Tuesday

I had arranged with the others to spend Tuesday in the clinic taking pictures and listening.  But when they opened it around 8:30, they asked me if I could work with Denise and explain to people how they needed to take their medication because Jeanette wasn't there.  It turned out that Johnny wasn't there either, so I ended up having to translate for Tammy.  My Creole was immediately put to the test, and I had no choice but to sit down and listen hard.  I was actually able to understand most of what the patients were saying.  Today, we had more pain and heart burn, but also several UTIs, many cases of worms, eye infections, and a woman who had been attacked by a donkey and had sprained her wrist.

Towards the end of the morning, I had an elderly man and his wife come in.  It was a little difficult to understand, but there was clearly something wrong with the gentleman's mouth.  Tammy looked in and then called Crystal over.  It turns out that the man had a huge abscess in his mouth.  It was likely that he had had a tooth infection or a cut in his mouth that had become horribly infected.  Crystal said that he really needed to go to the hospital, but that she needed to do something now or he would end up septic.  She gave him some oxycodone and some numbing cream, waited 30 minutes for it to sink in and then started work.  Now, normally I would have cleared out and prevented the inevitable vomiting and passing out that usually happens when I'm around stuff like this, but Crystal said that she really needed pictures taken.  So, I did my best and took pictures without looking too closely.  I also felt like the wife needed some support so I held her hand while she watched.  I'm not entirely sure what Crystal did, but I do know that she made a small incision and blood came squirting out.  I accidentally saw that while I was checking to make sure the camera was in a good spot.  Then, I took a tiny peek again and saw the scissors in his cheek.  After that, my head started to swim, my vision turned dark and my mouth started to water and I knew I needed to excuse myself.  When I came back in, his head was bandaged and they were telling him to come back tomorrow.

The afternoon went by without any other real excitement.  I saw a young man get his diabetic ulcer on his leg cleaned (with no passing out this time), but that was really it.  The real excitement started around 4:15pm, just as we were getting ready to close for the day.  A family came in and said that there was a woman in labor and she needed to be seen.  Crystal is not a baby doctor and Tammy isn't either, although she has three kids of her own and loves babies.  They said that unless it was an emergency, the family needed to take her to the hospital here in Gros Morne.  They said it was an emergency.  So, they brought her in and we got ready.

My headlamp had already been used for the abscess surgery, so someone found that and I ran to find my other flashlight.  By the time I got back, the girl was already on the table and Crystal was checking everything out.  I just want you all to keep in mind that all of this was being done by the light of a headlamp, a single bulb overhead and, while we had it, the sunlight coming in through the open door.  I started out holding a leg, but because I could speak Creole they sent me to talk with the large group of people that was crowding the door to tell them that they needed to leave because we couldn't all fit in the tiny room.  When I came back and asked what needed to be done, I was told that I needed to help support the mom because we couldn't figure out how to make the bed raise from a laying position and there wasn't time to try and mess with it.  So, I crawled up on the delivery table, situated myself behind the girl and spent the next two and a half hours supporting her while she was pushing.  She would push and I would use all my strength, (my abs got an incredible workout), to make sure she didn't move.  She would hold on to my legs and neck while she was pushing.  Although it was hard work and my entire body was sore for several days afterwards, I figured if this girl could push out a baby, the least I could do was hold her up and try to make her a little comfortable.

Things started out moving fast.  Crystal was thinking that the baby would come within an hour or two.  But, as time when on, she still wasn't dilated all the way.  After about two and a half hours of pushing with no baby, the mom was exhausted and the breaks in between pushes became longer and longer.  Around 7:00pm, I went with Tammy and Crystal to have a quick dinner and then went back to time contractions.  When I left around 11:00pm her contractions were still around 5 minutes apart.  They should be between 1 and 2 minutes in order for the baby to actually come.  I came back at 3am and the mom was sleeping and had no contractions within the 10ish minutes I was there.

By the morning, the contractions were still not close together.  The mom was placed on a stretcher that was carried by several men and they began (on foot) the two or more hour journey to the hospital in Gros Morne because she needed blood.  Gros Morne didn't have what she needed, so they sent her to Gonaïves, a larger city some distance away.  Gonaïves didn't have any doctors, so they sent her to St. Marc, another city even farther away.  By the time all this had happened, the baby had been in the birth canal for around two days.  Unfortunately, the baby did not make it.  The mom also had a pretty bad infection and there was the potential that the baby wasn't living when she first came to us.  But, the mom is doing okay and the last news I heard was that she was recovering here in Gros Morne.

To say the least, this was an incredible day.  Just to give you some perspective at how crazy it was, I am not one to swear, (like I've never uttered one in my life), but one may have crossed my lips when I first crawled behind the mom and we started pushing.  My roommate at school is a nurse and in the fall last year she had her maternity rotation.  She saw several births and would come back and tell me all about them.  She told me how beautiful they were and how it is something I had to see.  I told her that never in a million years would I ever watch a baby being born.  I guess I was wrong.  Although it was something that I don't need to see again for a long while, I will admit that it was an amazing experience and something I will never forget.  The girl was only 19 years old.  This was her first baby.  While I was sitting behind her, I was thinking about what I was doing at 19 and that there was no way I could do what she was doing.  I was surprised at the almost immediate connection I felt with this girl, although I barely knew her name and she had no clue what my name was.  Her mother wasn't there and I really felt that if I was having a baby I would want my mother there, so I wanted to make sure she knew someone was there for her.  During our time together, I had one of the Haitian women that was in the room ask me if I was the father .  Obviously I said no and was a little confused.  It turns out that the father, (I'm not sure if it is the father of the mom-to-be or the father of the baby), is usually the one that sits behind during labor.  Apparently what I was doing was pretty special in the Haitian culture, and I was touched that this girl would let a complete stranger play such an important role.

Overall, I learned a lot throughout this experience.  I learned a whole new set of Creole vocabulary and because the proximity of my head to the mom's mouth, I was often the one to tell the others that she was ready to push or her legs needed to be held.  I got to see what childbirth, (or at least half of it), is like, learn about everything that needs to happen internally for a baby to actually be delivered, and how to do all this using only the resources you have – using a headlamp for an examination, and putting in an IV without the proper needle.  I also got to learn a little bit about the culture around childbirth in Haiti.  It was an incredibly public affair, with tons of people trying to get in the room and watching outside the door.   The midwife, who was actually a man, came in with the mother and stayed with her the entire time.  There was no pain medication given or asked for.  While the mother was pushing, other women in the room would cover her mouth and tell her to be quite, because women do not typically show any sign of pain or emotion during labor.  Because I was sitting so close to the mom and we were both sweating profusely, I asked for a towel to wipe her brow.  When I went to do this, the women stopped me and said that it was better for her to be hot and sweating because it made everything easier.  Over the next few days, I learned a little bit more about the health care situation in Haiti, and the lengths people have to go in order to receive the medical care they need.  I also learned that it is common for women to lose at least one baby during their child-bearing years.

I will admit that there was some truth in what my roommate said.  Although I'm not sure I would call everything I saw beautiful and while she cried out of joy, and I wanted to cry out of shear terror at what was going on, it was definitely a special and an unforgettable evening.

My mid-labor selfie - fear combined with sweat and rain makes for a great photo.