It is hard to believe the end is so near. Like many a great adventure it feels as  though I have been here a lifetime and that I only arrived a moment ago.

I have gained so much experience and had so many experiences that I doubt I can describe them to anyone and yet they will profoundly  inform the Midwife I am to become.

not really but it made for some good jokes

Last weekend we took a break and met up with our colleagues in Jinga at the Kingfisher resort. Friday was a long travel day and we concluded with a “joyfull reunion”, a swim (in front of an audience of 50 or so muslim school children) and dinner.  It was also Angela’s birthday so we had another reason for celebration.

Saturday morning Alix, Zahra, Rachelle and I were picked up at 7:30 and transported to a spot further down the Nile. The Kingfisher resort is at the mouth of the Nile on Lake Victoria. We joined a group to go rafting down the Nile! We had an amazing day. It began with lessons on how to survive the overturning of our raft and Rachelle got a suprise ducking by our guide. Once he was sure we all knew what to do we started off. Immediately we reached the first rapid and our guide told us that unfortunately the river was too high and we were going to have to get out and walk around. We steered to shore and a guide grabbed our raft – but he couldn’t hold it and we shot backwards down the rapids! We were all shocked and exhilarated when we spat safely out the other end. Our journey continued with a leisurely drift and swim and a series of rapids. In one we flipped over entirely and in another we tipped to almost a 90 degree angle and everyone on the right hand side of the boat was lost, this included rachelle. The rest of us stayed in the boat, barely.

We ended with lunch about 2pm in a lovely spot over looking the nile and then were transported back to the kingfisher for more swimming, resting and visiting.

Sunday we took a lovely and sedate cruise out onto Lake Victoria, to the mouth of the Nile and up into the Nile. We saw many different birds, and some monkeys and enjoyed the beautiful scenery before returning to the Kingfisher for more swimming and lounging.

Later that same afternoon we departed for Kampala and the next stage of our journey.

Rachelle has borne the brunt of the blog posting so I thought it was time to step up to the plate with more than a few photos. Which are hard to add due to the slow nature of most internet connections I have come across so far.
Uganda is a beautiful country with red roads and lush greenery. There are flowers everywhere and the people favour brightly coloured clothing.
The hospital in Masaka is large, covering the grounds of a compound with various buildings for ART therapy (HIV/AIDS), antenatal, labour and delivery, a women’s ward and men’s ward, a canteen, and much more. I love the fact that the storks hang around outside labour and delivery.
Inside the labour and delivery ward is very crowded. The hallways are narrow and the building is in a t shape. You enter on the short arm of the t and straight ahead lies the family planning, a rustic toilet and ward 11 known as the Happiness ward, to the left is assessment, 1st stage room, delivery, and finally ward 9 which is high risk antenatal and to the right is post Cesar (as it is called here) and anyone else who may need some nursing care post birth. On the right arm of the T also lies the neonatal unit.
The floors are cement, the lights are minimal and often turn off, the staffing is low, there are never enough staff to accommodate all the people and the smells are very strong. You learn to mouth breathe quickly but then sometimes you can still taste the smells.
We spend our days in delivery and 1st stage, we are not very usefull in assessment due to the language barriers but are sometimes called in to do a VE to help with the assessment.
Quite often women deliver in the assessment room or in 1st stage either because the beds are full in delivery or because they didn’t get moved on to delivery in time.
The delivery room has three beds and sometimes we have a stretcher in there too to accommodate one more, this gets awkward as it ends up in front of the sink and you spend the entire delivery trying not to fall in the bucket of Jik (this is the bleach water we use to wash the beds and floors).
Clean up is the least favourite job as it involves squeegeeing blood and other muck across the floor to the drains.
The nurses/midwives work very hard here as there never seem to be enough on at a time. There have been days where there are only one or two in labour delivery and babies can come in three’s. Not enough hands.
We are learning a huge amount. I came to Uganda still feeling a little unsure about myself and the skills I had acquired to date. However after just over two weeks I feel like my skills have solidified, that my new learning is coming in leaps and bounds and I feel ready to move forward with my midwifery in Canada.
The women here are so amazing. They come in, and labour, often alone or with little support. They don’t complain, they don’t have access to pain medication, and they just have their babies, get up, shower and wander off to Happiness.
Sadly however, they sometimes come expecting help and there are too few resources, not enough doctors, or some other problem that means they don’t receive the care and attention they need until it is too late. There is a very high maternal and neonatal morbidity rate in Uganda.
The other day a family came to get their baby off the shelf; this is where our little ones who did not make it are placed until the family comes. All of a sudden there was a commotion and I was being summoned. The family thought the baby was still breathing and they wanted me to check and make sure it was really dead. I did as they asked of course, listening carefully with my stethoscope and let them listen too. It was very hard to watch their loss and not be able to offer words of comfort or at least compassion.
There are very funny moments too, the women have good senses of humour and seem to enjoy having us around even though we have to act out parts of our conversations or have very basic ones. I can tell someone to push, and to not push, to roll to their side, and to pant. My favourite is “cabina” for bottom. We get lots of laughs asking them to move their cabina, or telling them, “no hanky panky” after we stitch them up.
Some days are hard but most are amazing and I am very grateful for the opportunity to be here.