winning, ranting, and babies.

Last night India won the big cricket match against Pakistan. I must confess that after living in Barbados for 9 years, I still don’t like cricket so I could care less about the game, but it was a huge deal to everyone here. Just about everything came to a standstill so that people could go home and watch on their televisions. Around 10:30pm the fireworks and other various explosions started across the city and lasted for a couple of hours. I ran upstairs and on to the roof to witness the celebrations and had the most entertaining time with a few local boys who taught me some Hindi phrases. We high fived each other and shouted “Win India!” which is something like, “Chak de India!” in Hindi. So fun. The streets were filled with music and shouting and celebrations and different parts of the sky were lit up with fireworks. I’m sure they were entertained by my enthusiasm and efforts to participate in the excitement…

I’m functioning on pure adrenaline right now after an intense and monumental day in the labor ward. A number of people stayed home today, so Rachel and I had the opportunity to work in the labor ward –one that we couldn’t turn down. I can’t even explain how interesting and strange it is to go from a government hospital in Tanzania, to another government run hospital in Hyderabad India…  Two vastly different, yet somehow similar cultures with different health care systems and forms of governance. I find myself making constant comparisons and feeling very much like a sort of medical anthropologist. This process has helped to surface some incredibly painful experiences from Temeke that I have almost forgotten because I grew so accustomed to that environment that hardly anything disturbed me in the way that it probably should have. In general, the level of care that women receive at MGMH (Modern Government Maternity Hospital) is far better than what I witnessed at Temeke. So much so that it angers me. I know that there are some logical reasons why Temeke struggled to provide adequate care to mothers and newborns and while I would rather resort to compassion, empathy and pity –now I’m beginning to feel less grace and more rage towards the way that women were treated and neglected there. If it’s possible in India, why can’t it be possible in Africa? The women who come to MGMH don’t have to bring anything aside from themselves and their paperwork. They don’t pay for anything and they receive, in my opinion, excellent care (especially in comparison to Temeke). Yes, there are some reasonable explanations for this. They are well supplied and sufficiently staffed –and in some ways, these are factors that are outside of the control of the healthcare workers in Tanzania. But, who is to blame then? Is it all the government’s fault?

I’ve also been very impressed by how knowledgeable and well trained the staff is at this hospital. It’s a teaching hospital, and so there is always an abundance of keen, frightened students, eager to learn all they can on the job. I’m always amazed when I hear them answering one of the many questions posed to them by the doctors. And in my few days of working in ANC this week, I have already learned so much from the doctors who asked difficult questions and took the time to explain things thoroughly. The standard of care that was given at Temeke hospital was so poor and I think that I sort of accepted it as characteristic or normal of a developing nation hospital. But now I’m starting to think that it doesn’t have to be that way. Again, if it is possible here in India, why can’t it be possible in Tanzania or Africa? Of course, my experiences are limited to one or two hospitals in each nation so I can’t speak with much authority, but still!

The conditions at MGMH certainly aren’t ideal or wonderful –especially in comparison to a hospital in Canada or the States –but still, they are doing quite well considering their limitations. I think of the many situations at Temeke that I was involved in where I had to fight for a woman to receive attention and care

I think of the woman with stillborn twins and how she lay on the table unattended after giving birth and how no one even knew that there was a second fetus until I brought it to their attention. I think of the woman I came across with a ruptured uterus and how she also had been lying there waiting to be noticed and had to wait even longer to get in to the operating theatre for an emergency c/s.

It’s almost the opposite here.

I would say that the medical staff here might even intervene too often and perform unnecessary procedures like routine episiotomies for primigravidas. Every mother is given a round of antibiotics immediately post-delivery. At Temeke, I witnessed countless cases of puerperal sepsis and even infant sepsis, infection that would start physically manifesting itself within hours of delivery and would often be ignored and untreated –both mother and child being discharged with hardly a checkup.

I’m realizing just how shocking and disturbing the conditions really were at Temeke. There are still plenty of things that shock and surprise me here, but so far, not to the extent that they did at Temeke. The area that needs the most improvement at MGMH is their standard of newborn care. I definitely miss having the kangas that women would bring for the delivery at Temeke.

Delivered my first Indian babe today and it was quite the experience. We’ve realized that it’s going to be very difficult for any of us to get experience here because there are so many students and an obvious system of hierarchy in place. Hospital staff extend respect to you based on how many years of training or experience you have. Because our school is only a year, they are more hesitant give us opportunities. That, combined with the fact that there are SO many students that need to have deliveries in order to graduate, makes for a very competitive and limiting environment. We are slowly trying to gain their trust and respect, but it’s difficult to stand back and observe when we were practically running things at Temeke during the hours that we were there! If only they knew how many deliveries each of us has conducted or participated in and how much authority and responsibility we had previously… I think today was the first time I’ve ever stood back and been a passive observer while a delivery was taking place. Anyways. I’m sure that I’m still going to learn plenty during my time in Hyderabad.


In other news, it's april! I can hardly believe it. Only two months left! This fills me with a mixture of excitement and dread. Canada, real life, job hunting, school, moving house, and new family members await me. People need to take a break. And life needs to slow down a little.