Today I intended to go to the orphanage, but I thought the group was leaving at 11 am like they had did the previous day. Instead they were leaving at ten, which I wasnt up in time for. So I got up had some breakfast, lounged around and took a swim. At about 130 pm I joined 3 other students and went to the hospital. They had informed me that we were getting a mentor to follow in the maternity ward. I was a little disappointed since I had been in maternity already for 3 days, but I didnt care because I was getting more experience in the hospital. We started out by seeing a woman who was had been in labor since yesterday, but she wasnt fully dilating so they had to keep giving her a drug to induce labor. The drug was administered every 6 hours for up to 24 hours. They told us that the mother was only 28 weeks along and that they couldn't get a fetal heartbeat, so I instantly knew that I was going to witness another stillborn birth. The doctor said that if they couldnt get her to fully dialate and give birth that they would have to prep her for surgery, but they didnt want to do that since it wasnt really necessary. I also learned that a the mother had a disease called eclampsia. It is a rare disease in which the mother has high blood pressure and rapid weight gain. The cause of it are uncertain, but they believe that it may be due to genes, diet, blood vessels or the nervous system. This can be a problem because it cuts off oxygen to the baby, which I am almost 100% sure why this baby didn't make it. Finally after a while the baby started emerging and they got the head out, but once it got to that part the baby got stuck. The nurses were doing everything they could to get the baby out without harming the mother. After about a 2 minute struggle the baby finally was out and the mother was relieved. They next had to remove the placenta, which also took a while to get out, but finally made it way out and everything was done. We then followed the doctor to another patient that was starting to have contractions, but he informed us that she was HIV positive. In these cases, the doctors can not break the water or do anything to help the pregnancy move along. Instead they have to feel that belly to see how the baby is sitting and to see how far the head is in the pelvis. They are also able to use their fingers to see how far along the baby is. This mother was roughly 34-35 weeks along. If they are not able to have the mother give birth naturally, since they can't help her she will have to do a C-section. They said that they have a good rate of not spreading HIV to the baby from the mother. The mother has to recieve a shot right before birth and the baby recieves on right after birth to help insure the disease is not spread.
After finishing in the maternity ward since not much was going on, we made our way to minor theater. There wasn't much going on, but there was one patient in the room that we seen that had a huge mass on her breast. The woman was a 37 year old and the diagnosis was breast cancer, which they were sure had spread to her lymphnodes. The woman was not really all there, she didn't talk and couldn't really comprehend what was going on. We found out that the woman had been treated for malaria 2 weeks previously and ever since then she started not responding. The doctor said that they would get a biopsy to make sure that it was cancerous and to see what to do from there. I don't have a very good feeling about what will happen since the cancer had spread to the lymphnodes.
You could say today was a pretty somber day. I felt pretty emotionally drained because each of the patients we seen today all had a not so good diagnosis. It did make me feel better that when we were with the mother giving birth to the still born, one of the really nice nurses turned to all of our shocked and sad faces and said, "You need to practice not with sympathy, but with empathy because you are sympathetic, but can also give good care to your patient." I thought that sentence really put it in perspective, since we are not used to seeing this much pain and death that these people see. It is their way of life and it has been hard for me to adapt to it.
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