In the last few days I have been able to experience some of the medical diversity here in our local area of Jinja, Uganda. On Friday I was really privileged and happy to be able to be part of the birth process with friends of ours here. Her mother was not able to be there and she wanted someone 'motherly' and so I was 'it'. Rachel had a caesarian and after the baby was delivered and cleaned they then passed the baby to me. I then took the baby back to the nurse who weighed him and then I was in charge of him for about the next two hours. This was a distance away from where the operation occurred and where Robert had to wait for his wife. The baby was great, there was some small crying but none to be concerned about. In fact, at times I was happy for him to make some noise because I then knew he was all right. It felt such a responsibility with one so so young! In fact, it ended up that I held him for an extended time. This was because the anaesthetic used and the drugs given meant the poor mother was not awake or coherent for about 9 hours after the baby was born! He was able to feed after about 7 hours but until that time it was a matter of pacifying him and taking care of both mother and baby. Funny how the colour of my skin suggested that I would not know what to do with the baby! Thankfully I knew Rachel and Robert were confident so I should not be concerned.
So, what was so different. There was no nice bed provided with clean sheets, cups of tea and food brought around, no medicines supplied by the hospital, no easy transfer to theatre, no nurses checking constantly and no bed for the baby. The equipment you need you provide, so that meant providing sheets, food for the carers and patient, medicines had to be bought (including pethidine!) and even a sheet of plastic to protect the bed! There of course is more that could be said but surfice to say it was not ideal. The nurses were competent and knew what they were doing, breast feeding is strongly encouraged but there simply is not the equipment or the personnel. On a funny note about the breast feeding there was a sign saying "No feeding bottles are allowed in this hospital, only cups and spoons may be used to feed a baby". I think this might be a bit of a deterrent to not breast feeding.
We did not immediately find the correct place and so I did view conditions that were not of the same standard. This included a ward with about 20 or 30 women in it and they were all in various stages of labour. There was not a husband or support person in sight. When I talked about this with African friends they just laughed when I explained what the situation would be in Australia.
Important also to realise that a support person must be there to do the things needed for the patient, that is: their washing, helping move them, cook food for them and looking after the baby. The baby sleeps on the bed with the mother and the support person will be there if the baby cries all night - no nursery to send them too. This person will sleep on a grass mat on the floor by or under the bed.
So, this was my first experience. The next day I had a call from the distraught mother of Mary saying that she was heading to the hospital as Mary had been biten by a snake. It was hard to understand but I realised I would need to go to the hospital. This hospital was one within the Kakira Sugar Mills. Mary had been taken there by her neighbour and thanks to the grace of God she had been treated there. It is only for company people but somehow she managed to get in. By the time I arrived Mary was ready to be discharged and she was well after some treatment and a short stay. This was also a big ward with people but there did seem to be more staff around and certainly all the beds were in full view and attention was being given. Let me tell you how Mary was biten, she was asleep and she felt something cool on her head and thought it was her pillow. Then, she realised it was not and in the fright was biten by the snake. It was reasonably big, about the size of her wrist! The neighbour who was looking after her was somehow able to rush her to the hospital and she is fine.
Then, on Sunday we needed to take one of the children to a clinic. We dropped the mother and child off and the girl was admitted. This clinic is just like a shop you go into and then you go out the back and up the stairs and there is a couple of wards. Rachel was on a drip for malaria, I like the stands they use for drips - a wooden stand with a wooden bar at the top. Nice and stable and no problem to make. From her room there was a beautiful view of the lake and there was just another little girl in the room with her, also suffering from malaria. Clean pink sheets on the bed and basically quite comfortable. While I was there which was probably an hour, there were a number of checks on Rachel by the staff. This was a good experience for me. Yes, our mother did come home and prepare food to take and going to the toilet for the little girl was in a bucket. Also, the cost was not that much 30,000 shillings which included the drip, an overnight stay and medicines. Not much for us that is, but a week's salary for most of the working people we know here!
I did not make it in to visit Peter at the Childrens Hospital in Jinja. Its conditions are far worse than I have described here. More than one child to a bed, no room for the mother to sleep, no vigilant nursing care and the doctor not seeing you.