scrubs, bucket shower and dress in a pair of capri length goucho pants and a t-shirt. We came home and picked up trash that had blown into the yard before eating a dinner of fried plantains, potatoes, hot dogs  and bread fruit. I took a bucket shower and prepared for bed. It started to rain so I had to move in my beloved outside bed, At 11 it had stopped so I moved it back out again.

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