Saturday, September 1, 2012


A lot of times it seems like the things I post on this blog are very dramatic, and oftentimes sad.  In an attempt to balance the sad with the not so sad, I thought I’d tell you about the OB ward right now.  I’m not sure what happened 10 months ago that kept people from baby making, but for the past few weeks the ward has been pretty quiet.  One contributing factor could be that it is “hungry season” right now.  This is the time of the year when planting is going on and the harvest hasn’t begun yet.  People have run out of the food/money from last year's harvest and are trying to hang on until they are able to harvest what they’ve planted this year.  For this reason, there are very few if any elective surgeries and people wait until it is very late to come to the hospital. They will also try to deliver at home to save money.  That being said, our ward for malnourished kiddos (which is free) is overflowing right now.

For the last few days we have had 4 patients in the ward.  Patient number on is a woman who had a previous c-section.  Although that baby was born alive, he/she died soon after beginning to walk.  Mom said he had been having fevers, vomiting, etc.  Stupid malaria.  Anyway, she was told after her first c-section that she would need to have another one for her next pregnancy. (No attempts at VBAC’s here (vaginal birth after c-section. Too risky).  She lives far away but came to stay in this village with relatives about a month before she was due so that she would be able to come to the hospital quickly.  Because she acted quickly after her labor started and came when we asked her too, she and her baby are both doing great and are just waiting to go home.  Success!

Patient number 2 is also a c-section.  This was her sixth pregnancy.  I walked into this delivery soon after she’d arrived. She had been laboring at home for awhile but the baby just wasn’t coming. The nurse before me had started some oxytocin to see if she could move things along.  After a while she did her second vaginal exam and said, “Um, Emily.  I’m not sure what this is, but it isn’t the head.”  We confirmed with ultrasound that indeed, this baby was coming rump first.  Although it is possible to deliver these babies vaginally (especially if they’d had many pregnancies before) this particular presentation gave us a high probability that if we tried we wouldn’t be successful.  To the OR we went and she now has a beautiful, healthy baby boy.  Success!

Patient number three is a woman who is pregnant for the first time.  She is 7 months pregnant and came to us with a complaint of fevers and dizziness.  Her hemoglobin was 4.  Very, very low!  We gave her two units of blood and are looking for a third.  But she’s doing better.  I’ve seen malaria kill multiple babies in the womb so that fact that this baby is still with us and mom’s doing better….I’ll say, Success!

Patient number 4 is a baby who came to us at 23 days old.  He was born here and they brought him back after he was crying all day and night and wasn’t breastfeeding well. His scrotum was also very swollen.  Thanks to the skill of our Super Docs he was diagnosed with a strangulated inguinal hernia.  This is where there is a weakening and hole in the wall of the abdomen and a small amount of bowel is pushed through the hole….. in this case into the scrotum.  The hole is so small and tight around the piece of bowel, that the blood supply is actually cut off and if it isn’t fixed, the patient will have some dead bowel and if left untreated will eventually die from the infection.  We see these all the time (especially in men) here, but almost never in a baby this small.  Our OR team came to the rescue and today they said he could go home.  Success!!!
Our OR team working working on the smallest belly ever.  You can barely even see the patient on the table!
There is a lot of heartbreak here in Sierra Leone and we thank God that He is with us in the midst of our pain.  But we also thank Him for the times when things go the way we want them to! J  

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