Mazungu = white tribe

     I’m feeling my whiteness today. Theoretically I knew we blinding white folk would be quite the stand-outs in Uganda, but it is hard to get used to the attention our (lack of) colour earns. Little children wave enthusiastically or run up and hug us, adults blurt out “mazungu!” seemingly without meaning to, and everywhere we walk we have dozens of eyes on us.     
     Today was our last day on Ward 14 for a while. It’s been an interesting three days – although we have only made it to six births since we’ve been here, we’ve had quite the range of experiences. As Lyanne posted, we stepped onto the high risk ward yesterday for an orientation and to follow up with two women who had been sent there from Ward 14 earlier in the day. Immediately to our right as we walked in, there was a midwife calmly drying a newborn at the resuscitation table. We don’t know when this baby was born, but it was immediately clear that it needed a lot more help than just drying. Angela stepped in and began ventilating the baby, while we checked heart rate and air entry into this little babe’s lungs. Heart rate continued to decrease, despite our best efforts, and when it went below 60 beats per minute I began chest compressions. Lyanne took over the ventilating. Although we did everything we could, by Ugandan standards (there is no intubation or epinephrine here for neonatal resuscitation), unfortunately the baby continued to decline and eventually its heart stopped beating. This is the first death of a term infant Lyanne or I have been present at. Both of us seem to be coping well with the outcome, but I can’t know if that is more or less healthy than if we were very upset by it. Neonatal death is by no means rare in Uganda, and I feel confident that we took every action available to save that baby. The most upsetting thing for me in this process has actually been that we have no idea who the mother of this baby is, and had no way to inform her of her baby’s death (the midwife who had been there initially had disappeared somewhere while we did the resuscitation). Of course, even if we had known who the mother was, there is no guarantee she would have spoken English, but it felt very disconnected to wrap up this beautiful lifeless baby and not be able to offer anything to it’s mother.
     Following this experience, we walked back to Ward 14. I went in to assess a second-time mom in labour, and was about to take her blood pressure when her water broke. Lyanne was by my side, and cleverly suggested we check her cervical dilatation prior to blood pressure – turned out there was no need as her baby’s head was visible with the next contraction. We all scurried around getting on aprons, goggles and two pairs of gloves (our protocol for every birth in Uganda, regardless of HIV status), and baby was born 10 minutes later. There was a tight cord around the neck and I got to try out the somersault maneuver for the first time, which worked like a charm. After unwinding baby I passed him right up to his mama. He was crying, healthy and gorgeous, and his mom transitioned into her postpartum beautifully.
     Yesterday was Lyanne’s birthday (Happy Birthday Lyanne!!) and coincidently my half-birthday. It seemed fitting, in some way, to see both ends of the spectrum: a death which likely could have been prevented had the resources and technology been available, and a life which would have slid easily into this world with or without our help.
     Tomorrow we move on to Mbale, a five hour drive by bus, and we begin our work in the hospitals there on Tuesday.

Posted by Sarah