Still no pants

Another week in Aweil. I’m going to stay away from a lot of the clinical stuff for the time being because a lot of it is shocking and sad. I want to get a better feel for the big picture. A lot of the national staff are very qualified, but I’ve also seen large gaps in knowledge leading to less than stellar outcomes (eg. fetal monitoring of any sort is rare).

For my clinical friends, I want to share one story. Last night we did a c-section on a patient who presented to triage after bleeding heavily all day in her village. 8 months pregnant with a complete previa, an IUFD, and a hgb of 6.8.  We did a straightforward c/s with minimal blood loss and decided on no transfusion. (To put that in context we had a pt in the gyne ward the day before who walked in with a hgb of 3.4. She got transfused).  The mom saw the baby after delivery, and I told her she could hold the baby in recovery. I asked the maternity attendant, “Can you wrap the baby in a blanket so that the mom can hold it.” I was bringing back a family member to see the baby (hospital policy), and as I entered the delivery room, I realized the maternity attendant (though saying, “yes, yes, yes”) had no idea what I said other than “wrap.” The entire baby was wrapped in a chuck and taped up. It was terrifying, and I’m really glad I stopped the patient’s mom before she saw it. We got a blanket and things went as well as possible after that. Communication, language barriers, and IUFDs are really rough.

Also, another week without pants! The president of South Sudan decided to come to Aweil a day earlier than scheduled, and we are not allowed in the market today due to the increased military and police presence. I’m not sure how I feel about delivery babies in a skirt, but maybe I’ll give it a try. I think an ankle length flowing hippie skirt will be good for tomorrow.

On a fun note, our group of expats reminds me of home. We try to have some sort of activity every Saturday night. Tonight is a drag competition involving lip-synching and judges. Unfortunately, no videos allowed for this event. Hopefully I’ll have some good pictures to post.

So much for my avoidance of posting about clinical situations.