Maternity Ward

After the first few days of getting a feel for the hospital operations, I decided to spend most of my time in maternity because of the high number of births that happen every day. One of the nurses estimated that the hospital saw between 3 and 7 births every day–and that, of course, does not count the births that happen at home with Traditional Birth Attendants (TBAs). With so many pregnant women and new mothers, the maternity ward was overflowing.

My main duties were giving treatment to new moms. They all got antibiotics for seven days after they gave birth and many also needed malaria medication to reduce the risk of complications during pregnancy, delivery, and breast feeding. I helped mix the medicine, drew it up into syringes, and administered it through cannula ports that were inserted by the trained nurses. (I am definitely not qualified to put in an IV.) I also helped clean wounds after women had to get C-sections, weigh and clean babies after they were born, and bring the newborns and their mothers back to their beds in the ward. I loved seeing the little newborn babies–they looked like aliens, but really adorable aliens.

Birth in Uganda is very different than birth in the US. There are no epidurals and doctors very rarely, if ever, assist in births. That task is left up to the nurses and nursing students. The mothers have to provide their own waterproof sheet to lay on during the delivery as well as all of the bedding for her hospital bed, all of the towels to clean the baby and all of the blankets to swaddle it. Additionally, mothers┬áhave to bring sterile gloves and a sterile razor blade for the nurses to use during the delivery. The nurses use the bottom of the gloves to tie the umbilical cord and then use the razor blade to “cut” the cord (its more of a sawing motion rather than a cutting motion).

The mothers are rarely accompanied by anyone and certainly not a husband. There were never any men (besides the male nurses and doctors) anywhere near the labor suites. The women were mostly quiet, occasionally moaning with the contractions, but there were never any screeches or screams that Americans would usually associate with childbirth. The women in the ward ranged from teenagers having their first child to women in their late thirties or even older having their fifth, sixth, or seventh child. In Uganda, the total fertility rate is 6.7 meaning that, in her lifetime, an average woman will have about seven children.

The women I met in the maternity ward were so hardy and strong and inspiring. They cook all of the food for their family, they fetch the water, they clean the house, and they give birth with little help from friends, family, or modern medicine. Like the rest of the hospital, the maternity ward has not changed since the 60s and could really use a face-lift.

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These are the rooms that the women give birth in.

First Impressions

After spending quite a lot of time getting ready to travel across the world to Uganda, it was surreal to actually be in the Entebbe airport waiting to be picked up by Bazil, our in-country coordinator. Like we were warned, Bazil ran on “Uganda time” meaning that he was about an hour and a half late to the airport but I didn’t care because I was about to start the greatest adventure of my life.

We drove several hours to Gombe, the place where I would be volunteering and living for the next four weeks, on bright red dirt roads through beautiful green jungle. I was very excited to start volunteering in the hospital because it truly seemed like an area where I could actually make a difference.

It took a while before we all got settled in, the creaky metal beds and pit latrines were a far cry from what many of us were accustomed to in the US, but eventually we got used to life without amenities. It was actually very calming to not have to worry about texting people back or talking to them on the phone–to be totally disconnected form technology was the best vacation I could have asked for.

Every morning we all would walk the 3+ kilometers into town to the hospital. It was built in 1969 and nothing about it has changed since then except for some of the technology in the lab and the 20 year old solar panels on the roof. The walls, both inside and out, were stained with red dirt and the eaves were full of birds’ nests–it was definitely not one of the pristine and sterile hospitals that we would be used to in the States. But that fact did not mean that the hospital was not providing vital services to all of the people in and around the village. Yes it was not state of the art, but that hospital was incredibly important to the community and provided women with a safe place to give birth and gave men, women, and children somewhere to recover from severe injuries and diseases. And I was chomping at the bit in order to be apart of it–to learn, observe, and assist in the daily goings-on of the Gombe Hospital.

I wanted to be as much help as possible so I decided to assist in an area that I actually know about–HIV testing and counseling. In Missoula I volunteer for the Open Aid Alliance which provides HIV and Hep C testing and counseling to at risk individuals, so I felt confident that I would be able to successfully perform HIV tests in Gombe. At first I was a little nervous because of the high prevalence of HIV (7.3% of the population), but in all of the testing I did, I did not see a single reactive case. I was very pleased to not have a positive individual not because I was concerned about my safety (I was wearing gloves and correctly disposed of all sharps) but because I hope that the increased testing and counseling will help bring the epidemic under control. I felt very fulfilled to be able to test in Gombe Hospital because I could tell that I was actually making a difference. And, in fact, the testing methods between Uganda and the US are almost exactly the same which made it very easy to transition. I know that the work I am doing will not greatly affect Uganda in the long run, but I would hope that by testing and educating individuals I can make a small difference in Gombe.

I am excited to see what the next few weeks will bring!

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