Halfway through week 2! Today I watched a C-Section, sat in on the GYN clinic, and then there was another C-Section after lunch. I have been on the maternity ward this week with a Dutch OBGYN who has been working here for 4 years and a Ugandan medical student named Fred. Today, we were joined by a Ugandan physician – she was the one that performed today’s sections. All the Ugandan students are expected to be competent at C-Sections when they graduate, so I saw Fred do a good chunk of two sections earlier in the week. The maternity ward is pretty steady – plenty of business. The hospital has a midwifery program and the midwives handle most of the vaginal deliveries, while the physicians round on patients and handle the surgeries. They also oversee deliveries from time to time. For the most part OBGYN is the same over here as back home with some caveats, namely less prenatal care, HIV prophylaxis is something to consider more frequently, there is no cautery for surgeries so they can be quite bloody, and the women have more children. Like way more children.
Over the weekend I went with Dr. James, a surgeon and my ‘supervisor’, to vaccinate a bunch of chickens. I mean a BUNCH. I originally thought they were owned by the hospital, or that it was a public health measure (they were flu vaccines, bird flu, I dunno), but turns out they are just Dr. James’s chickens. He raises them and sells them for meat to supplement his his income and help a young man who also tends to the chickens. It was kind of surreal and hilarious. He would say, “Come here, chick-un, do not be afraid, it is just your vac-see-nay-shuuunn.”
I finally made it down to the soccer ‘pitch’ outside the hospital compound. Men that work at the hospital and men from the community come play soccer in the evening, and I had heard about it but didn’t venture down that way till yesterday. I showed up in the pants I wore around the hospital, a T-shirt, and my Vans feeling like Woody Harrelson from White Men Can’t Jump, minus that sweet mid-range jumper. Honestly, I had no idea what was going on for a while. The ‘pitch’, first of all, is a scene from the D-Day beach storming in Saving Private Ryan. It is sloping in more than one direction with paths running through it, rocks, and dirt mounds ready to rob you of your feet at any time. On top of that, we were just playing on one half and the goals were bricks that had been set up, one on either end of the half. So the object, I assumed, was to hit the brick with the ball. Literally no one was going for goal. The other team would get the ball 10 feet from our brick and just play the ball back, switch it, dink around with it, and I was defending a brick no one was attacking. I finally figured out they basically just play keep-away. They play really good soccer (football). There are a couple of guys that can ball, for sure, and it’s all one and two touch – very impressive. I think they’re warming to me, too – yesterday I was mzungu (pronounced mih-zoon-goo, means white guy), and today a few of them were calling me Scott. I have even been invited to play with some of the staff from the operating room this weekend in a hospital tournament.
I got some company in the guest house after a week of solitude. Two Portuguese nurses who were serving at a hospital north of here came to see the NICU, and two nursing students here to rotate – one German and one Brit. We all wandered outside the compound last night to sample the local fare – ‘Rolex’. That’s what it sounds like to me, anyway. I think it was ‘rolled eggs’ at one point, but it all just runs together now. It’s like a mini omelette with tomato inside a tortilla type wrap. Worth the shillings.
Otherwise, just grinding on the daily. reading, asking people to repeat things several times, and trying to learn from the experience. It has been quite humbling in a number of ways – not being familiar with the language spoken by the majority of the patients and struggling to understand the English spoken by the hospital staff has made everything harder. It’s tough to rotate in a new place because the way they do everything takes a little acclimatization, but here that is compounded by the differences in the culture, the demographics, served, and the limitations of the facilities and equipment available. It has made me think a lot about what serving in a place like this would be like as a physician (read ‘grown up’). Hungry for greater perspective and more Rolex.