Access to care and Drinking games

I’m working today and off tomorrow, but I figured it’s best to follow through and post anyway

 

Writing clinical stories is incredibly tempting, but I’ve been hesitant because of the sensitive nature. On the other hand, to accurately describe the maternity health conditions in Aweil (and possibly the rest of South Sudan), I want to share a preventable and disturbing case from this morning.  

A patient presented this morning with an obstructed labor and full term fetal demise.  She was fully dilated on arrival and had been pushing at home for over 12 hours. Her history and lack of access to care make this death preventable. First pregnancy resulted in a full term fetal demise from obstructed labor, and her family did a “destructive delivery” at home. Her second delivery was at Aweil Civil Hospital by c-section for obstructed labor, and the baby lived. She was instructed to immediately present to the hospital with her next pregnancy because of the significant probability that it would also result in an obstructed labor and require a c-section. Because of the size and shape of her pelvis, a normal vaginal birth would probably not be an option for her.

Due to distance from the hospital and her family’s extreme desire to avoid a c-section, she labored at home and pushed for a full day before looking for transportation. Upon arrival, there was no fetal heartbeat. Vacuum delivery failed, but we finally got the baby delivered by forceps under spinal anesthesia. All I can say is that at least the mother lived. It was very sad and represents a few maternity issues in the area.

On a lighter note, I’ve moved into my new tukul (hut) and am settling into daily life in Aweil. We have quite the work and social calendars. We kind of oscillate between the most intense work ever and summer camp. Tonight’s activity is a fashion show and drinking games. Kings, also known as Circle of Death, has already been suggested. I must be getting old; I don’t remember the rest of the fun games! On the fashion side, one option is for our clothing to represent our country. I’ve already been told I should incorporate my baseball cap into my outfit. I was surprised to find that a baseball cap was a specifically American accessory. I'm very open to outfit suggestions, particularly those that involve my hat!

I would also love to post pictures, but we can’t upload or download because of the slow internet connection :-(  ... I'll catch up with the pictures when I come home in March.

I have to go back to the hospital, but I really hope to post more frequently because by Saturday I can barely remember Monday's catastrophes.

Still no pants.