I’ve been hanging out with Vicki Chan. She is here until
Tuesday so I am having a fairly thorough orientation into FreMo, Nairobi,
Kenya, the staff, the markets…. Everything she can think of she is sharing. For
that I am grateful.
On Saturday we started the day with a meeting. It wasn’t
long before the meeting turned into an active birth workshop with Vicki and the
other staff. There are two midwives here – Magadalene and Penina. Mercy is the midwifery
assistant. Fred is our doctor and he lives not far away. The other staff are
clinical officers. Their role is that of junior doctor for all the non
maternity cases that walk in the door, and a cross between PHO/Registrar for
maternity. I say that but I have never, ever, ever seen a doctor care for a
woman in such a midwifery way as these clinical officers do. It is beautiful to behold.
Rocking it! |
Vicki is a totally complete and accurate encyclopedia of
active childbirth. In the couple of hours we spent together I think I’ve learnt
more about active birth than I ever had. If you ever get a chance to have a two
day workshop with Vicki, then do NOT hesitate.
Exhaustion or Relief... you choose! |
It costs 4800 Kenyan shillings to have a baby at FreMo. Currently that is about $57.60. For that they get birth, a room, food and postnatal visits. And not surprisingly, many women can’t afford it, some work on a payment plan so they start paying it off when they know they are pregnant. Some can’t pay, and Moffat works with them. Sometimes they continue to pay little by little in the postnatal period. Sometimes they don’t. Moffat is working on a system where instead of insisting they pay what they can’t give, he gives them a plot of land in a block he is renting, gives them a startup fund and they can grow vegetables there. They can use them to feed their families and they can sell them to finance their family and to repay debt. He gives this to the women.
So, 26 hours after this woman went into labour, Neil Obama
was safely brought into this world to join his three sisters and older
brother. We all breathed a collective
sigh of relief, shed our emotional tears quietly and whispered our gratefulness
to whichever higher being was watching for her that night.
Welcome to the world |
My turn for a cuddle while awaiting the placenta |
But wait, there’s more.
There is only one staff member on overnight. We are living on site so it doesn’t seem
right to simply walk away when there is business about. We continued that
night…. Another multi with a K36 delivered through what looked like infected
liquor…. Baby took a couple of breaths and decided it was too hard. After about
5 minutes of active resuscitation (the best you can do with only a neonatal
ambu bag) she decided that she would breathe by herself. There was another
collective sigh of relief.
Ivy looking sweet as!! |
Meanwhile next door,
an 18yo primip was going slowly. In the wee hours of the morning we detected
fetal distress at around 6cms, high head, slow progress. The decels were deep,
long lasting and variable. There was no need to rupture the membranes to know
there was also meconium liqor… the thickest, greenest I have ever seen. Again,
she refused transfer. We talked with her about her baby dying… she knew more
about life and death than we did…. She would rather die here than go to a major
hospital. We slowed down with the fetal monitoring, listening in around every 5-10 mins. We only needed to know how active to be with the resuscitation when the
time came. The Mamma asked us to pray for her. Vicki did – out loud and with
passion. There were more tears. The young mamma was so brave, she worked so
very hard and pushed that baby out in under an hour. The beautiful little one came out crying God
Bless Her and yet again, we are grateful for a miracle
Vicki helping mum to bond with her baby |
This is Vicki and I doing a selfie with that euphoria when
everything turns out ok, at 5am at that silly time all night duty people will recognize after we have been awake since 6am the previous morning.
Looking fab after being awake for 23 hrs..... but wait, we didn't get to bed for another 4 hours!! |
FreMo in the quiet and still of early morning. Three mammas
and babies resting quietly, two midwives and a clinical officer taking a cup of
well earned Australian style tea. We
have definitely earned it.
And so, off to bed…. But only for a couple of hours. More adventures to come!!
And so, off to bed…. But only for a couple of hours. More adventures to come!!