I recently had a rather difficult and interesting experience
with a baby delivery.
Frankly, I am at
the point in my language learning that I feel fairly comfortable in
conversations – especially in the medical realm. Often I bump into words or concepts that I
don’t know, but I know enough Yalunka to allow me ask questions and figure out
the meaning -usually. I have come a long
way from our first year in the country – where I felt lost a lot of the
time.
In our new village, though, we are
suddenly being exposed to two new languages that I am being challenged to
learn. At first, it was just going to be
Pular (spoken by the Fulani tribe that surrounds us) so I set out to add that
language to my Yalunka and French.
Fortunately, many of the Fulani also speak Krio – a language that I grew
up speaking in Sierra Leone (well, actually a mix of 40 languages that has
become one language). Speaking Krio has
saved me many a time as I encounter a Fulani in a medical situation.
I have a basic understanding of Pular now and
can understand a lot of what is being said in a medical context and can
communicate on a toddler level about how to take medicines. Now, however, as our patient base broadens,
the Malinke language (the trade language in the bigger towns in this area) is
being used more and more.
Seriously???? I am not that
smart! SLOWLY I am recognizing more and
more words in Malinke and can usually communicate how to take medicine –as long
it is only one or 2 pills – and taken not more than 3 times a day!
On Friday, a Fulani man came to get me to tell me that his
wife was in labor and waiting at the clinic for me. “Dr.” Sana, the other healthcare worker, was
out of town. I arrived to find a young
woman sitting quietly on the porch of the clinic. One of the midwives arrived at the same time
as I did. We opened up the clinic and go
the woman settled on the floor – lying on top of an old tablecloth. I was beginning to feel frustrated as I tried
to talk to her. I could tell from her
medical record that she was full term – and that this was her 6th
baby.
When I tried to ask how long
she had been in labor, and if her water had broken, I was not getting clear
answers from anyone. It was about 6 pm
when we arrived in the clinic. I was tired
from working all day, and the midwife was exhausted from not sleeping the night
before and from working all day. Added to that is the fact that we are at the
end of Ramadan, the month of fasting for Muslims. All of those things added together to make
the midwife a little crabby and not super willing to help.
After getting her settled, we checked progress with her
labor. She was barely dilated. The midwife wanted to send her back to her
home – quite a distance from the clinic.
I said, No, let’s see how she does for a while and if things are going
slowly, we can send her to stay with friends here in town. That way I knew that she could get back to
the clinic quickly if needed. We hung
out for about an hour and then check her again.
She had made quite a bit of progress in that hour and was now dilated to
2 cm.
Since it was her 6th
baby, I wanted her to stay a while longer.
The midwife was quite put out and fussy.
Within another hour, Dr. Sana showed up and we checked her again. She was about 3 -4 cm. Dr. Sana and I decided that she was still a
little ways from delivering, but that she should stay at the clinic, based on
the progress that we had already seen.
With that decided, Sana went to bed (in his room in the clinic) –
telling me to call me if we needed him.
He too had been up all night the night before and had just returned from
another village with his wife – having to walk the last few miles in the
decreasing daylight because their motorcycle broke down and they had to push it
home.
By this time, the two other midwives in training had showed
up and they were all crabby. They wanted
to send Kadiatou home. They all insisted
she wasn’t really in labor. Darkness was
coming, which meant that it was reaching the time they could break their fast
and eat for the evening. I insisted
that they go and eat. Reluctantly, they
agreed and took off, leaving Kadiatou and I alone in the dark clinic. I was a little frustrated at my lack of
ability to communicate, but was thankful for peace and quiet with the three
fussing midwives gone. (Side note here,
if I had been up all night the night before and fasted all day, I would likely
have been crabbier than they were at that point.) I settled down on the floor beside her to
wait. She would rest, and then a
contraction would hit and she would reach for my hand. I sat there, praying for her and for the
village.
Another hour slipped by.
She was getting increasingly uncomfortable, and so was I. It was getting late. I was tired.
The mosquitoes in the clinic were terrible. I was hungry.
One by one, the midwives came back from eating. I decided to take a break and come home for a
bite to eat and to grab some bug spray.
I returned to the clinic and we sent the two midwives in training
home. Kadiatou didn’t seem to be making
a lot of progress, though she continued to have lots of contractions. I still could not ask her how she was
doing. The midwife settled down to sleep
on a patient bed that was in the next room.
