Wednesday, March 18, 2009

Tuesday March 17 in Vanuatu.

Tuesday here in Vanuatu.
The night before we crashed to bed early after a day of births and heat. A month-long slow detox via sweating is how we’ve begun to think of it. It would feel good if it weren’t for the…well…inescapable heat.

Today I hung about young Dr. Robin while he examined a young woman who said she was about 20 weeks pregnant and was having abdominal pain. Dr. R is a tall, very softspoken ni Vanuatu (native to Vanuatu) who will flash a happy smile once in a while and who charts in perfect English as far as I have seen. I listened as best I could to his interview of very few words, then I watched him carefully examine her very small belly which had barely a bump. She could have been miscarrying, or had appendicitis, an ectopic pregnancy, or a number of other conditions. He did an internal exam with which I assisted (trying to hold in place a ridiculous lamp that hangs from the ceiling). His guess was she had an ectopic pregnancy. He sent her off for ultrasound which turned out to show an intrauterine pregnancy with fetal heart tones (i.e., she had not lost the pregnancy). Dr. Robin’s conjecture was that she had a uterine infection going on. The next step was to set her up for observation, which they did in the surgery ward.

There was another induction of labor yesterday begun for a woman who was “post term” –her chart showed she was not quite yet 42 weeks. They inserted ½ a 0.2mg misoprostal tablet and gave her a bed for her to hang out. We put her on the fetal monitor every few hours. When we left the ward at about 5 or 5:30pm she was still hanging about in the hot ward.

At 11am a young woman having her first baby presented with mild infrequent contractions whos water broke at 10am. She was sent to wander the ward. At 4PM she was 4-5cm and was clearly now getting into some labor.

At 11:30am we had someone come in who thought she was in labor. “Yu lookem blood mo wota?” (Any bloody show or did your water break?” and “Wanem taim soa I start?” (What time did your contractions start). Niki and I decided she wasn’t in labor, just dehydrated. Which was a good thing because she may have been preterm…not clear which due date to go with, and there were two. We put her on the monitor and did a vag exam and sent her home.

We joined the midwives for lunch, having been invited to share their island cabbage soup and white rice. And more breadfruit, prepared a different way from our first taste of it. The women on the ward get some fabulous smelling cooked island cabbage for lunch every day and I have been eager to try it. Tonight we bought a huge bushel of it that I will cook up. It should feed us for lunch for several days.

Another primip (woman having her first baby) came in in early labor.
And a woman having her 2nd baby came in in early labor.
All this and we got out of there with only one baby born after being on the ward for nearly 10 hours today. But no matter. I have now met all my clinical requirements for graduation and licensing in the state of Washington (woo hoo). It’s a nice feeling to know I can stop documenting every hiccup I observe and every baby I touch.

No comments:

Post a Comment