Well Hello Africa

I don't know how to pre-empt this, so I'm just going to spit it out.

I watched a woman give birth today.

Yup.

Let this fact sink in for a minute.

Okay. I know I haven't posted anything about my internship yet but this little fact was something that just couldn't wait. Prof Rode (the doctor I work with...he goes by Prof) gives consultations at a health clinic located in Kayelitsha, a township right outside the city, every tuesday morning. A township is technically an area where people (specifically "Blacks" and "Coloureds") were relocated under the Apartheid policies and thus are very underdeveloped and essentially like slums.

Today I accompanied him, along with 2 medical students from Belgium, to his weekly visit. He asked if I wanted to watch a woman give birth, and hey, who am I to say no? So I did. Now, I don't have any point of comparison with how this is done in America but I know for a fact that it is VERY different here. There was no real fussing over the woman. I believe she came in a few hours before, walked around until she/the baby was ready to pop out, and then when it was showtime she lay in a bed that was closed off by a few curtains and within 20 minutes was off the bed again. They told her to push, she pushed, the baby came out, and that was that. I can't describe how nonchalant the atmosphere was. There was no real set-up beforehand, no monitoring of her vitals, no family in sight (apparently it is very very rare to see the father or anyone else around), and when the baby was out the nurse grabbed him by his feet, and held him upside down for a few seconds for mom to see her progeny. It was just the mom, 2 nurses, a baby, and 3 foreigners. The mom was 20 years old and this was her 2nd child. She would be sent home after 6 hours.

Now, if you're interested, a little something about my first day at my internship.

Last Thursday was the first of many days that I will spend at the War Memorial Red Cross Children's Hospital. Lets just say I was thrown right into it.

Once I arrived and found the doctor I will be working with he almost immediately handed me off to a medical student to put me in scrubs and take me to Theatre 3, the burn unit operation room. Perhaps a little background before I get into the nitty gritty:
This hospital is solely a pediatric (or paediatric, as it is spelled here) hospital. It is an absolutely amazing establishment because it has world-class facilities and the majority of people that come here for treatment can walk away without paying anything. The Doctor that I am working with used to be the head of surgery and now focuses his attention on the burn unit. This is, of course, a pretty depressing place to be. On our first visit to the hospital it was quite a shock to everyone to see these children all bandaged up, especially once you realize that pretty much all cases could have been prevented.

Okay, so I wear these scrubs and am taken into the room to observe. I have never watched a surgery before, let alone on a child for burn wounds.

At first I was standing awkwardly in a corner, just trying to stay out of everyone's way (even though the room is quite large) but it became apparent over time that people here don't mind. They are used to having students in the room and are really open to telling you what they are doing and answering questions. I ended up being in the surgery room from 8:30 a.m until 2:00, and watched 6 different patients. The first one was the most major, because it was skin grafting for almost the entire body of this 3 year old boy. It is not for the faint-hearted, and I did have to leave the room once (the room is also kept quite warm because the children don't have the usual protective layer of skin so it gets real hot in there). 2 other cases were small skin grafts and 3 were just changing of bandages. It was hard to watch, but I did get used to it and began to really understand the process and could predict what the surgeons would do next. So, if you ever want to know something about skin grafting, you know who to call. The sad thing is, as I mentioned before, that all of these cases could have been prevented. These burns were caused by living in small shacks where generally the kitchen and bedroom are in the same space and the cooking is done on ground-level or it is easy for the child to hit a kettle or boiling water onto themselves.

When it comes down to it, seeing these things as an undergrad who isn't even really pre-med can only be attributed to being in Africa. I could have had a much more hands on role in the clinic today if I actually knew anything about giving birth. T.I.A y'all.