Trip to Boroma

Dr.Bird from Kijabe Hospital in Kenya with medical students after his thyroid lecture.

Visiting the villages with medical students from Amoud Univeristy.

With Abdi, an intern, and Halimo, a midwife at the General Hospital.

Being Fruitful

Edna picking tangerines.

Sweet sop.........

......papaya.......

.....and cantaloupes at Edna's farm.

With Sohur and Dr.Mohamed.

Providing breastfeeding support.

Today I received the most beautiful e-card from Mother Constance. I thank God for her continued prayers, love, and support. The card was a gentle reminder that God has ordered my steps, and I am right where I should be.........bearing fruit in Somaliland.

Yesterday I had the opportunity to manage an eclamptic patient. This 23 year old mom at 8 months gestation arrived at the hospital with convulsions and BP of 180/120. We quickly started an IV and I administered anticonvulsant medications. Antihypertensive meds were also given per protocol. Mom was semi-conscious and at other times very combative. Three hours after arrival to the hospital she gave birth to a beautiful baby boy. This was the most challenging delivery I've had to date, as mom had to be physically restrained by 2 family members and 4 staff while I delivered the baby. One midwife was even bit in the process. Thankfully both mom and baby are fine and stable today. Of course, she has no recollection of what transpired. Interesting note: baby was born with an extra set of nipples.

Today I went to DHL to mail out my absentee ballot request. There is no regular mail service in Somaliland, thus I have to use an international carrier. There is no way I'm going to miss my opportunity to cast my vote for Obama. Here in Africa they absolutely love Barack.

So yesterday I provided labor support for a woman who was having her 13th child. Yes...13th! She asked me where I was originally from. I told her from Jamaica. The next thing she said was Bob Marley. Gotta love it.

Downtown there is a store called Dollar Store. No, there are no dollar items there, as $1 US is equivalent to $6500 Somali shillings. Anyway, Usher's photo is on the sign. I found this hilarious. There is also a store that has a large drawing of Jackie Chan and David Beckham. These Western images seem so out of place to me juxstaposed to the Koran readings blaring from mosques throughout the day, poverty stricken faces of refugees crowding the streets, and conservative Muslim traditions and culture.

So I've had quite a few new experiences here in Somaliland, and the learning is not limited to midwifery care. I've picked tangerines for the first time while at Edna's farm. Ismail also recently taught me to play table tennis, as there is a table on the 3rd floor of the hospital. Tonight I actually won a game against Dr.Mohamed.

Simply Incredible!

This baby was born at another hospital via face presentation. 

Had respiratory distress

and the family brought her here. 

I helped with the resuscitation. Now she is just fine.

I delivered this baby.

Unfortunately the maternal mortality and morbidity rates in Africa are horrendous to say the least. Complications that can occur from prolonged labor are IUFD and fistulas. Yesterday morning a woman was transfered here from another hospital. She had been in labor for a few days, the baby had died 3 days prior, and there was a prolapsed arm hanging out of her vagina. The doctor had to decapitate the prolapsed arm, and then use a metal hook to position the body in such a way so he could deliver the rest of the body buttocks first (breech). I was brave and watched as much as I could, despite the scent. Thankfully the woman is alive and being treated with high doses of antibiotics. She was also speared a c-section, as this could have resulted in sepsis. 

Camel's Milk

Outside the hospital with 2 nursing students.

The 3 Amigos.....Maxamed, Ismail, and Abdulrasheed.

Hibo, Sohur, and Nimco.

My favorite picture for the week from Edna's farm. Isn't she the cutest?

Celebrating Eid at the Monsoor Hotel.

My Somali sister who is all for Obama.

Visiting Hargeisa Univeristy with Sohur.

Interviewing students for the lab technician training program.

Drove past this camel a few days ago.

I can hardly believe that I’ve been in Somaliland for 3 weeks!! I have experienced quite a lot in this short period of time. Today I tried camel’s milk for the first time…didn’t care for it much as it has a pungent smell and unappealing taste. It also sent me to visit the porcelain throne.

Today I also assisted with the interview process for applicants to the lab technician training program here at the hospital. There were over 100 applicants. One of the requirements is proficiency in English, thus it was easy for me to participate. At one point I asked an applicant his birthday, after which he looked quite puzzled. The representative from the Ministry of Education conducting the interviews with me then asked him in which year was he born. Edna later informed me that many Somalis don’t celebrate or acknowledge a birthdate, just the year in which they were born.

 

So far I have caught 13 babies at the Edna Adan Hospital, and did 1 delivery at a local government hospital. My experience at the government hospital was quite interesting as Sohur and I were chastised by a hostile midwife who thought we were Ethiopians. This woman had not done any work pertaining to patients while we were there. She was too busy putting henna on her hands and feet. Maybe she was disgruntled because Sohur and I were actually doing her job……like catching babies and giving breastfeeding support in the immediate postpartum period. I can’t begin to describe the condition in the delivery area of that government hospital…I’ll just say that there is no Vitamin K, eye drops, suction bulbs, or oxygen. Babies born with respiratory distress are out of luck. Instruments don’t appear to be sterile, and I only saw 3 pair of sterile gloves. Luckily we had brought our own sterile emergency deliver packs. Thank God for the Edna Adan Maternity Hospital.

 

Last week I provided immediate newborn care to a baby born at 35 weeks with an omphalocele. His liver was protruding through his umbilicus. I was present for the surgical repair, which was simply short of amazing. I’ve also done quite a number of newborn resuscitations. Those chest compressions actually work! Yesterday was the first time I had to actually have epinephrine administered, as baby was unresponsive to prior resuscitation efforts.

 

I’ve eaten more meat in the past 3 weeks, than I have for the first 9 months of the year. Here they eat a lot of goat, lamb, and pasta. Edna took us out to a restaurant for Eid (celebration at the end of Ramadan) and I ate the most delicious fish.

 

I spend most of my time here at the hospital of course. However I’ve had the pleasure of visiting Edna’s farm, Hargeisa University, and the Ministry of Health. Somaliland is safe, and most of the people are quite nice. I met one woman at the outpatient clinic who thought I was Ethiopian (for some reason most people assume I’m Ethiopian). When she learned I was from Jamaica, W.I. by way of NY, she held her fist in the air and said “Obama!” I just love itJ