A 24 hour snapshot ...

So it has been a week since my last post, literally been catching babies constantly and sleeping in shifts. I think I have gone to bed between 3-4am the majority of the week, including another all nighter... only this time I couldn't stay uo for the antenatal clinic the next day because I was so roasted. That particular night we had 3 women labouring, and it was like a chorus, rising and falling almost in unison. 'Mezami' they would cry (meaning loosely, 'my friends' or 'help me' depending on who you ask). Two had been labouring most of the day, but when the 3rd came in actively at midnight, they all got going again. As Bonnie, this awesome Oregon midwife, and I lay listening to the sounds and reflecting on the accoustics of a dome birth centre, and they all, as if on cue, went quiet and slept. Their labours all continued to ebb and flow throughout the night, with Bonnie and I changing our bets on who would go first every hour or so. In the end, it was an almost a dead tie between a gravida 5 (had birthed 4 children at home, this is her fifth) and the double VBAC (meaning she had 2 previous c-sections, no vaginal births yet) who came in fully dilated at 6am; they birthed within minutes of each other. All told, we had 10 births in 72 hours (alot for a new, small birth centre), and many random drop in kids with diarrhea, pregnant women with vaginal infections or 'pain' and even one of the construction guys desperate for solutions for his wife's swollen gums (not even pregnant, suggested salt water gargaling, which he says is working!).

But the 24 hours I wanted to describe are more recent. Yesterday, pediatric clinic was somehow harder than other days. Every sick baby or small child seemed to challenge all our resources and knowledge. From the distinctly down syndrome baby who came in at 7 weeks postpartum with his 48 yr old mother who literally eats once a day and has no idea (at least as far as I can tell) that she has a special baby; to the two kids covered in openly scabbing 'wounds' that we decided were impetigo; to the post partum check ups for all the many babies born this week at Bumi. I was tired, irritable and feeling way in over my head. But on the bright side, it was one of the translator's, Darlene's birthday. So she was in fine form and we were all looking forward to the release of a little party celebrating her and another translator, Marie Antoinette, who's birthday was the day before. When we finally got out of the clinic, it was 4pm. We went down to the house and all cracked a cold beer or coca cola, depending on our preferences. There were ballons and music and soon we were all dancing our hearts out.

That is until one of the security guards came running in saying a patient had come in 'chaud' (this means in really active labour). I didn't grab anything, but just ran up the hill, and sure enough by the time I got there, the baby had been born. She had made it to the clinic, to have a friend catch the baby. I got there minutes later, settled her down and waited for the placenta. Luckily, she wasn't a bleeder and when the 2nd midwife got there, once the placenta had been born, she sent me back to the party. By this time, however, the party had dispersed somewhat, so I showered and hung out with those who had stayed. Just as we were lighting the candles for the cake, the midwife who was at the clinic with another labouring woman, called and said she was starting to push, so again, I ran up to the dome. This time, however, the woman was nowhere near ready. She laboured hard all night and we encouraged her to alternate between rest and activity. She was heavily supported by her husband and her brother (the first predominately male supported birth I have attended here). Her mother, meanwhile, was praying heavily to Jesus in various parts of the dome, sometimes even entering into what I can only describe as a trans-like state. As this G3 laboured, her birthing history seemed to be catching up with her. She had a normal birth in 2002, but the baby died at 2.5 years of ages of seizures. Then in 2007 she had a stillborn at 32 weeks, delivered (apparently?) by forceps at the local hospital. We wanted so badly to help her heal and have the birth she deserved. Without a translator, I was doing my best in my wierd French-Creole to support and encourage her, while Bonnie took charge of the clinical aspects. When she had been pushing for ages, with little progress, we started to get worried, and sure enough the next internal exam seemed to indicate she might have a breech presentation. Now I want to be all about vaginal breeches, but I have only attended 2, in Zambia, neither of which I managed. We decided to transfer to the hospital, at 0200. After loading her in the truck, we climbed in the back and set off. Arriving at the hospital I was shocked to find the spot where the maternity department had been just a few short days before, was now a demolished building surround by barbed wire. This is all too typical, with the redevelopment happening in spurts, but was anxiety provoking to say the least since we were trying to get our labouring mama some help sooner rather than later. The dad pushed away the barbed wire and I saw that in fact the maternity building was in tact and that it was the building next to it that had been destroyed. The hospital midwives greated us less than enthusiatically and we carried the women into the delivery room for their assessment. They kept her, stating they were sure the head was down and that she had a swollen cervix and we had to say goodbye and hope for the best. We hoped and prayed that by the time we returned in the morning, she would have a live baby in her arms, however it was meant to be born.

Back home for 3 hours of sleep before heading up to the hospital to see her. Only before we left for the hospital, the 2 traditional midwives who had brought in their client just a few days before and with whom we had shared a magical birthing experience, showed up with a massive bucket of mangos for us. We had been planning to go and visit them in Bassin Bleu (about 30 minutes away) but clearly my French-Creole understanding was off and they wanted to come and visit us here. We sat and exchanged ideas on birth for over an hour and they left with a few packages of gauze and some candles, to continue the good work they are doing (we had given them gloves after the birth). We headed to the hospital and found out that our mama had given birth to a lovely 6lb baby girl, who had yet to breastfeed but had had her ears pierced already! Likely they gave her 'pit' (oxytocin, a drug which is used regularly here to help get strong contractions) but we didn't really get the full story because the relationship between the hospital and our clinic is a work in progress. Again, she was overjoyed to see us, and promised to come to follow up with us at clinic on Friday.

From there Bonnie and I headed on our afternoon out to these amazing deep blue pools, reknown in the area. It was a crazy ride with both of us on the back of a motorcyle, through a river (never forded a river on a motorbike before) and up a steep mountain, to a peaceful oasis where we floated and felt a million miles away from sweating, birthing and cultural negotiations. It was the perfect escape, for 2 hours, and then we were back on the bikes, streaming down the mountain, getting updates on the Brazil vs Northern Korea game (Haitian's love the Brazilian team)via groups of locals listening to the game on the radio.

And now I am here, writing this hoping that the rain that just fell, doesn't push too many new mamas into labour, as sometimes weather changes do. And that maybe, just maybe, I will get more than 3 hours of sleep tonight ...