Kristen Kenny’s Blog

so many pregnant women, so much malaria

9/6/08

Thursday also started out slow. I told the nurses I would be in room 4 and to send me some English speaking patients. I waited. I went and asked again. Oh they are coming. More waiting. I finally saw one patient, a college student with a small lymph node in her arm pit and nothing else. She was reassured and told to monitor it. Then more waiting.

The midwife came into my room looking for something and invited me to work with her. Antenatal appointments are Mon, Tues, and Thurs so there are tons of pregnant women those days. They have talks for the women about what to expect during labor and other important topics. Then patients come into the little antenatal room to get fundal height, fetal position, and heart tones checked. After that they go back out to wait. In the same room at a desk patients’ charts are reviewed by the midwife and she writes them prescriptions for drugs and vitamins, talks to them about nutrition, and assess any problems they are having. First I was helping out with the measuring and recording. Then the midwife had me sit at the big desk and interview the patients. She was there to help me and answer questions. After about the second patient the midwife was called in to help with a difficult delivery. She said to go ahead on my own and if I had questions she would be back in a bit. There was also a nurse helping out but she was on break. It was just me. I was doing ok with the first few. They had few problems, some needed refills on prenatal vitamins. Then I had a patient with malaria and a UTI. Treating the malaria was decently straight forward but I had no idea what they typically prescribed for UTIs. The midwife was still in the delivery so I went to ask a doctor.

Before I even asked a question we went to go check a baby. In the delivery room one mother had just given birth and another was in the process of delivering. The baby of the first mother had not cried for the first 5 minutes after birth so we were there to assess him. The baby was on oxygen, wrapped up but there was no warmer. He was crying, lungs were clear; he looked ok. The other woman in labor was having difficulty. The baby was large and just wouldn’t come out. For all the work she was doing the woman was very quite. She was doing breathing exercises. Anytime she started to make noises the nurses would remind her, “don’t make noises just breathe.” I was impressed. All of the sudden I noticed that I was very hot. The delivery room was small and the fans were off. The room started to get cloudy and I got nauseous. I ran out of the room just in time and laid on an unclaimed patient bed. I was so relieved I hadn’t fainted in the delivery room. It was probably a combination of the heat, not eating much for breakfast, and the woman having a hard time. I decided I had enough of the delivery room for the day. Grabbed a bite to eat and head back to see more pregnant women. Unfortunately I heard later that the baby of the woman who was having trouble had died. It was very sad. At least we could be thankful the woman had survived.

Back in the waiting room the pregnant women were getting annoyed. They had been waiting a long time. I began seeing patients again. There were so many women. I felt we would never be done. To borrow another student’s thought, it was like there were women getting pregnant in the waiting room. Luckily the nurse came back and would help me when I had questions. The majority of the women in the afternoon had blood films positive for malaria. I wrote out malaria medications and prenatal vitamins all afternoon. Finally we had seen all the patients. I was tired but it felt good to have been useful. The midwife, nurse and I ended the day in a prayer. We prayed for all our patients, especially the one whose baby had died. They also prayed for me and said they would still be seeing patients if I hadn’t helped out. It was good to be so loved.

Friday I woke up early to go round with the doctor on call only to find that my insides had liquefied. All morning I was either in my bed or running to the bathroom. Even one small sip of water would come right back up. By afternoon I felt much better and was able to eat some fufu but I spent the rest of the day lying around. It was a bummer missing a day in the clinic but I am glad I spent the day resting. Only one week left. It is hard to believe. Sometimes I wish I could stay longer. There is more I want to see and do. I feel like I finally understand what I am supposed to be doing on this rotation and am comfortable where I am. Then a minute later I will be dreaming of being home and counting down the days. I have made lists of foods I want to eat when I get back. I can’t wait to hug my friends and family, take a hot shower, drive my car, understand what people are saying, and (I never thought I would say this) have a working cell phone. I’m sure that day will come sooner than I can imagine.