Tuesday

I try to get to maternity around 8 or 8.30. Formal “Rounds” – where all staff meet to discuss progress and management planned for each patient  in the office and then at the foot of the bed – don’t seem to have caught on here. Neither have documentation or Filing, so nobody really is sure who is in the unit and doing what, and no individual midwife seems to be responsible for anything in particular. The medical records, such as they are, are haphazardly strewn across the desk and a dusty shelf in the one other piece of ward furniture, a wobbly old book case. Inside the drawers of the desk is a mess of bits of paper, old documents, an empty drug carton, and various other items that mostly need to be put in the rubbish. It’s the same on the bookshelf. Someone tried to get a system going using a whiteboard, which is still on the wall but the markers have all long ago dried up.

So after rummaging about and assembling the files and determining which belonged to women still in the unit and which belonged to women sent home or seen  casually and never admitted over recent days, we, that is up to three or four midwives and myself set off to try and see everyone. Firstly though , on this occasion I gave to Mesaye, the male midwife who I had worked with during the night, the remaining birr to settle the account of Sebsabe..

Mesaye, I should say is quite a frightening looking fellow – he is darker skinned than many, and short, and he is blind in the right eye which is completely white with corneal scarring. However he is an excellent and hardworking midwife and I have huge respect for his experience and wisdom. It has been wonderful the way he has offered suggestions to me at various times to help me find my way – so lacking in ego or a need to engage in any sort of power struggle.

We saw the woman with pre-eclampsia – she was obviously getting her blood pressure medicine and was feeling fine. And next we entered the small room where Sebsabe was. The poor thing was naked but covered by her own coarse and grubby blanket, now trying to recover from the traumas of a prolonged labour, the death of her first baby and major surgery. I felt terribly sad for her. She was still unwell and in pain but her husband and mother and other relatives, all dressed in filthy rags were crowded in to look after her, using god alone knows what resources, but it was their responsibility, and they were doing what they could. Her urine was still heavily bloodstained but otherwise she was stable. I suggested she could have fluids to drink – this is usual practice in the west – but one of the midwives objected. It was my second day at work and I should have listened to her but didn’t – yes she can drink I said, and ordered her antibiotics and a blood test. A lot of talking in Amharic followed, back and forth, and I asked Mesaye what was going on. He had just informed them that I had paid off their account, and with that the old grandmother and a man perhaps her father threw themselves at my feet , wrapped their arms around my legs and started kissing them and crying out. “Please, no” I said and bent down to them, overwhelmed, and couldn’t speak, tears welling up in my own eyes.– I just felt so sad for these sweet caring people. It was terrible that their poverty and their need was so great that  that such a tiny gesture could mean so much and be so gratefully received.  


Bed One