Yesterday (Monday) was Day 1 for our Vision Clinic and our Free Medical Clinic. The vision screening and eyeglass fitting have been slow going, but those workers saw patients all day long for two days so far. I've heard some of the stories about how the people are reacting when they can finally see after being unable to see well for so long.
There was a woman who came in because she was in labor. The staff could not reach the midwife who normally is there at night. That left me to deliver the baby...Keep in mind, I'm just an LPN. and though I've been present at several births, I've never delivered a human baby (Kittens and puppies, yes...not people). I had been monitoring fetal heart tones as the labor progressed. The mom was having strong contractions less than 1 minute apart.
The baby was still pretty high up and the head hadn't yet engaged. I could barely feel the baby's head the last time I checked to see if the woman was fully dilated, so it wasn't really close to time for delivery. But then we lost fetal heart tones. I had a couple other people check her, but they were unable to hear anything either. At this point the labor had stopped being effective. The contractions had weakened. Not good when you can't hear a heartbeat!
The water broke as I checked her the last time. Still very weak contractions. Time was critical. The staff nurse started their equivalent of a pitocin drip which, under the conditions of any rural Ugandan medical center is pretty mind-blowing. There is no such thing as sterile technique. They vent the plastic bottle by stabbing it in several places, then they add the medication to it by just stabbing through the side of the plastic bottle with a syringe needle and squirt.
Mom was fully dilated and the head was coming down the birth canal. It was time for mom to push and for the baby to be born. I felt a sense of dread, as I still had not been able to hear the fetal heart tones. As the head crowned and the baby came out, I grabbed its lifeless body, holding back tears. I yelled for Debbie, "Stat!" and she came around the corner immediately.
The staff finally found an ambu bag, but there were no infant or pediatric masks. The ET tubes we shipped in 2007 were no longer anywhere to be found...they must be wherever the tray of various sized laryngoscopes disappeared to from that same shipment...
I pumped the ambu bag, just to blow air into the nose and mouth. Then Debbie fashioned an infant sized O2 mask out of a plastic medicine cup and O2 tubing. the suction machine we'd sent previously had been used and was missing pieces...important pieces, like the suction canister. We rigged it to use anyway...I won't say how, and got the baby's lungs cleaned out a bit. By this time the baby had a heart beat and gasping respirations. We had to leave just after 7pm and had to leave the baby in the care of its mom and staff, so our hearts were very burdened.
Pastor Solomon told us that, even in the big hospitals, nurses will just lay the baby on the bed next to the mom and observe it. they don't do any heroic lifesaving procedures. This morning when we got there we entered the room where momma and baby had been, and the bed was empty. My heart just sank..."Where's the baby?" We were told that the baby was in the ward on the other end of the building. He'd come back to life with a will to live! The sounds of his crying were like music to our ears. All I can do is praise God for the miracle!
Soyini got to help me deliver the baby, along with Tracy.
Me holding my first delivery...