Wednesdays are crazy days at Nyahuka Health Center. I spend the morning conducting an ultrasound clinic adjacent to the HIV Care and Treatment Clinic. I see a variety of obstetric, gynecologic and pediatric cases. But, mostly I am there hoping to catch HIV+ women in for routine HIV care so I can quickly scan to confirm their dates, do some continuing education about their pregnancy/HIV issues, and try to build bonds of trust with the medical establishment. Today, one of our HIV+ moms was in the "walking around stage" (active labor), but the midwife on duty (Judith) was concerned about the baby's position. Indeed, her scan showed the baby was breech and still very high in the uterus. Judith was not comfortable delivering her at Nyahuka and asked if I could take her to the hospital so that emergency surgery might be available if necessary.
"Fine, no problem. How, many centimeters dilated is she?" "Ten centimeters, doctor (fully dilated--7th baby)". "Judith, she's going to deliver in my truck on that bumpy road!!" (No response. Awkward silence.) "OK, Judith. I'll take her. Get her stuff and her people ready."
Ten minutes later, the patient and her belongings appear at my red LandRover with their pots, pans, mattress, etc.. And Judith. "Doctor, I am going to come with you just to make sure she's OK."
So, we proceed, bumping, jolting, groaning over the twelve kilometers of undulating road which appears more like a rutted, rocky riverbed than a road. One hundred meters from the hospital the passengers in the back bang on the glass. "Slow down." "Is she ready to deliver?" "Yes." "Then shouldn't we speed up?"
We pull into the hospital parking lot and I hop out. The baby's hips are out. Judith applying traction gently, expertly. In typical fashion the crowd gathers, gawking, staring without one bit of respect for the fact that this woman is totally exposed in the back of my truck. I move the truck trying to position it to protect the patient. No time to move the mom. A few minutes and the baby is out.
"Webale Kwejuna" (thank you for surviving). "Webale kusabe" (thank you for praying).
One more thing.... it was a boy. Baby Obama.
We turn around and go back to Nyahuka Health Center, the baby receives his medicine to prevent HIV transmission from his mom... and the mom walks home.
(Note: cell phone photos...apologies to the shy).