I got an old plastic tablecloth and lay down on the floor at Kadiatou’s
head, so she could reach my hand if she needed.
I quietly tried to encourage her – knowing that she didn’t understand
what I was saying. I could feel her
watching me in the dim light emitted by a small lantern.
As I lay on the hard, cold floor, I could hear the mosquitoes
buzzing in my ears. I could see spiders
crawling on the walls and floors and see other bugs zooming towards and away
from the lantern. I looked over to see a
centipede making its way toward my head. I grabbed my head lamp and smashed it –
smelling the nasty odor they emit when killed.
I was exhausted, but sleep wouldn’t come. I was frustrated that I couldn’t really ask
how she was doing.
Every once in a
while, she would tap my hand and look at me pleadingly, asking me to check her
progress. I would check, but explaining
what I was finding was difficult. The
baby was coming SLOWLY – I tried to explain with gestures. I dozed a little, waking up to find Kadiatou
throwing up all over the floor by my head.
I looked at the clock. It was
after 1 am. I woke the midwife up. We needed to make a decision about what to
do. We could barely reach baby’s head
when we examined her. It seemed that we
were still a long way away from delivery.
Did we keep her at the clinic or send her to a friend’s house? I wanted to go home, leaving the midwife to
sleep in the clinic on the bed – NO go.
She wouldn’t let me leave. She
said – it is YOUR fault we are still here.
I wanted to send her home a long time ago but you insisted she stay
here. I don’t think they baby is coming
tonight. If YOU go HOME, I go
HOME.
Okay then…… I tried to ask
questions of the mom and granny with her – translating through the
midwife. I could understand enough
Malinke to know that what I was saying was NOT was the midwife was passing
on. I was getting more and more
frustrated. I felt like I couldn’t get a
good handle on how mom was doing and what she wanted to do. This was her 6th baby, after
all. It wasn’t like she was a newbie at
this.
In the end, we decided to send her to friend’s house in town
– knowing that she would only be a few minutes away if she needed to come
back. We told them to come back in a few
hours. Kadiatou looked uncertain. I gave
her a few Tylenol. I debated about
waking up Sana to talk to him about it – but decided in the end that the
midwife and I could make the decision. I
wrote him a note and slipped it under then door. She was having lots of contractions and in
the back of my mind, I wondered if we were doing the right thing. But the progress seemed to have slowed, and I
knew that she would be just up the road from the clinic, so I sent her on her
way and we took off for home.
I got home and fell into bed, exhausted. I woke up at 7:30am – anxious about Kadiatou
and how she had done through the night.
I wondered if they had arrived back at the clinic. I tried to sit down and have my quiet time
and drink some coffee, but I couldn’t concentrate. I felt like I had failed her. I should have tried harder to
communicate. I should have insisted that
the midwife work harder to talk with her.
I got dressed and ran to the clinic.
As I passed one of the in-training midwives, I asked how Kadiatou was
and if she was at the clinic. She looked
at me funny, and said, no. I arrived at
the clinic and met the midwife. I asked
about our patient. She started
laughing. Apparently, Kadiatou arrived
at her friend’s house, and delivered the baby about 15 minutes later. 15 MINUTES!
I felt very stupid. How did I
miss that? Now I really felt like I had
failed her. How horrible it must have
been to know that the baby was coming and to be sent home by the white lady who
is supposed to have a clue about delivering babies! I knew I needed to go and see her, even if I
could barely face her. I asked which
house she was in, but they said, wait.
They had sent someone to bring mom and baby to the clinic. I sat and waited.
Soon she showed up. Baby was SO beautiful – a big, healthy
boy. Mom had a BIG smile on her face and
thanked and thanked me. For
what???? I wasn’t sure. The baby was naked, wrapped in a blanket, so
I dressed him in a little baby outfit donated by friends in the US. I told mom in Yalunka how beautiful he was
and what a great job she did. I know she
didn’t understand, but I saw her watching me hold and kiss on her baby. She was smiling and she was thankful. I was blown away.
I learned a few things through that experience….
1.
I need to
listen to my gut more.
2.
I need to work harder to find out what is going
on my patient.
3.
Babies do seem to have a mind of their own.
4.
People here are very gracious if they fell like
you have tried to help.
5.
Despite my lack of understanding a mutual
language with her, I was somehow able to at least communicate that I cared and wanted
to help. She saw that and forgave my
mistake.
May I be as gracious to others!
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