Danish pastry

The hospital is now full of Danish visitors, the great and good of Maternity Worldwide Denmark and also, suspiciously some researchers from a University. There is a stakeholder group meeting to which I am invited and it transpires that they are trying, with the help of poorly projected, overcomplicated powerpoint presentations (yes they get everywhere) to persuade the clinics to buy into a project whereby women can contact midwives on mobile phones for advice and receive health promotion texts. This is a big sell following moderate success in Madagascar, a small relatively flat island, with it must be said similarly poor obstetric outcome.
This area of Ethiopia is mountainous, with patchy reception and the most vulnerable would not know which buttons to press even if they could afford a phone, however they will press on regardless. Possibly more important if not the purpose of what I suspect is already funded research would be a decent transport infra-structure to get people to hospital, but the ranger motor cycle ambulances are tied a customs shed in Addis helping fill the coffers of the Ethiopian revenue authorities.
A morning of discussion of mobile phone coverage is more than I can take so I return to my on call….big mistake. Three Caesareans, emergency kiwi cup delivery (tip, if you are reusing a kiwi cup for the nth time and all the sponge rubber has fallen out put a gauze swab in the cup but be careful to make sure you count it. Two babies very flat so getting access to oxygen concentrator and prophylactic sugar as blood sugar monitor still sans battery. Allow American ‘resident’ with prolapse tourists to do two Caesars and a breech extraction-sadly a cord prolapse that has been out for some hours so she cannot do too much harm, though the cervical descent suggests that she will soon be getting a dress and shoes during the next prolapse tourist visit. The baby is left in the room next to the mother in a plastic bag, as she looks on at the asphyxiated babies lying there and little Jabba. It is indeed a heartless place sometimes, correction most of the time. The Caesar baby looks a little tachapnoeic but not much more I can do and Karen had a nasty surprise in the midwives sleeping and kettle room, but to find out what you will need to visit her blog – may be fewer sleeping midwives though. Sadly the very asphyxiated baby of the night before died today. As I am on call I have had to watch others drinking the red wine which was very sad and no film night.
With all this going on Jabba was getting a little hungry so I fed him his 4.30 feed at 5.30 and his 7.30 at 9.30 having re inserted his tube-those little hands are very active.
I spent the night playing paediatricians and the rather flat baby had glucose overnight I hope but both he and jabber were wrapped up together in the cold and wet this morning. Given that mother has relies around her, though she is not looking great post Caesar, I take baby and oxygen concentrating device to family and get them to cuddle baby who is more likely to retain his temperature that way and hope that either breast milk comes or the ‘C’ team who is on today feed him a little sugar water intermittently. I hope I am getting the hang of paediatric dosing.
What oh what have we come to!