Thursday, September 4, 2014

Push!! No no, don't push!!

I felt like I was in a movie. A low budget, confusing, irritating movie, but a movie none the less. Here is how the story begins. I had planned on checking in on the VHWs (village health workers) in Nakayot and dropping august's meds off to them but after spending the night in Lormoruchbae listening to it rain for hours I knew my plan might be changing. I packed up the truck and headed out with several guys from the village to just see if it was possible to get out there anyway. Well... we made it 2/3 of the way before I miscalculated and slid down into some bad ruts where the mud was just too deep. After more than an hour of slogging around in the mud, sweating, digging it out from around the tires, cutting branches and piling stones and a lot of good natured pushing we got unstuck. After a brief discussion the decision was made to continue on. It was mid morning and the sun looked like it was going to really dry things out so we'd head on to Nakoyot, spend a few hours there and then we should be able to make it back through later in the day. That was the plan at least. Until we got stuck again 5 minutes later.  Two guys headed into the bush at a jog and it was explained to me that Nakayot was only a few km "through the bush" (translation: as the crow flies) so they were going to recruit more man power. They came back with several more guys. At this point I suggested we just unload the meds, and they carry them into the village and we just leave the vehicle until the mud was less muddy but no one except me seemed to think this was a good plan. And as I wasn't the one pushing I didn't fight with them. They pushed the truck out a lot faster than the first mud hole and it was smooth sailing the rest of the way. After we got into the village I set off to the home of one of the VHWs but had not even gotten there when some women came running up to me. There was a woman in labor and would I take them to the hospital?  (But if you are still trying to picture this as a movie you need to have in your mind several women yelling at me in a language I don't really understand in the middle of a very remote village, covered in mud, struggling to figure out what their crisis was.)  They led me to the home where in a dark, smokey hut a woman girl was laying on the ground. At this point one of the VHWs found me (but they don't do birth as they are all men and that is NOT a man's thing here) and translated for me that she'd been in labor for three days and the women were sure something was wrong. The girl looked exhausted, pale and was clearly dehydrated.  After listening for fetal heart tones and getting numbers persistently 180+ I decided that was all the exam I needed to do and we were going to brave the terrible road about 6 hours earlier than I wanted to. The patient, her mother, mother-in-law, sister and daughters to the sister all piled back into my truck together with a basin, blankets, a jug of sour milk and 10 kg of sorghum (to pay the hospital fees) and we set off again. Very shortly we got to the place in the road where we'd been stuck before. I got out and walked it first to see if there was a better way through. But the road was just too slippery and I couldn't keep the wheels out of the deep mud. The women all hopped out. I did have to give them a lesson on how we needed to rock the vehicle but once they got that I had to just shake my head that the women were clearly far stronger then the men that had been pushing 30 minutes before. We made it though quickly and everyone scrapped the mud off their bare feet and legs and piled back in and we set off once more. I was trying to watch the patient and had to ask "Is she pushing?!". “Of course” is the answer I got back. “You tell her to stop pushing!” It was at this point that we hit the initial muddy place where we'd been stuck so long before. I had been praying pretty hard by this point and there were all the branches and stones we'd already put there and the sun had been drying things out for a bit and these women took their vehicle pushing very seriously so we managed that .2km in less than 25 minutes! I did take a few minutes when we were stopped the second time to throw in a line and hang some NS as the patient wasn't even keeping down sips of water (or sips of the sour milk which is what the mother-in-law kept insisting on but I over ruled and told them they had to use water instead) but then we were on our way to the hospital and got there in less than 2 hours. And by 6 pm she had a little girl. It was determined the mother had a bad case of malaria and there was a lot of meconium at birth so I'm really glad for the sake of both the mother and baby we made it to the hospital. And by 10 am the following day she was already back at home.  And they all lived happily ever after. The end.It was at the point where I was leaning out the window yelling “push!!” and then looking over my shoulder into the back seat saying “But not you. Don’t you push!” that I felt like it was the script for a bad comedy. All we needed was a sound track. 

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