If at first you don't succeed...

Hello again and here's to a second try at Week 5's post,

Not to be outdone by last week, this week brought some new form of crazy with each new day. When I left you last Saturday, a bit of sickness had begun to settle somewhere deep in my throat. Unlike any cold I've experienced before my symptoms consisted of mostly chest tightness and pain in swallowing. The difficulty in swallowing in turn kept me from consuming very much food on Sunday and by Monday I found myself completely weak and unwell. I left the house only once Monday morning to purchase water enough for several days and a supply of chicken soup, and I returned home shortly thereafter to rest, sip water, read, sip soup and rest again in ongoing rotation until Tuesday morning. The sleep and liquids provided enough healing to return me to work for the remainder of the week. And despite waning illness, return to work I did. As has become my routine, travel continued to and from clinics, Ndola and various other locations in and around Kitwe. This week also included another maternal mortality meeting, continued laps up, down and around the three levels of Kitwe Central Hospital and the completion of my second Stieg Larsson novel (which I stayed up much too late on Wednesday evening/Thursday morning to finish).

Now, while the motions of this position may seem repetitive, please don’t be fooled. The experiences tied to this role are ever changing and so counter-cultural to my limited American reality that this country manages to surprise me on a daily basis. With that said, a few eccentricities from this week:

I learned within my first few days at the hospital that it is respectful tradition to mourn the dead with agonized and prolonged wailing. These cries echo through the halls of various hospital wards each day between 4:30 and 5:30 in the evening, the designated visiting hours. What I did not realize is that it is also considered the responsibility of the family to deliver the bodies of their deceased to the hospital to be pronounced dead. It turns out the backside of Kitwe Central Hospital is also the site of the local mortuary. Apart from my grandmother’s funeral many years ago and one semester in an Anatomy cadaver lab, I’ve had very little experience with those no longer living. This week I observed the delivery of two listless bodies, carried between two or three family members. It felt so idiosyncratic, but I know I was the only one to find it uncommon.

On wards this week I encountered one maternal psych patient, who sang a few tuneless notes through her contractions. It was very eerie, but she didn’t seem to be bothering the laboring patients behind the curtains around her. I also came upon a very full special care baby unit without any nurse. I remained until someone returned. The midwife who slipped back into the room a few minutes later had taken a restroom break. There wasn’t anyone to cover.

Finally, the highlight of my week was also among those things entirely uncharacteristic of anything that would ever occur in the States…to my tremendous advantage. This past Friday, on my final clinic visit, I had my first assisted delivery. My arrival at this particular clinic happened just as two patients were on the verge of their delivery. The first had her baby within less than five minutes of my entrance and was attended to, single-handedly, by one of the only two midwives on duty at the time. The second mother was close behind the first and quickly called out to the other “Sister” on duty as a newborn breathed his first cry one bed over. This second delivery was not, however, so clearly anticipated as the first and nothing was yet prepared, which meant the midwife immediately enlisted my assistance. I was there and, without really contemplating anything but the most immediate need, I drew up a needle and syringe for a shot of postpartum oxytocin (used on every patient to induce uterine contraction after delivery), then donned gloves and flocked to the mother’s side. In turn we three (the midwife, the mother and I) counted breaths and alternately pushed through contractions. I held the woman’s legs and encouraged her to bear down. Within very little time the midwife pulled a newborn girl into my own hands, where I held the baby as she cut and clamped the cord. We then toweled the crying infant and I placed her on mom’s chest. Just as I did so I remembered that in Zambia it is considered unclean for a woman to touch her baby while it is still covered in birth fluids, but the newborn quieted as soon as she contacted mom, so I held her there for a moment more before handing her off to be wrapped by the midwife. I then returned to the mother with tearful praise. She was also crying. Looking back in reflection the most beautiful moment throughout this process was not actually delivery, but when the mother’s deep, pained groans gave way to flooding relief and murmurs of gratitude. On Friday I learned to say congratulations in Bemba, “Mabo bene.”

I suppose this is beyond enough for one week, and besides it is growing dark on Sunday evening here in Kitwe.

Temporarily signing off and hoping, as always, these words find you well.

With love,

Jess

Wit