Yesterday I went to the Singida hospital. I met up with Brad and Nicole, the pre-med students that are working there for the summer. We take a quick tour of the facility. It is FILTHY. Absolutely filthy. Dirtier than my garage at home. The building is one storey and made of cement. The walls are covered in peeling paint and the heat is unbearable. The place reeks. Some of us cover our noses. Outside, women sit along the cement, waiting. Waiting for test results, waiting for loved ones, waiting to have babies. We tour the pediatric unit. We can hear a small boy screaming and screaming in the minor treatment area. It’s tiny. The beds are leather benches. In some of them are a mother and more than 4 children. If they can't all fit in the bed, the sickest children get priority and the healthier ones sleep on the cement floor under the bed. We pass a tiny boy with AIDS. I will never forget that. His face is sunken, his arms are so thin, it’s hard to imagine him raising a hand. He just stares out the window. He’s 11 years old.
This unit is filled with TB, Malaria, Parasites, bowel obstructions, malnourishment. As we walk through, the mothers smile at us. They think we are all doctors here to help them because we are white. No one asks any questions. I talk to a few people, they want photos with us. Mzungus are the height of interest. We walk into a small storage room, where a premature baby is kept. The “incubator” is a box filled with Katangas (fabric that the women wear) and there is a bare light bulb overhead for heat. The baby is TINY. I want to take it home with me and give it immediate medical attention. I just stare.
Nicole tells us about the facility as we walk. There is no medication. No analgesics. No sterile technique. The supply cabinets are bare. No autoclave. No running water. They boil instruments when finished with them. I’m appalled. This is disgusting. It’s scary and disgusting. We keep walking. We end up in the OB/GYN unit. This is where everyone lines up to give birth. There are 3 beds. By beds I mean leather benches. Filthy, no coverings. The sharps container is a 10 gallon bucket. There is a hole cut in the lid and it’s only sitting on top, as the bucket is overflowing with used needles. There are drops of dried blood on the lid. I am paranoid that I will accidentally kick it over. In the other corner is a tin bucket, filled with urine. The women all pee in here. In the corner, in front of everyone. There are no curtains.
The beds are in a row and 3 naked women lay spread eagle. Filthy Katangas barely covering them have been removed. They make no noise, save for occasional grunting, sucking in air sharply with each contraction. Remember there is no pain medication. All 3 women are having their first baby. One is 20 years old. 2 years younger than me. The look on her face is fear, but she doesn’t say anything. I feel wrong standing here, looking at them like this. But as Nicole says, “TIA” (this is Africa). It sure is. Just then a woman grunts. The baby is crowning. She walked 40 Miles to come here to deliver. We wait. It’s just me, Nicole, Anna and a nurse who graduated from DAR 2 weeks ago. We tell her “pole” which means sorry and tell her to push.
The baby arrives. They don’t do episiotomies here and the woman receives a second degree tear, exacerbated by the fact that she has been circumsized. They all have. These women are exhausted. She finally pushes the baby out and it utters it’s first cry. It’s a boy. We weigh him “3.3Kg” that is enormous here. We smile. I gaze upon the baby's new face. I am a stranger. I am the first thing he sees in this world. I feel so…strange but wonderful. I hold him and smile and smile and tell the mother “safi sana.” Her eyes are closed and I don’t even think she hears me. Anna and I hold the baby while she delivers the placenta. The other women are all watching, minutes away from delivering their own. There is no privacy. Everyone is going through this with an audience. I thank God that I was born in Canada.
The evening supervisor asks us about medicine in North America. He can’t understand how we can have epidurals and machines to do things like check vital signs. We tell him that it is to avoid pain. He doesn’t understand. Neither do the other nurses. They think that this is so funny, that women in North America can’t handle childbirth and do all of this to avoid discomfort. They look at me like I am from an insane land. Maybe I am. It makes me think about our culture and how we spend every second of our lives trying to avoid reality. We’re so ungrateful. We sue doctors. Here they kiss their feet. What is wrong with us at home? How did we become so selfish? I give the baby to his mother and she sees him for the first time. They just lay there, looking at each other while she is sutured up. It’s powerful. I can’t believe I am standing here. I just walked in off the street. TIA is right. Nicole tells us that they have about 13 babies a day. More are on their way as we leave the hospital.
We go for dinner and say goodbye. We’re told there aren’t enough beds in Mvae and the work is almost done. I’m going to Mghumbu instead. It’s a larger site and there is more to do apparently. Interesting. It was so sad saying goodbye to Musa. I’ll never forget him, he’s one of the coolest people I have ever met. He IS Africa. Today we meet up with the people staying on at the villages. It’s just us now. Us volunteers and a guard. Thrown into a village in the middle of the desert. I am SO excited. Everyone we met who has done it has just raved about it.
We go to the market and haggle for groceries and supplies. I buy a Katanga for my bed and a blanket. Outside we meet 3 street kids. 2 of them are best friends. Duma is 5 years old, he lives on the street and his friend who is 8 takes care of him. The 8 year old smokes and drinks and is very wiry and tough. But they love us. Duma jumps into my arms, tries on my sunglasses, kisses my cheek, holds my hand. They keep asking for me to take photos with them. They cuddle us and laugh. I can’t believe they live on the street. They are filthy, barefoot and scabby with runny noses. Duma is so cute I just want to keep him. They hang around our necks like monkeys. We dance with them, teach them high fives and to say “cool dude” I love these little street kids. I love this place.
We are going for lunch now, then heading out to our remote villages in a jeep. Everything is still wonderful. I am continuously amazed by the culture. The days here seem to last forever. I met a woman today who is a medical worker. She is old, maybe 70 and she does AIDS testing. She says she has been here 22 years. She was white, from America. She was so sparkly and happy. I want to do this. I am going to come back to this place to work. Don’t worry Aaron, I am having the time of my LIFE here. This is where I always wanted to be and it is better than I dreamed it was. Bad things happen here all the time, but there is so much good, just walking down the street, you can’t help but love it.
