A Day on the Ward

two days a week, I spend my day at Queen Elizabeth Central Hospital, here in Blantyre.  QECH is the largest referral hospital in Malawi, with approximently 1100 beds, spread out over a massive land area.  It is interesting, because, apparently, when they were designing this place, it must of thought it would be unwise to go "up" in building, so they just went a single story... so, it is perhaps the most sprawling hospital that I have ever been in.

Have I ever mentioned how much I am a big fan of public health care?  Think what you might, but I think that health is a human right~  not something that you should have to pay for.  and, that is why it thrills me that I get to be doing my  clinical rotation in a public hospital in Malawi.  I was even a patient there, during my week of explosive diarreah.  and, I when i was brought there, I was asked "Are you scared?"  um... no?

they do have qualified doctors and nurses, right? (yes)
they do have medications if needed, right? (sometimes.  Mostly yes.)
they do have ability to do diagnostic tests, right? (yes.  though it took 30 minutes to find a urine dipstick)
they do have sterile syringes and equipment, right? (yes)

am I scared?  nope.  Because despite the problems with public health care (especially in resource poor situations), I want to encourage it.  and, I trust in it.

I have been doing my clinical rotation at the Labour and Delivery ward of the maternal unit. This unit has 25 delivery beds (give or take) and gives birth to about 650-800 babies a month.  so.  needless to say, it is a busy place.

Why... hello little Malawian Neonates.  Welcome to the world!

The Labour and Delivery Monthly Statistics Board

now... is labour and delivery my primary "area of interest?"  i'd say...... no. not at all, actually.  BUT it was suggested that I do a bit of time there, so that I could have a better understanding on my research topic.  which, it has not really done. but, whatever.  I am realizing (as I do reflective practice) how much I am learning, despite (at times) thinking I am not learning.

but, it is definitley interesting.  to hold a baby that is 15 seconds old?  to hold it when it takes it's first breath and cries?  what an amazing priviledge.

 the women here... so strong.  SO STRONG!  it makes me think that I better "man up" when i plan on popping out a baby~  cause, honestly?!  you would not imagine what women will do without any pain medication (try imagining this: Vac delivery, episiometry, and sutures... ).  what incredible power and strength.

Today, I realized just how important it is to have a continual labour support, as a woman just held onto my hand, my scrubs, whatever... every time that a contraction came along.  I can't speak her language (actually, I could.  I discovered a while later that she can at least understand english, and speak some), but I was there to support.  and, as a nurse, it was such a relief to know that I could provide some support... the kind that says "i'm here, squeeze the hell out of my hand if you need to;  look at me and breathe;  let me rub your back when those contractions come;  let's push that baby into the world!!!"

Nursing is different here.  well.  actually, maybe it is different here.  I have met great nurses and awful nurses in Montreal~  just as I have here in Blantyre.  I do wish that there was an "intensive Chichewa" language course in edmonton that I could've taken... because I am realizing how much i don't know.

I also had the chance this afternoon to attend a handoff between the day-physicians and night-physicians on one of the paediatric wards.  In the middle of the report, there was this... voice that rose up over all the other sounds on the ward.  it rose up, kinda like crazy people on the street who talk loudly to themselves.  but, as I looked over, I saw this girl... she looks between 7-9, who was speaking with the boldness and strength of a woman 20 years older.  the entire ward was quiet and listening to her.  you could tell that her words had power.

and, all of a sudden, the entire ward, as one, said "AMEN!"  and, i realized... this girl was speaking encouragement and praying.  and... everyone was listening.  if this happened in a ward at home... all I gotta say, is that girl would get kicked out quicker than you can say stat!

side track: That is one thing about being here in Malawi.  It is quite a religious country... it is not rare to speak about things of faith.  Faith, and christianity, and religion is different from what we know (though I will post on how excited I am to be Anglican in Malawi right now, at a later date, mostly because of how much it makes me feel "at home"), but, it is very much a part of everyday life.   

she would pray, she would speak, then she would start singing... and, the entire ward would sing back with her.  she was there for about 15 minutes, doing this.  I even asked the nurses what she was saying; and, apparently, she comes every 2-3 days, after school.  At one point, I think she was a patient for a short time... but, apparently, she "Speaks like a leader" and is "saying incredibly encouraging words."  

when she was finished... there was a huge clapping... and people would call her over, as she was walking away.

there is no way that words can explain what happened this afternoon on that paeds ward.  but... for some reason, it was incredible.  and, it just reminds me why it is so incredible to be here.

just another reason why being on this continent fills my heart with such a deep rooted joy.