Amy's Adventures in Darfur

I started this blog when I left for Darfur in June 2006. I was working as a midwife with MSF aka "Medecins Sans Frontiers" aka "Doctors without Borders" but this blog contains my own opinions and stories- not those of MSF. It is less political than I want it to be and I have been unable to post stories about certain topics due to the fact that this is on the internet and accessible to anyone. I wish I could tell you all of the stories but since I can't, I will tell you the ones that I can...

Friday, June 23, 2006

Day off


there is something afoot in habillah and we don't know what it is. today at the hospital one of our nurses handed us a letter from the local "police" station. the letter told us that we are no longer allowed to leave habillah without a police escort due to "security issues". every time we plan to leave habillah we MUST inform them and they will send a car with us. milena and i, ever the cynics, decided immediately that it was less about our security than it was about us not seeing things that we're not supposed to see. our staff validated our suspicions by telling us that the chadian rebels have been gathering outside of habillah and the nearby villages, preparing themselves for an attack on chad. if this is true, it would lend a lot of validity to the accusations by the government of chad that the sudanese government is supporting the rebels. being a neutral organization means that we won't allow the police to escort us, so tomorrow andi gets to have the pleasure of informing the police of this. i figure the worst-case scenario is that we have to cancel our mobile-clinic program, which would suck as i was planning to start going out with them. i'm not going to say much more as it's just speculation at this point.

be forewarned, the rest of this email may only be interesting to my plethora of midwife friends :)

as predicted, my first official day off started early this morning with a birth, hence no sleeping in. the number of births, and patients, at the WHC have picked up dramatically the past couple of days, leading hind to remark "i hope you're happy with yourself". i totally am :) i got home from the hospital only to be radioed immediately that there was another woman ready to deliver (which i may have made it to if we had drivers on fridays instead of my trekking to the hospital each time). the earlier birth was the first one i've seen on a friday, which is the one day off here. only the midwife on call is present at the deliveries on friday unless one of the tba's brings the patient in, in which case she stays as well, so there were far less excitable midwives there twittering about. it was a bit more peaceful than usual :) as much as i'm a fan of calm, peaceful births, there are too many midwives here who want to be trained and having a huge party at each birth seems to be fine with the mothers. the age-range of our midwives and tba's spans decades, but they all turn into crazy, giggly teenagers with each birth. the ones from habillah aren't used to the idea of an actual 'birthroom', and i think it intimidates them. one of the tba's, a woman i would guess to be in her 70's, gets so nervous about having to wear gloves that she stands at each birth with her gloved hands up in the air, terrified to touch anything and get them dirty. whenever i ask one of them to do something, like hold the woman's legs for her, or get her water, they all clamber to do it and do it so enthusiastically that all i can do is laugh.
the midwives from khartoum (the capital city), used to being the experts compared to the "uneducated" village midwives, have not taken such a liking to the fact that i actually agree with far more of the village midwives practices than with theirs. when i first arrived they were telling me that the tba's deliver the women in their huts in the kneeling position. rather than gasping in shock at the archaicness of it all, as i gather i was supposed to do, i said "that's awesome! let's try doing that here as well". the delivery table, a symbol of all that is wrong with birth today, no longer stays flat, keeping the women on their backs. half of it is propped up as far as it will go, and then i employ pillows to get the woman as upright as possible. the stirrups no longer hold legs and are now mostly used as arm rests for the midwives :) the practice of routine episiotomies on primis (first time mom's) was the first thing i abolished, much to their extreme dismay. thank GOD the two primis who have delivered since i arrived have only had small tears. the midwives were convinced that any primi without an episiotomy would undoubtedly end up with a fourth degree tear (through the rectum). the birth this morning was the first one where the baby wasn't ok, and my first instinct was to turn on the suction machine to suction the bloody, meconium-stained fluid from his nose and mouth. uh, don't have those here, so i try to use the manual one and it doesn't work. i then turn to the delee and pray that none of it ends up in my mouth. his colour was bad and his heartbeat was sluggish and as i stimulated him i asked milena to get me the oxygen. she tells me that we don't have oxygen. i say "are you serious??? in the entire hospital?" yup, serious. if i want oxygen we need to get andi to drive the generator to the hospital, then bring the oxygen concentrator over to our side of the hospital and set it all up. i could probably have oxygen for the baby in about half an hour. awesome. thankfully he ended up being ok, but i definitely had one of those moments where you just stand there and wonder what the hell you're going to do with none of the equipment that you're used to. ah well, it's all about improvising and making do, non?
as for my staff, i'm really lucky. the expat midwife who was here before me set up an amazing system for training the women. the centre runs smoothly and all i have to do is supervise and work on the details of training them for births. some need more training than others, but that will come with time and experience. most of them (aka the ones from habillah) are SO eager to learn, and so humble. the midwives from khartoum....uh.... not as much :) one of them actually said to me "i'm not here to learn, i'm here to work". i tried to tell her that we're all here to learn, but it was during a delivery and it just didn't seem like the time to have that conversation. i'm not looking forward to dealing with people who are set in their ways- this is why i hate having to be the supervisor. i would so rather just deliver babies all day.
another way that i'm lucky is with my team. there are only 4 of us, which means it would completely suck if we didn't get along as well as we do. not everyone loves everyone, but the girls all love each other, and i get along with each person individually. carmenza, our colombian doctor, is the sweetest, gentlest soul. english is a new acquisition for her, and she still manages to make me laugh out loud with most of our conversations. SO funny. milena is our crazy nurse from switzerland, but originally from macedonia. she speaks pretty much every language on earth (she speaks german with andi, french with me, english with carmenza (who is eagerly awaiting our new team member who speaks spanish as his first language as well), italian with francesca (from another ngo here), and macedonian with her family. oh, and she's basically learned to understand spanish in the last 3 months as well. she, too, is hilarious and entertaining. milena leaves in a month and i pray that the nurse who replaces her is nearly as quirky and fun.
alright, this computer is too hot to be this close to anymore.


note the tba with her gloved hands in the air...:)

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