Babies, big and everywhere!

Hey all, time for another quick post. The week has kind of flown by, so I'll just give you a couple of highlights.

I started in "B" ward this week, which is all things OB. I have now completed two weeks in Peds (A ward) and three in Medicine (C ward). It's hard to believe I've almost been here 6 weeks already! I have been feeling bad for my friends Josh and Sarah who were only able to be here such a short time. A lot has changed for me in the past 3 weeks since they left, and I just hope they can make it back sometime to get the full experience. But back to the OB ward. Rounds in the morning go pretty quickly, because if a mother is just a routine post-partum recovery, they aren't seen by a doctor. In fact, if a mother is in normal labor and has a normal delivery, a doctor may never see her at all. The nurses in this ward are very capable, and handle everything that is routine. Part of the reason for this is that, let's face it, women have been giving birth successfully for ages without doctors around. Why let us in and make things complicated? The second reason is the sheer number of births. With everything else to do in the hospital and all the outpatients to see, there just isn't time for a doc to sit back in B ward and deliver babies all day. This brings me to the best story of the week, which is actually two in one.

There I was on Tuesday morning, my second day on B ward, when we saw a woman who had a bit of slow progressing labor. She had also had a problem with retained placenta (placenta was not delivered within 30 min after baby) with her last delivery, so it was a patient we needed to be aware of. We had just finished rounds, and after checking the woman, Dr Niles let me rupture her membranes, my first AROM. We were then about to leave for clinic, and Niles said, "Hey Ben, why don't you stay and deliver that baby?" I was more than happy to, since I didn't get too many deliveries in the States. Sister Sylvia, the head nurse, was going to be there and help me out if needed, so I was feeling okay about the whole thing. Pretty soon, though, it started getting crazy. Women just kept coming in, all in very active labor. Before long, there were about 5 women ready to have their baby any minute, and only 3 birthing stalls! The plan was then to just deliver as fast as possible and get the place cleaned up and ready for the next in line. My lady was cooperating, and as soon as Sister Sylvia came back in the stall with me, the lady started pushing and the baby was out in no time. This was my first unassisted delivery. No picture, though, because our camera was still on the fritz. It was a shame, too, because that was the biggest baby I've ever seen! The final weight was 5.4 kg! (or 12 lbs for you metrically challenged) Fortunately, the actual birth was very smooth, but she once again was having lots of difficulty with the placenta. After about 10 minutes, the placenta started to separate, but didn't completely, so she started some pretty significant bleeding. When the placenta still could not be delivered, I called Niles back to help out. By the time he got there, she had lost probably 2 units of blood, so Niles manually extracted the placenta from the uterus. In other words, the guy was about elbow deep, pulling out pieces of placenta. He told me that now that I've seen it done once, I'm up next. (in medicine, there's this "see one, do one, teach one" thing)

So anyway, we finish with that lady, who is not helping the crunch on space, and we have to hurry to the stall next door where a lady had just delivered a baby, but no one knew she had twins, and the second was coming out breech! Niles wanted some equipment to resuscitate the baby after it was born in anticipation of a difficult delivery, so a nurse went to quickly assemble what we needed. While we were waiting, I noticed the woman standing by the bed begin to moan. Now, I had just assumed she was the watch-woman (wasmeri) who was accompanying the woman giving birth. I quickly realized my mistake when she squatted down and began really moaning. Then she started screaming, "It's coming! It's coming!" Someone threw a clean tarp down on the ground for her to lay on. When she did lay down, the baby's head was almost out already! Niles jumped over and literally caught the kid, cut the cord, and hurried back over to deliver the breech baby. I just stood there flabbergasted saying, "the things you just don't see anywhere else..."

Sorry, that story turned out to be a little longer than I expected! I was a bit disappointed in the lack of pictures as well, but I don't know how many of you would appreciate a picture of a baby's feet sticking out of a vagina. (You must forgive me, it's getting late.) So the other major news is that our camera is now fully functional! Well, almost. The date and time don't really work, but hey, it takes pictures. I definitely won't complain. I learned after the fact that the thing to do when your camera gets wet is 1)don't turn it on immediately to see if it works, and 2)take the batteries out ASAP and open it up to dry. If you are unfortunate enough to drop it into salt water, you're actually supposed to take all the batteries out and then rinse it in fresh water before drying it. Well, we did just about everything wrong. We definitely did turn it on right away (it actually worked for a few seconds) and we forgot about the little watch-type battery that is for saving date/time for about a day before finally taking it out. Somehow, though, it has pulled through and it's condition has been improved from critical to stable. I'll take it.

Today, Dr Andy was kind enough to give me a real day off to go to Mt Hagen to drop off the Batdorff's at the airport and do some grocery shopping. (Dr Niles and his wife Patti, a PT, who were here volunteering for almost three months. I'm not sure who will be in B ward with me tomorrow... probably Scott Dooley who just returned from furlough.) Stephanie, Caleb, and I went with our good friend Judy Bennett (Andy's wife and Sam's mom), and our new friend Gail Dooley and her daughter Olivia, who is just about 5 or 6 months older than Caleb. All in all it was a good day. The ATMs weren't working this morning, so we had to borrow money from Gail for groceries, who was very gracious about the whole thing. At BestBuy (the grocery store), Stephanie and Gail did the shopping while I walked around Caleb, which was fine with me! After one lap around the store, Olivia decided to hang out with the cool kids and came with us. Caleb actually held Olivia's hand (those of you who know big-personal-bubble-Caleb can appreciate the magnitude of that breakthrough) and the two of them had a great time running around the store. Caleb informed me that Olivia has brown eyes, just like him and mommy. Sniff... my little boy's growing up!

We again went to the Highlander for lunch, where I had a burger complete with a fried egg and a piece of ham that was intended to be bacon. It was delicious! Caleb and Olivia had fun in the shallow part of the pool, and fresh off my liberating Suicide Rock experience, I put on my trunks and joined in the fun. Hopefully soon I'll get those pictures loaded up and on here. Stephanie went off with Judy to run some errands while Gail and I watched the kids at the pool, where they discovered the ATMs were functional. So, fortunately, we were able to pay off our tabs we had accumulated since Stephanie's last fateful trip to town where her bank card and money were lost. After that, it was off to the open market and then back home. It was a really weird sensation pulling up to the station this afternoon... this place really has become home to us, albeit briefly.

In other news, two weeks ago there was a huge landslide not too far from here that cut off the only supply line for a very large chunk of the highlands. As a result, there are all sorts of problems coming up, mostly as a result of diesel shortages. The implications are huge, starting with doubling or tripling of prices for public transportation vehicles, meaning people can't afford to come to the hospital or transport their home-grown coffee or vegetables to sell. There are also now starting to be food shortages in Hagen, with increased prices, limits on how much of certain products we can buy, and nil stock of a few things. This will soon affect the hospital, especially with regards to things like oxygen and medication. When the hydro power goes out, the hospital is powered by a generator that runs on diesel. Thankfully, we have adequate stores for now, but that will run out eventually as well, especially if diesel cannot be purchased and the vehicles on station are needed for various things. There is lots of mixed news about the progress being made towards starting to find a solution. This is when some parts of Melanesian culture can get a bit frustrating. Remember these people in your prayers.