Friday, April 10, 2015

Samaya and Kyla's time at the Tamale Teaching Hospital

During our stay in Tamale we spent five days in the Tamale Teaching Hospital (TTH). After a quick orientation of the hospital, we started our maternity experience. We were introduced to the lovely staff who escorted us to the antenatal unit where we assisted the nurses in antenatal assessments. We felt (attempted to feel) the position of the baby, and then proceeded to monitor the fetal heart rate using similar equipment to what we would use at home. Many of the women admitted to the unit were  there due to various complications, such as UTI's, PROM (pre rupture of membranes), and hypertension. We took their blood pressure and communicated with them to the best of our ability (not one of them spoke English), however we find smiles and waves to be a universal language. Overall, we felt it was a great first day at the hospital, we learned a lot! We spent our second day on maternity in labour and delivery. We were not aware that we had to bring a separate pair of clean scrubs and shoes to change into prior to entering the unit. However, the head nurse on labour and delivery went out of her way to find us the necessary apparel (even though they were a couple sizes too big) so that we could work on the unit. We were incredibly thankful for her eagerness to help us!

Our first experience on the ward was observing a cesarean section. The procedure had already begun prior to us entering the room, and the first thing that we noticed was how big the incision was! The head nurse of labour and delivery explained to us that it was the woman's third c-section, which meant there was quite a bit of scar tissue present on the uterus making the procedure difficult. Once the baby was born, they quickly wiped him off, showed the mother the sex and and his face, and then proceeded to take him to a different room to have a more in depth examination. The mother was then sutured up, and brought to the recovery unit. It was our first time watching a c-section, and we were relieved that everything went well for both the mother and baby.

Kyla and Samaya suited up.  
 We then intended to grab a quick drink of water when we heard a mother in labour while walking by. We were invited to observe, so we jumped at the opportunity to perhaps assist in a delivery. Once we walked in the room, we noticed that the baby was already crowing, and we didn't even have time to grab a pair of gloves to assist. We were however able to witness the mom deliver a healthy baby girl. At first, we noticed that the baby wasn't crying, and we were both holding our breath, concerned with the wellbeing of the baby. Just as we were about to question why the baby wasn't crying, she cried! We were so relieved and happy that all was well. After the delivery we were busy admiring six newborn babies present in the room from various mothers (Kyla asked if they all had the same mother as there was only one mother in the room-the nurses laughed). We then noticed a nurse enter the room carrying something wrapped in a blue pad in her arms. We didn't see what it was, but she asked Samaya to pick up one of the newborns residing under a warmer. Once Samaya picked up the newborn she glanced over at the nurse, and noticed a very premature baby being placed under the warmer, Then, the nurse casually asked someone to grab an ambu bag (as casually as asking for a glass of water), and then proceeded to start CPR. The nurses were looking for an ambu bag but there was none to be found in the room. Kyla then remembered seeing one in the operating room, so she ran there looking for it. Due to the language barrier the staff had some difficulty understanding what we were requesting, but with assistance from another nurse, Kyla was able to obtain an ambu bag and bring it to the nurse giving CPR. We noticed that there didn't seem to be the same amount of urgency with the medical emergency that was taking place as we would see in Canada, however we later learned this was because the hospital did not have the necessary resources to care for such a premature baby. The nurse was attempting to perform the entire resuscitation independently, as the other nurses were busy with the mom who had just delivered.  The both of us then stepped in to help the nurse to resuscitate the small baby. Kyla was administering respirations with the ambu bag while Samaya performed chest compressions. Eventually doctors arrived and attempted to place an artificial airway, however due to the lack of proper sizing of equipment it was unsuccessful. The nurse who had originally brought the baby in the room made the decision to stop resuscitating as there was nothing more that we could do, as we had exhausted all possible life saving interventions. It was very difficult for the both of us to take part in the situation, as we felt that we were essentially 'giving up' on the baby. After a few days of processing our thoughts, we came to the realization that the baby may not have lived a normal life due to being 15 weeks premature. We were both thankful that the baby is in a happier place, free of pain and suffering. It was a tough thing to come to terms with, but we feel we learned a lot from the experience.

Samaya & Kyla

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