A CHALLENGING DAY…
I had to include this picture – This was a particularly challenging day, Breech delivery ( Bottom First) stillborn baby, Successful Resuscitations X 4 – One unsuccessful, one baby died about and hour later after resus, obstructed labour and 6 caesarean sections for various reasons, eclampsiai ( fitting in pregnancy) and after a normal delivery
Washing day at Amana Hospital
I look down at my feet – they are swilling in water…my first thought was – oh great burst water main….but no its cleaning day!
On day four – they usually just mop but today is water and scrubber day, electrical cords lying in the water….broom, meanwhile we still have no soap at the sinks to wash our hands – I bought Sapoderm soap at the Duka la Dawa (Pharmacy) and placed the at all the hand basins – amazingly there is this fantastic poster on how to wash your hands etc BUT no soap, no pump pack, but they provide one 100 ml Sanitizer gel per week!!!!
GLOVES, GLOVES, WHERE ARE THE GLOVES!?
It’s gone in the first 5 minutes. We wear gloves for everything – double glove for deliveries, and Chase and I bought 20 packets of gloves with 100 gloves per pack – but 10 am every day they are gone – we share with all the midwifes as well. The hospital does an amazing job providing what they can in such an under resourced environment.
Chase and I stuff our scrub pants pockets with gloves so we have enough for the day.
Chase favorite baby – he was a wee cutie pie.
Chase second favourite baby
Chase second favourite baby – this baby was a successful resuscitation – so many babies are so tired at both – the mothers have often walked long distances and are very under nourished.
This wee baby was quite flat at delivery – we gave him positive pressure ventilation via bag and mask and he picked up really well.
He actually had a lusty cry which is very rare here.
Check out the fabulous Osh Kosh Hat!! Best dressed baby that day!
This little man was being checked after a few resus
This little man was being checked after a few resus – some unsuccessful – it’s so frustrating because the mothers arrive after long labours – sometime we have no idea how long they have been in labour – foetal, distress is common place and it’s such a race to save so many babies – this little man was being checked cos we had so many tired babies – this is just me checking him after ten minutes – he was so exhausted as was his mum – see the poster in the background – fantastic posters from US AID and the Help Babies breath program http://www.helpingbabiesbreathe.org/
HELPING BABIES BREATHE
Helping Babies Breathe (HBB) is an evidence-based educational program to teach neonatal resuscitation techniques in resource-limited areas. It is an initiative of the American Academy of Pediatrics (AAP) in collaboration with the World Health Organization (WHO), US Agency for International Development (USAID), Save the Children’s Saving Newborn Lives program, the National Institute of Child Health and Development (NICHD), and a number of other global health stakeholders.
THE GOLDEN MINUTE
The Golden Minute: A key concept of HBB is The Golden Minute. Within one minute of birth, a baby should be breathing well or should be ventilated with a bag and mask. The Golden Minute identifies the steps that a birth attendant must take immediately after birth to evaluate the baby and stimulate breathing.
One part of newborn care: The HBB curriculum is designed for use as part of a coordinated educational approach to early neonatal care and can be effectively combined with other curricula. It is much more than a classroom-based educational program. Its system-based focus is designed to change clinical practice across systems of care.
Helping Babies Breathe
Challenge: An estimated 717,000 newborns die each year from intrapartum-related causes and the inability to breathe immediately after delivery.
Mission: To train birth attendants in developing countries the essential skills of newborn resuscitation, with the goal of having at least one person who is skilled in neonatal resuscitation at the birth of every baby.
These twins were born to mum who had polyhydramnios ( lots of fluid around the babies ) she was very big – the mum had a Caesarean section and they were big babies 4.2 kg and 4.6 kg –which is extraordinary.
Jeanette see your knitted beanies on the babies! Hey Kasey …Go BDO our accountants – this little guy was very snuggy ! Tiz & Kim’s head beanie – BDO bootees !!!
Jeanette see your knitted beanies on the babies!
HEART-BREAKING.
Chase comforting a young mum who lost her baby this morning – this was her second still born baby.
It was heart breaking – There is so little time for the comfort because in the other room mothers are pouring in the door delivering ….I hugged this mum and cried with her whilst I watched the midwifes manage to deliver another 4 babies in the 10 minutes I gave this mum…it was such a small time to say sorry (pole – pronounced Polay)
We gave this mum a beanie, booties and a little one-zy ( Barbara – they were your gifts and I said to the mum they will bring her luck for her next baby)
The midwife counselling consist of saying to the mum when they get home …and ask god to help you and at next pregnancy you must come every month and be at the hospital early…..there are no tissues to dry their eyes and so Chase and I bring in a small packet each day and they always get used.
Chase & I go into postnatal ward every day and give beanies to those mothers who birthed over night and touch base to those we looked after that morning to the day before – it’s always so rewarding to re connect and I love the continuity of care being part of their after care.
Me in the cleaning room
This is me in the cleaning room – we soak the baby resus bags and masks, nasal prongs ( there are only two sets) and the penguin suckers – soak for 10 minutes in chlorine solution, then wash in soapy water then rinse in clean water – then dry on an old no sterile sheet.
The nasal prongs are hung on an old hook by the open window – so I wrap the prongs in a sterile glove – at least its clean …ish.
In a busy day the babies can be sucked out by a bulb syringe used on several babies – I simple wash then in soapy water if we are out of time and believe I am making a difference – I have had at least 4 sisters have come to me and say I am very good trying to stop cross contamination.
In front of me is a wee baby that had died that morning …this is where they are placed.
THE LUCKY ONES
I say a little prayer when I go into that room and often go in that room several times so the babies are not alone – and know I am watching over them at least while they are with us in labour ward – I say a prayer for these little babies …all the while pretending to clean equipment that I have already cleaned…..these wee angels I pray god will give wings…..
We have in Australia so many things we don’t realise.
We may complain about tax but we enjoy education for our kids, roads without pot holes the size of trucks, warm beds at night, good food, and healthcare should we choose to seek it – and for our babies ( and ourselves) we have the best chance and we can find no excuse not to give our babies the best start.
We think our lives are difficult at times – we complain and stress over minor things… One thing I take from this experience personally is there is still much to be done….it’s not enough to enjoy career, family, friends and life without giving back to someone, somewhere, and for me in every mothers eyes I see hope & dreams no different from yours or mine – except they were born into a nation crippled by poverty, poor health, failing infrastructure.
Aunty Glenny’s Hat
THE GENEROSITY
The generosity of you all in what you have donated, given and knitted may seem so small to many of you, maybe even trivial but it’s a truly honest gift of generosity and giving – these mothers love to know someone cared 1000’s of miles away –that someone cared enough to knit, purchase or donate – that they are not forgotten and invisible – they are cherished no matter how briefly, no matter how fleeting – the human touch, a smile, a look and your gifts gift are full of meaning, humanity and love.
For strangers we don’t know ….. but sisters in humanity. I leave you with this poem tonight
Love Chase & Jan XX
Go to www.midwifevision.org
To improve the health of mothers and babies through community support, education and getting involved
Dar es Salaam
Tanzania