Saturday, April 19, 2008

What Happened to the Prayer Shawls?

A couple of weeks ago, I went to start the TB project I'm doing in Lugela, another of our rural sites. I went with a driver up to Mocuba and met Stacey, our clinical advisor in Lugela. From there, we caught a dugout canoe across the wide river.

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Right in the middle, a drenching, cold rain decided to soak us as we sat helpless in the canoe. I curled over the top of the lab equipment I was hauling in an attempt to keep it dry. It may be the first time I've had goosebumps in Africa. We arrived on the other side dripping and climbed into the FGH truck for another hour down a dirt track to get to Lugela. The hospital, like all our rural sites, is in the middle of gorgeous but completely empty country. There were tons of people milling around in the hospital's yard.

I was introduced to the hospital staff and we made plans for the Tb training the next day. Right before we left for the afternoon, one of the staff asked if we could transport a patient to the larger hospital in Mocuba. She was a young woman in labor who had cephalopelvic disproportion (baby's head too big for pelvis). When she stumbled out of the maternity ward supported between two family members, I could see why. She was tiny, the size of a child, and in obvious distress. She was just wrapped in a one thin capulana and after the sudden downpour, it had actually gotten a bit cool. It was starting to rain again. She had a long way to go and had to be transported across the river in a canoe in the cold rain. Remembering how it was chilly for a healthy, non-laboring, North American woman, I had a flash of inspiration and pulled a shawl out of my backpack and wrapped it around her. There is a group of ladies at our church in McMinnville who knit and crochet beautiful shawls for people who are ill, bereaved, etc. Before we left for Africa, they gave us two to give away here. I had been carrying one around in a ziploc bag in my backpack for awhile, looking for the right opportunity and it presented itself in Lugela. I hope it's wrapped around a healthy mom and new baby right now.

After spending the night with Stacey and her two cute daughters in Mocuba, we got up early and caught a motorcycle taxi down to the river (I thought it was going to be the end of my life when the driver sped up and passed a gas tanker on the rutted roads. He seemed amused by my panic attack). We crossed again in the canoe and headed back up to Lugela where I did my training with the lab guys.

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After that, I saw a man I had seen yesterday. His wife had recently given birth and apparently hemorrhaged. She was very weak, vomiting frequently, and her tongue was almost white. I've never seen anemia like that. Chronic anemia is a common problem here due to malaria and other diseases. She may have had chronic anemia anyway and the loss of blood in labor put her over the edge. Since there isn't a good way to store blood in electricity-free Lugela, patients who need transfusions have to find a donor themselves. (Which can be difficult since many people, as in the states, are afraid of donating.) She didn't have family willing/able to donate and her husband was desperate. He haunted the medical staff, always in sight, trying to find someone who could give blood to his wife. I was nervous when they drew blood for the pre-tests but carefully inspected all needle packaging. It was near the end of the workday, so the lab was winding down. I ended up having to do many of the required pre-tests myself (that is an odd situation, but the lab guys watched and confirmed the results). I'm glad to say I'm free of syphilis, HIV, hepatitis, malaria, and have a Hg of 17mg/dL (the lab guys did that one. I'm pretty sure I don't have a hematocrit of 51. Whatever it actually was was sufficient because I didn't pass out). I asked Stacey to actually be the one to collect the blood after I saw the lab guy donning a giant plastic apron in preparation (you shouldn't actually need that right? I mean, nothing should be spurting.) I hated to be a chicken, but I would much prefer an American nurse practitioner to collect it than a lab guy with one year of education past high school. We actually did it in a supply closet, because there was no other free space.

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I didn't see them give the blood to the patient, but Stacey did and said it went well.

1 Comments:

Blogger Spence and Lori said...

Lara/Kevin,
I'm a friend of Bill Selph. I hope we can cross paths in Nashville sometime if your schedule isn't too crazy. My husband and I are trying to adopt from Ethiopia. I'd love to hear more about your adventures in Africa.

May 18, 2008 at 5:30 AM  

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