Muhima, c'est comme ça!

The District Hospital of Muhima:
we had to get used to it at first (a much bigger team, loads of work, getting to know everybody and so on), but we settled in just fine.
They call it the 'baby factory', and now we know why!

As we participated in the Unicef congres, our first week was a short week, but the second week we really blended in with the Muhima team. Every day starts with the staff meeting at 7am, where they discuss all the cases of the night or weekend shift. Unfortunately it's often in Kinyarwanda, but it's incredible how much you start to 'understand' just by the context ;-). The staff might just be the toughest part of the day; the cases here are numerous, and unfortunately post-delivery bleedings and infections, and cases of (pre-)eclampsia are common, and unfortunately some times fatal... (it was very shocking for us to hear that a 26-year-old mother died due to bleeding and shock after giving birth to her first baby... and that was not the only case in the past weeks) It's tough being in gynaecology and obstetrics here, because the doctors work very hard, but there is still lack of staff and monitoring in order to prevent the worst case scenario from happening...

Fortunately in many cases things go well, as well (although the bad cases are the ones you'll never forget...) Not every day is as busy, but most of the times a baby is born every half an hour, and there are many cesarian sections to perform. As Muhima is part of the University Hospital many 'stagiairs' are there (both medical students and people becoming midwives), so we had to adapt our schedule to them. We found our spot in the OR and the 'salle d'accouchement'. On a busy day I managed to do 4 deliveries
(note that the delivery techniques here are quite, uhm, 'different' -a lot of pushing on the belly by the midwives, a lot of voice raising in Kinyarwanda accompanied by soft, but intentional slapping if the woman doesn't cooperate well, no use of anaesthetics when doing an episiotomy -"it doesn't hurt when you do it while the woman is having a contraction"-, but we try to do our best to make it a little bit more easy on the women with the few encouraging and reassuring words we know in Kinyarwanda, for what it's worth...)
in a row (fortunately 4 easy, uncomplicated deliveries and equally healthy Rwandese boys -and they are soooo cute when they are born!). Doing the night shift was really hard work, assisting in 4 cesarian sections in a row, it was nearly a marathon ;-)!

Unfortunately last week, after our adventure of climbing the Mount Bisoke -but that's another story- I couldn't resist, what I call, the 'Mzungu virus' (about every white person I know was having intestinal problems...). So 3 days of 'repos au lit' were needed to recover...
So Muriel worked for two, and yes, she did her first cesarian section! Congratulations Mu! :-)

This week there's a whole week of courses for the specialists, and we'll be participating in them as well. And as we are nearly at the end of our internship, we started off this morning by giving a presentation (all the interns have to do that here) at 7am (!) and I must say it went pretty well, the public -consisting of the whole Muhima staff and medical students- was enthousiastic!

So far on Muhima, Rwandese buffet is waiting for me (jummy! bananas, rice, spaghetti,... we just can't get enough of it! haha! ;-)

Big hug,
Tjalina.