Wish for Africa Foundation

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Thursday, 14 May 2009

Wednesday 13th

Today we had an early start. We had arranged to be at the medical centre for 07.00, as today we are performing the caesarean section. On arrival the doctors and most of the staff were there but a misunderstanding with the head nurse meant she wasn’t. This led to a delay in commencing the operation. Their were further delays as staff were unfamiliar with what needed to be done and this is something that will need addressing, by writing up guidelines for them to follow. Simple things like aseptic procedures, passing stuff to someone who is sterile, these had to be demonstrated.

Once everything was in place and Femi had pretty much told them step by step what he required, we were underway. Funmi was on the couch and her analgesia for the section was administered, lignocain, this to those who aren’t aware is a local anaesthetic that you may have for minor things such as stitches, episiotomies etc. To my surprise she did very well, she was obviously in varying amounts of pain but not to the extreme I had envisaged.

A beautiful little girl was delivered just after 09.00 and I took the baby, no not to the resuscitaire (because there is not one), but to what is commonly known the general ward (the only ward, a room with 6 beds in). As I rubbed the baby dry the assistant insisted on sticking a suction tube down baby’s throat, at this point baby went floppy and pale. I insisted she stopped and rubbed the baby vigorously until it began to gasp and cry. A moment of internal panic as there was no resus equipment, not even a bag and mask. But by five minutes she had good respirations and was screaming, always a good sign! I returned to theatre leaving the assistant to clean baby with oil (not something we practice in the UK).

In theatre the temperature was immense, both Femi and the other Dr, which had been employed for the section, were sweating even more than the rest of us, as they had theatre gowns on that are in affect water proof, so have a similar affect to being in cling film. The uterus on inspection was thin and badly scared, so it was a good call to not allow labour to commence. Funmi was sutured up and with a minimal blood loss, was cleaned up and remained in theatre for a while for observations. Later she was taken to the general ward with her baby, no skin to skin was encouraged and no immediate feeding. On enquiry later I discovered that they feed glucose water to the baby for the first day, not even attempting to put it to the breast.

After the excitement of the morning I was treated to lunch by the lovely Mr Dee, a member of the wish for Africa team. He knows how to treat a girl (unlike Femi and the Gala!!). We walked to the local fast food outlet, which in itself was great as I have not been out and about much and enjoy every opportunity I can grab to step into local life. The outlet (which excuse me if I get this wrong) includes Mr Biggs, Tasty Chicken and Nigerian Village it has several types of food, donuts, ice-cream, tasty chicken, and a more traditional flavour. Mr Dee guided me through the choices to which I remained slightly confused, so in time honoured tradition I went with anything. I don’t really know what I had, but there was pounded yam (someone had asked me to bring some home, so I took that as a recommendation) a green vegetable thing, a very slimy other dish and plonked on the top a giant snail in sauce! (De-shelled, I don’t think the slime was from the snail). It was tasty and very filling, Mr Dee asked if I was going to use my finger as is traditional, of course I was…. Then he proceeded to use a knife and fork himself, whilst I got messier and messier!

I must say, as many people back home were concerned of my safety here in Nigeria, that everyone is so polite and friendly. Wherever I go people smile say hello, open doors, I can say I don’t feel at all concerned for my safety (except when crossing the road, then it’s every man for himself!!). Nigerians are a handsome race, both in looks and from my experience to date in nature.

On our return to the medical centre after lunch, I had a beautiful welcome from Funmi’s husband and little girl who was excited to see her baby sister, a very pretty little girl, with a typical Nigerian huge smile. I went up stairs and looked in on Funmi to find she looked distressed, I found Femi and shared my concerns, including the fact that the venflon had tissued and wasn’t flowing. She then began to bleed and misoprostal, a drug to help contract the uterus was given and additional fluids were put up. All appeared to settle down but from this I also realised that there is no postnatal observation guidance to follow. No one had even notice the venflon was compromised and the fluid to help the womb contract was not getting through.

Today I came away with a greater understanding to why we in the UK have so many guidelines and policies. These can sometimes appear overwhelming because of the amount of them. Today I saw what happens when there isn’t any, chaos; no one is sure what to do, how often to do it, why there is a need and what the consequences can be. So much of how we practice is down to evidenced based practice, things are researched, tested, and applied. Here much of what is done is just handed down, no one questions why or if there is a better way, is it safe, and is it necessary. This is where charities like wish for Africa need people with experience, expertise, knowledge to come and share their skills. This is how people can help, this and by helping to provide the bare essentials. Femi was over the moon because I had some tourniquets, they had none and they had been using drip tubes.

I left for the evening, to return to the luxury of a flushing toilet and running water at my hotel. Funmi appeared to be stable and baby albeit not fed (something I tried to encourage to a staff member) was well. Tomorrow will tell if this continued through the night. I hope and pray for no surprises.

3 comments:

  1. I pray this baby and mother get healthy and well soon. And its interesting to read a more full on health related blog and its a bit more sobering as well, showing that you have skills and knowledge to pass on. You are a blessing!

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  2. Another busy day in the life of mummy wattage :) im proud of you old girl :) lol
    Hope the baby n mother are good tomorow
    take care x x

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  3. I now follow your report with keen interest and anticipation.While appreciating the efforts of WISH FOR AFRICA , I would like to observe the lack of basic equipment in the hospital.Efforts should be concentrated in making sure that these items are sourced from organisations and well meaning people.WISH FOR AFRICA should be a pace setter and with the exposure and experience of Dr Femi,the difference will be clear. I hope Dr Femi will also take you to other hospitals in Nigeria where the standards are above average; this will help you to have a balanced view of medicare in Nigeria. Please do not forget to help them in writing the procedures and guildlines. God will bless you.

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