Midwives for Haiti Trip Day 3

Monday October 1st 2012

Today actually started last night with my first night shift.  I went with Jenna a CPM(lay midwife) from Maine that has spent a lot of time here and has a decent grasp of Creole.  She only has experience with normal labor and birth, so she was a great help, with the language barrier but not comfortable with the large volume of high risk patients we had last night.  The hospital only staffs 2 Haitian midwives to work at night and they are actually paid by MFH not the hospital or government.  One had called in sick so we went to help. 

I am so glad that I am used to co-managing high risk patients back home because we had 11 patients there with pre-eclampsia on a potentially dangerous medication, Mag running freely because they don't have IV pumps.  It was scary to try to do the complicated math to figure out drip rates to try not to over or under medicate them.  At home these patients have 1 to 1 nursing care and here they are just 1 of the 17 patients we had to look after for 12 hours. 

The above picture was obviously later morning after the sun had come up.  We did have electricity, but very little lights, so made things that much more challenging.  I was able to do 3 of the 4 deliveries.  It is so amazing to watch and listen to these women labor, knowing that pain medication is not an option. And fun to see that labor sounds the same in any language, which is good because other than Jenna I didn't have an interpreter, which was hard, but I somehow muddled through.  It is so weird how much I take for granted that our nurses do for us at home.  Here I was alone to help a woman labor, deliver and recover the baby and stabilize mom.  And these strong women would stand up within 10 minutes of delivering and get dressed and then walk to the postpartum ward! 
One patient that really bothered me was 30 weeks with severe asthma.  She sounded awful and needed a nebulizer treatment but we couldn't get one from the pharmacy until the morning.  It is so hard to realize that even when you know what to do to help someone, due to the broken system they may not get what they need.

The picture above is where they kept their medications.  It is a total mess of everything from empty vials to high risk medications.  The crazy thing is, in the middle of this busy, hectic night the Haitian midwife had a headache so she just went to an empty room and took a nap on the floor next to the cleaning lady! What a night!