Tuesday, 1 June 2010
Tuesday 1st June 2010 (A baby is born)
Happy Birthday Angela who has been blessed with 40 years, a great husband and 3 gorgeous children, congratulations!
Well after the heaviest rains I can remember and a storm that was relentless, the generator went off at midnight and darkness fell. Ok any one in England rarely experiences total black out, not being able to see your hand in front of your face, but that’s what it was. Although I couldn’t see I could however feel (maybe my imagination in part) the gnats were biting even though I sprayed my room and could hardly breathe myself, they still came.
After a pretty hot, sweaty sleepless night with no NEPA I received a text at 7.30 to say I will be picked up at nine. Not wanting to fall back asleep I got up and showered in an attempt to wake up. The driver on African time turned up at 10.30, NEPA turned up at 10.15, just in time for me to leave. I gratefully sat in an air conditioned car and the traffic was light and we arrived at Mafoluku within about 15 minutes, to a NEPA free clinic. I am certainly being forced to experience true Nigeria whether I want to or not.
I thought the roads would be bad after last night’s downpour but the areas we drove through were fairly clear of water. The one area that was affected slightly had LAWMA scooping up the mud from the drain sites in the road in an attempt to drain the water away. All credit to the people, most of whom appear to be women, they work hard by the road sides with brooms, dust pan and brushes to improve the look of Lagos, hard work and probably not much pay.
We arrived at Mafoluku and all was quiet, I sat in the office and sorted out some things with Femi and Mr Dee. Femi and I then went to the UBA (United Bank of Africa) to draw out money for wages to pay the staff. Femi prides himself that no matter what, the girls always get paid monthly, regardless of his own finances, a rare thing it seems here. The bank is very different to what I’m used to seeing. Firstly you enter the building via a tardis type doorway one at a time, as the door behind closes the door in front opens, to prevent robberies I assume. Inside there is organised (I’m sure) chaos, cheques are still the norm, lots of paper is still used, broken filing cabinets crammed with files, extension leads and hanging wire everywhere that is typical from the streets to shops to homes. The queue was long and I sat and watched while waiting, finished we entered the tardis again to get out.
After exchanging more pounds for Naira with my airport friend we received a call from Mr Dee saying someone had turned up at the clinic in labour. So we made our way back. On arrival back it became apparent that this woman only spoke French (my poor French was better than everyone else’s). She had just arrived from Niger Republic (a French speaking country just above Nigeria) into the country and had only one episode of antenatal care at 23 weeks which included a scan report (scrap of paper, this ironically is all too often how we see Nigerians in the UK). From the scan we deduced she was around 41 weeks and 4 days and her observations (BP, urine, pulse, fetal heart rate) were all ok. Femi examined her and she was certainly in labour (around 6-7cm to those that understand). She is the sister-in-law of the woman whose son Femi delivered on his return to Nigeria and also a second child recently.
We admitted her to the upstairs ward and I observed whilst a lot of people ran around. The last time I was here I wrote protocols for delivery far less in depth than those back in the UK but trying to improve what the Nurses and assistants already do. To my surprise they all needed constant reminders on what to do. They only monitored contractions and didn’t record strength or length of each one. They were asked to record the fetal heart rate every half an hour and I had to constantly remind them to listen in with the sonic aid. Thankfully all was going well. I encouraged the woman to get up and mobilise and to drink fluids, Femi said to them to give her water at least every 15 minutes as it was so hot with NEPA down.
Suddenly the nurses called out and we went in grabbed our gloves and the baby's head was descending beautifully. Although the woman's pushing was erratic and she was doing her own thing, it worked and the head crowned and seconds later a beautiful baby girl was delivered, no pain relief, no tears, she did very well. The baby was taken to another bed where we dried her off and I prevented them from routinely suctioning the baby’s nose and throat, although later she was a little snuffly and Femi asked that her nose was cleared.
Here they oil the baby pretty much immediately, then after measuring head and length (by holding the baby by the legs and hanging her upside down to my horror), they weighed her (3.1kg about 6lb 8oz). After this they then bathed her in soapy water, welcome to Lagos little one! The baby wasn’t encouraged to have skin to skin contact or breast feed, this probably will not happen for a while, they were not that keen to attach baby too soon the last time I was here. Practices here are so very different to what I am used to and it is very difficult to watch and not want to jump in and change so much, but we had a safe delivery and all was well. I was able to watch over and guide towards change in some areas, but at the end of the day I go back to the UK and they stay here and do what they think is best. It was great to have the delivery but it also saddens me to see how outdated and under trained they are. This is why help is needed to bring healthcare up to developed countries standards.
Shortly after this I had to make my way home, through the rush hour in the lovely Mr Dee’s car. So after being in the heat all night then all day, then in the car whose window won’t open and has no air con for a slow hour’s drive, I was disappointed to find no electric at home. I smiled and asked Mama to put on the generator as it was getting dark and I needed a cool shower like never before.