Back at St Elizabeth's

After spending the weekend relaxing at a near by hotel pool! I have made my way back to St Elizabeth for my last full week.

I'm, again, helping at the MCH (maternal child health) clinic. I'm working with a different Midwife than before and it is actually running very smoothly. Other than not being able to speak swahili, I am doing everything the nurse midwives do, in fact she is often asking ME to check her. I'm now comfortable ordering the labs that they order for the pregnant women, giving the appropriate medications based on the lab results, doing HIV and syphilis rapid testing, listening to fetal heart rate, identifying the position of the fetus, and estimating fetal age with my hands.

Yesterday, I discovered a set of twins that had not been confirmed yet. (mainly because ultrasound is not ordered on every pregnancy, only if there is a complication or concern) Two heads, two heart beats. I tried to ask the woman and she said "3 babies" I looked at her confused, then read her medical record and noted that this would be her 3rd child. Ahhh the communication barrier! So I waited for the nurse midwife to return and ask her. She confirmed that twins ran in her family but she was not aware of a twin pregnancy. She seemed excited.

Today, I had my first newly diagnosed HIV woman. :( This was hard, and this is when the communication barrier works to my favor! She was very upset and had a variety of emotions as you could guess. In the end, she says she will go home and tell her husband and then decide together what to do next. We are hoping she returns, but the nurse midwife doesn't think she will. The sad reality!

Also, in my free time, I'm working on getting umbilical hernia surgery for the little girl Cassie and I met last week at our housemate's orphanage. She is 6 and has the largest hernia I have ever seen, the actual abdominal hole is nearly 4 cm in diameter. Cassie and I discussed it before she left and decided we would pay for it ourselves, if they would have the surgery done! So now to try to get that accomplished in 6 days :) or less. Wish me luck! If this one is successful, I will attempt a second little girl who also has one but not nearly as large as the first.