Sometimes
encouragement comes just at the right time, and with all the recent upheaval in
the Baby Unit, Sarah was definitely in need of encouragement. Meet Survivor.
Her mother came to Kitovu Hospital at 27
weeks gestation. What you need to know
is that in Uganda, the official “survival age” for babies is 28 weeks
gestation, therefore any baby born below that is called an “inevitable
miscarriage”. Their mothers aren’t even
given steroids by doctors (giving the mother steroids helps the unborn baby’s
lungs to develop), as after all “what’s the point” if they’re going to die
anyway, right?
Survivor’s
mother reasonably asked whether she could go home – she would rather be in her
own surroundings if this baby was inevitably going to die. Our baby unit nurses encouraged her and
counselled her that some of these babies CAN survive. So she stayed and gave birth to 1.08kg
Survivor. Survivor is now a month
old. Yes, of course, there was more than
encouragement involved – there was a glucose infusion to keep her going when
she couldn’t start to feed initially, a tube to help her mother give her
expressed breast milk, antibiotics to prevent infection, medicine to help prevent
her from stopping breathing, and warmth (via our overhead warmers, the Embrace
sleeping bags, and mum herself doing kangaroo care). But actually the thing that I am most proud
of is our nurses taking the time to encourage a confused and scared mother, and
thereby save a little baby from actually being the “inevitable miscarriage”
that she was declared to be! She is very
well-named, isn’t she?
As well as an “inevitable miscarriage”, we
also have an “intrauterine foetal death” on our unit! After midwives couldn’t hear her heart beat,
they told her mother that she had died.
I can’t imagine how distraught that poor mother must have been,
especially since this was her seventh pregnancy, of which she had lost all but
one baby. Two days later, by caesarean
section, doctors were a bit taken aback when this little baby was born alive,
if in poor condition. Amazingly, though,
she is doing really well, and is even breastfeeding! So here’s to babies beating the odds this
month!
On other Baby Unit news, Sarah, and her
trusty side-kick Baby Noah, have been continuing in their work to train all the
midwives from the Maternity Ward in neonatal resuscitation, newborn care, and
the workings of the Baby Unit. However,
staffing has really been a challenge over the past couple of weeks, which has
prompted a number of strategic discussions.
It has been agreed that we should hire another nurse to be based
permanently on the Baby Unit with Head Nurse Cathy, with the rest of the
staffing offered by the newly trained (and certified.... yup, they have a
practical and written test to be sure they’re up to scratch) midwives who
rotate through the unit for a month at a time.
Since some of the midwives were unable to calculate a heart rate
correctly in their tests (!!), the pool of midwives eligible to work on the
Unit is quite small, but growing!
In addition, we’ve had an influx of
exciting new Baby Unit equipment brought by visitors, and have got a new oxygen
saturation monitor (the previous one having headed to that fluffy place in the
sky), neonatal monitors, and a number of other treats that we’re enjoying
putting into action. So THANK YOU SO
MUCH to Joy, Jo, Jan and Tracey!
Meanwhile, on a course last week, Sarah was
somewhat baffled at the large number of new “facts” that she learnt from their
(non-medical) trainer in the “health” module.
New revelations included....
·
You can catch sexually
transmitted infections from toilet seats
·
You can figure out if you are
pregnant with a girl or a boy depending on your age and the month you fell
pregnant in
·
Family planning causes disabled
children
·
Milk causes cancer
... and a whole host of other factoids
which can only be described as twaddle.
Hilariously, when Sarah decided to object
as the presentation of spina bifida was being totally incorrectly described,
the trainer looked at her and basically implied, reminiscent of Ron Burgundy
(a.k.a. Anchor Man), that we should “agree to disagree”. In HIS experience, he said, this was how it presented. I guess 16 years of medical training and work
doesn’t match up to his case study of 2 individuals!!!!
Things we’ve learnt about parenting the hard way...
#4: if you stand cooing over your naked
son, there’s a decent chance you will get pee in your eye. Normal saline is a far better eye irrigation
fluid (though it doesn’t make as good a story).
