Kampala

Sarah and Lyanne arrived in Kampala on Thursday.

Friday and Saturday, we went to Ward 14, the "low-risk" ward at Mulago hospital. The walk between the hospital the guest house is always exciting, with giant ant hills, busy streets filled with cars and boda-bodas, and the occasional cow hanging out on the narrow sidewalk. The soil is red, and a fine, red dust ends up covering everything, including the white scrubs and shoes that we wear every day at the hospital.

The hospital corridors are all outside, and women use the surrounding fields to do laundry by hand. The ward itself is very well organized, by local standards. There are about 12 beds, divided into four "rooms" by pink curtains, so that there is some semblance of privacy, though women can certainly see, and hear, one another in labour. Women on the low-risk ward have to have been to at least a couple of antenatal visits, and women with any risk factors (high blood pressure, breech baby, slow progress) are transferred to the high-risk unit.

We've had quiet days so far, with a total of only three births, all of which went very well. Most of our work has been assessment and triage. Women arrive on the ward, and wait patiently on benches. They are examined in the hallways; those in active labour are admitted to one of the beds, while those in prodromal labour are sent back outside. No visitors are allowed on the labour ward. Women bring their own plastic sheets for the bed, bleach, baby blankets and cotton wool; some women also bring syringes and sterile gloves. Labouring women are re-assessed every hour or so, but otherwise they are left alone until right before the baby is born. After the birth, women are expected to clean their bed and the floor before they are discharged to the postpartum unit next door.

We have also dropped by the antenatal unit (which sees 300 women a day!) the pediatric units, and the high-risk labour ward. Although we were only on the high-risk ward for an orientation, we ended up doing a newborn resuscitation as soon as we stepped in the door. We saw one of the women who had been transferred from Ward 14 for slow progress, labouring on a mat on the floor, waiting to be seen by a doctor or midwife. It's clear that the doctors, midwives, and nurses here all work very hard and do the best they can with limited resources, but that ultimately they can only deal with the most urgent situations as they arise, and everyone else has to wait.

After work on Friday evening, we went with our instructors to the local market. It was quite the experience -- blocks and blocks of vendors, setting up on tables or on tarps on the ground, selling everything from fried grasshoppers to shoes to clothing -- like a Canadian flea market, magnified, with boda-bodas and cars driving through the middle of it. We really were shining beacons of whiteness -- everyone was quick to identify us as "mazungu" (foreigners) and encouraged us to buy whatever they were selling, but we managed to resist their encouragement. Saturday night we celebrated a birthday at the local Irish pub -- it advertised "sports night," but unfortunately they weren't willing to switch from the rugby game to show us the Canucks. :)

Sunday we're back to Ward 14, then on Monday we head for Mbale.

Posted by Lyanne and Sarah