I am back to the hotel early today as exhaustion has set in. I am sure it’s a combination of not drinking enough water, not sleeping well, etc. I will be fine!
Today I went to a different district hospital, called Muhima. Muhima is a 128 bed hospital that specializes in ob/gyn and neonatology and is a public hospital. They are the referral hospital for many surrounding health clinics. They delivered 700 babies in the month of January, which is stunning given how small they are. To compare, some of the largest hospitals in the US deliver about the same number of babies. I forgot to take pictures of the hospital, but I did take some baby photos–>.
Our day started with grand rounds at Muhima, where the nurses, doctors, and medical students discussed cases that came in overnight and the prior day. There was an interesting case of a woman who is pregnant with triplets who is now 34 weeks pregnant (40 is term). Her babies are all small (around 3.6 to 4.2 lbs) but they look healthy otherwise. She will be delivered by c-section tomorrow after getting a dose of steroids today (to help the babies’ lungs mature). Her photo is –>, she is wearing an orange dress.
We saw 2 babies delivered today, one by c-section and another by vaginal delivery. Both babies were healthy and moms did well. There doesn’t seem to be much communication between the staff and patient after the delivery, and the second mom hid her face under the sheet and was crying after the delivery. I wondered what she was thinking since the baby was whisked away from her immediately after delivery and she could not seem him. I took the a photo with my phone (baby has on oxygen mask–>) and showed it to her and she seemed so relieved. It is really hard not being able to communicate directly, and Kinyarwanda is not an easy language to pick up. I did learn “thank you” from our taxi driver today (murakoze).
So the title of this post is “finding my place”. It can be hard to feel useful on a surgical mission when you are not a surgeon. I spent the day yesterday helping to organize the storage closet at Kibagabaga, where the IOWD stores patient charts, supplies, medications, and everything else we use while there. This task was necessary and important but dirty and unrewarding. But I also had a chance to work with a US and Rwandan medical student to teach patients about post-operative care, and this was very rewarding. So as with many jobs, my place here changes day to day. It’s nice to remember that being flexible is sometimes it’s own reward.