Gugulethu: HIV/ AIDS treatment & A Birth

Wow, what an amazing week.  I honestly never thought that one week would have such an impact on me.  While I still have a lot to learn and experience I can now say that I’ve worked abroad in a health clinic, taken blood pressure, worked with HIV+ patients who have noncompliance issues, saw a woman deliver a baby (more to come) and test urine for pregnancy and abnormalities.

The doctors and sisters at the clinic quickly grew to love us and showed sincere gratitude for what little help we were able to provide.  Our teacher put it perfectly for us as we discussed our work in the pharmacy packing bags of medication for patients—though the work was boring and tedious and not always as exciting as working with the patients themselves, we helped over 300 people get their meds for the following day. 

Today in class we discussed the issue of the government intervening in healthcare.  The problem? No one knows where to begin.  These people wait all day, literally, for sometimes even the simplest issue such as a headache or sore throat.  Whether it be the lack of education that leads them to conclude they need the doctor that badly or not they’re still sitting there.  The conditions of the clinic are as good as they can afford with the resources they have but sanitation is a serious issue.  Even the nurses working in the HIV clinic lacked some of the knowledge of what exactly ARV drugs do to stabilize or improve the condition of someone with HIV.  I have never experienced something so frustrating—from sanitation to the management that leads to the patients lining up at the door at 5am when the clinic opens at 8.  The worst feeling is knowing that something could improve but no one knows how.

As for the fun and exciting part of the day:

After thinking that I had missed my opportunity to see a birth in the maternity ward I was pleasantly surprised when we were passing through the department and heard screams from one of the women in the labor room.  The women are placed in one of three rooms—the room for post-delivery where there were about 10 girls (very young teens to older) with their babies, another room where they lay waiting to dilate enough for labor and then the delivery rooms.  The woman was pacing and grabbing the beds in the pre-labor area and we were told she was 8cm dilated.  Our best decision of the day was to skip the beginning half of our lunch shift because within 25 minutes she was ready to push. 

The conditions are soooo different from an American hospital—there are no men or family allowed in the Maternity ward (MOU).  The women are by themselves and know when they are ready to go to the delivery beds.  Until then they are pretty much on their own.  Sister nurses and mid-wives are the ones that deliver the babies since there is only one doctor for that ward and she is shared amongst about 5 other clinics and only comes once a week.

This particular woman was HIV+ and I was extremely surprised when the nurses did not take more precautions with her than another HIV- patient.  They helped her to get in the right position and then instructed her to push—no fancy breathing or hand holding.  The woman was in extreme pain but was alright with us being in the room which allowed for us to have such a great experience.   The tools used come in a big metal bucket along with some towels and gloves.  We stood behind and had a full view of the whole birthing process.  To be honest I didn’t know if I would be able to watch the whole thing (especially the after birth) but I realized that I would most likely never get the opportunity again so I grabbed Emilys arm and watched the whole process.  When the baby was finally cleaned and began to cry the mother just started whispering, “thank you jesus” over and over again.  It was one of the most amazing experiences I have ever had.

One of the most interesting aspects of the birthing process in this clinic and I believe South African culture is that the baby is cleaned briefly and placed directly on the mothers stomach with a blanket—no incubator or taking away for minutes/ hours for tests.  They do this within a few minutes of mother/ child connection giving time to create an instant connection. 

Tonight we are having a Braai (BBQ) with our RA and made a trip to the pick and pay (grocery store) to get cider and frozen mojito mix.  Up early tomorrow to visit the more touristy area and see the water front!