Aug
9
August 9, 2011 | | Leave a Comment
What is in a word? What we make of it. There really cannot be a context without content.
Standing in the maternal ward of Mbarara Regional Referrral Hospital (MRRH) on Friday, I could not fully comprehend the ease with which the midwives, doctors, and assistants referred to the unsettled mother laying on the first bed of the delivery room. With two fully robust expectant mothers just two beds away from her, there had to be something wrong if this young mother was laying on the hospital bed, ready to “deliver,” yet looking to be only about five months pregnant.
One thing I learned this past Friday is that abortion seems to have two distinct connotations in the United States and Uganda. While in the United States an abortion refers to the early termination of a pregnancy by choice, in Uganda, an abortion is a spontaneous act of the body, when a mother begins having contractions and signs of delivery too early in the pregnancy – in this case, at 25 weeks. I wasn’t sure if my heart could bear to watch a young mother lose her child that Friday when the doctor told me they were about to deliver a baby that was most nearly aborted but fortunately, my inquisitive mind, mostly out of shock and fear, was forced to question and further investigate the purpose behind the procedure. I was overcome with a deep sense of sympathy and mental persecution for the mother as the doctor laid out her medical history. Not only did she have to undergo this spontaneous pregnancy, she also had a low-line placenta, meaning the placenta is presented first at the cervix, instead of the baby’s head. That’s two complications. To top it off, this woman already had two spontaneous abortions in her past, all resulting in miscarriages!
Although it was such a wonderful experience to witness two healthy deliveries that morning (Carrie and I held and weighed two beautiful baby boys – one at 3.4 kilograms and another at 3.6 kilograms), it was nearly disheartening to learn about the several complications that can occur during pregnancy. From malaria to spontaneous abortions, low-line placenta to internal bleeding (thanks to the Maternal Health Team for all the research), I can clearly see just how important our work this summer will be, especially as the Safe Motherhood Initiative begins this September.
The fence that separates Mbarara Regional Referral Hospital, where we shadow on Fridays, from Mbarara University for Science and Technology.
The maternity ward at the Kashongi Health Centre III, where the Safe Motherhood Initiative will be monitored.
The purpose of the Safe Motherhood Initiative is to ensure that all pregnant mothers deliver at a health centre, starting with the Sub-county of Kashongi. Carrie and I have been working on the medical records system, a program designed to provide a faster and more efficient form of collecting and storing patient information. After five weeks of research, preparation, and anticipation, it was quite the sight to watch Village Health Team (VHT) members from Kashongi come to an understanding of our mission and look forward to helping us reach our goals. While creating the training manuals, we had some form of trepidation as to whether or not the VHT members would find it difficult to integrate technology into their daily workflow, but I must say, the fervor, enthusiasm, and determination we witnessed during training leaves me no doubt that the community health workers will be able to successfully follow-up with expectant mothers in the field, enter information into the FrontllineSMS application on their cell phones, and send forms to the computer at the health centre. We both look forward to training the midwives this week before piloting the entire system within our last few days here in Uganda.
The medical records system computer and cell phones for the VHT members to use in the field.
A pair of VHT members practicing for follow-up visits in the field.
-Joan