Sunday, July 02, 2006

Lions and tigers and hippos, oh my! Well, not quite...

Greetings again, and happy (belated) Canada Day. We just returned from a weekend at Lake Mburo National Park. It was quite the spot, a lot of firsts for me. It is about a three hour drive from here. Mickey and Cathy treated us to a hired car, which you kind of have to have for game drives. This is one of the smaller parks in Uganda, and thus not many tourists go there, also 'cause there is a lack of lions and elephants... but guess what we did see??? Lots of very funny looking hippos, huge crocodiles, many beautiful birds, vervet monkeys, zebras galore, all manner of antelopes and gazelles, African hares, warthogs (which are most hilarious creatures!), mongoose, buffalo (the most dangerous, after hippos!) and all kinds of other things. It was a very rustic place to stay, small simple 'banda's' to stay in, and a lovely stilted open air restaurant right on the lake, overlooking hippos usually. We did an early morning game drive the first morning, and then a guided walk this morning, which was wonderful to be walking quietly and coming upon herds of zebras, impalas, waterbuck, bush buck, warthogs etc. NIce sunrises and sunsets, also a fantastic boat trip. It felt somehow more authentic than a busier more touristed park might be. I have to say I loved my first African Safari! Also nice to spend time relaxing away from this work. THe stars are stunning and unfamiliar in the sky, a sure sign I am far from home.
The people here are just so lovely. They are also highly religious, mainly Christian (Pentecostal, Anglican), Muslim. Our friend Betty, a nursing student, asked us what religion we are and if we went to church. She was quite puzzled when we stated that many people in Canada, including ourselves, don't attend church. "But how do you communicate with God?" Hmmm...good question. WE have to think of an answer to that one. OUr driver this weekend, Peter, spent his spare time reading a bible and a book about Victory and the means to get there.
All the days in the hospital sort of blend into one. We are getting experience with different baby problems. Last week a woman arrived with a tiny twin, just hours old, born at home. The other one had died. SHe was not the mother but was bringing this 32 weeker in for care. NO one really was eager to help her in any kind of hurry, and it;s hard for me not to get involved with the women I encounter, so I am always getting attached and urging for prompt treatment! THis babe was actually in quite good shape, and ended up in the warm room and recieved antibiotics. A baby that we delivered ended up with a problem too....we are often abandoned by the midwives for periods of time in the delivery room, and once a babe is born it is wrapped and may be left for an hour or more while the mother is attended to (this is just how it is). Anyways, we had a baby wrapped and waiting patiently, and after some time I went to check on it and there was blood on the blanket. I hoped it was soiled from the delivery, but unwrapped it to check it out, and it was bleeding from the cut end of the cord! It had actually lost quite a lot of blood for a newborn. Here we use cotton cord ties (like a candle wick or flat shoe lace). It is hard to tighten it and it doesn't shrink with the cord as elastic glove bands do, so it was bleeding from there. Apparently this happends on occasion. THe baby was fairly ok, a little dusky perhaps (but colour here is somewhat difficult to assess). We gave it a volume expander and the next day she seemed fine, thank goodness. Another baby was brought back the day after birth burning with fever, we treated with antibiotics and fluids, I sure hope she is all right. Cathy caught the baby of an older, HIV positive (and likely active AIDS) and then was asked to name the baby. It was a Muslim family so we enquired of another mom about some good Muslim names for a boy. Cathy chose Abubaker, son of the prophet, and the mom was quite pleased with this. What else.....A couple of post partum hemmorhages, one on Friday that just wouldn't stop, and we were out of oxytocin...gave ergot, rounded up some more oxy, and only had enough IV fluid to give her one litre. Her uterus continued to be boggy, and we got some more clots out finally and used bimanual compression. Palpating her fundus, I could actually feel here spine! (like we are supposed to compress as a very last life saving resort!). ANyway, she lost about a thousand all told, and will likely be fine, but it was an interesting case for us, just figuring out what to do under the circumstances, and considering the cause.
We had a bit of a problem with some black belts too, last week. (senior midwives). They returned from being away and had not been informed that we would be working there, and were quite choked to have been left out of the loop, even though the head OB and the midwives actually working on the floor were welcoming etc. Yikes, I think things are smoothed over.

AIeeee, the internet cafe is closing, I better sign off! MOre later...
love ais

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