Tour of St Francis

Firstly, we are sorry we cannot update the blog more often. Our internet access is very limited and often short. Much has happened since we last wrote. Sometimes, I lie in my bed at night and imagine that I am actually in Africa. Surprisingly, after being here for a while in some ways it is just like any other place. There are people, families, children, work to be done, seasons, bugs, animals. Some people have more money than others. There is a lot of poverty and a lot of sickness and death as a result. At the beginning I was so frustrated at the lack of resources that I had become so used to in Canada. Now, I am still frustrated but also have come to a place where I know we are all doing the best that we can with what we have. The women here in Zambia are strong. Very strong. I feel blessed to be able to attend childbirth in this beautiful country where women are birthing so many babies. Witnessing their everyday work and strength it is not surprising the women here are able to deliver babies without pain medication, without very much actually. At times they could really use more, not only pain medication but so much more. Maybe we should explain the ward first.

St Francis is known as one of the best hospitals in Zambia. It is a referral hospital and quite busy. There is a nursing and midwifery training school here as well. They train approximately 20 new midwives each year. Midwives here have to take 2 years general nursing before applying to midwifery.

Every morning we greet the watchmen at the door wearing their green uniforms. Then we walk down the corridors (which are all outside) until we reach Bethlehem. Bethlehem is the maternity ward. Once inside to the right is the antenatal and postnatal ward where women stay if they have pregnancy complications such as anemia, malaria, leaking of fluid, epilepsy, high blood pressure, or AIDS. Also on this ward are the women who have delivered. Vaginal deliveries usually stay for 6 hours postpartum and then return home. Those who have had cesareans stay for 6 days before being discharged. There is a room in the back called the SCBU (Special care baby unit) and this is where the sick babies stay until they get well or die. It is very hot in there and there are a lot of babies living in the SCBU. Mostly their mothers care for them by taking their temperatures, changing their linens, and breast or cup feeding them. There are no bottles here. The women who have been discharged from the ward but whose babies are in the SCBU have a room that they share sleeping in.

Back over to the right and through some swinging doors is the labour ward. Just before entering the labour ward, there is an area where we do MCH (maternal child health clinic). In this clinic we see women for their pregnancy visits as well as doing HIV counselling and testing. Women who are 6 days and 6 weeks postpartum can come to MCH to have their babies checked as well. The Waiters come here as well to have their prenatal appointments.

Labour ward has 6 plastic covered beds. Beside each bed is a metal pan for urinating and bowel movements. There is no sense of privacy. Each bed is separated by a cloth divider or a partial wall. When a woman arrives in labour or “complaining or backache” she undresses and lies on the bed. If she is lucky there is linen for her. Otherwise she labours on her chitenga or the plastic bed. We do a vaginal exam and she is admitted only if she is already 4cm dilated. We could learn from this idea. Women do not need to be in hospital prior to 4cm! For the most part the women labour alone and in silence. For example, one woman called M.M. was so quiet Aly almost missed her delivery. Her membranes ruptured so Aly did a VE to make sure there wasn’t a cord. M.M. was fully dilated. Aly asked her if she needed to push. One of the Zambian midwives also asked her. She insisted no. So we waited. Suddenly, she called Aly, “Sister” and grabbed her arm, lifted the sheet and her baby’s head had been born!! Aly quickly put her gloves on and helped catch the body of M.M.’s beautiful and healthy baby girl. M.M. was completely silent.