Friday, March 26, 2010

ROUS and Birth in Africa


Written one week after returning to the USA from attending births for the first time in Africa

From Princess Bride- Buttercup to Wesley while walking through the Fire Swamp: “But what about the ROUS’s?”

Wesley: “Rodents of Unusual Size? (After seeing one a few minutes before.) I don’t think they exist.” A huge rodent jumps on Wesley and attacks him.

I’m here to tell you, rodents of unusual size do exist in Senegal. I’m not usually one to jump at the sight of a mouse, or scream at the size of a rat. (I even had a rat as a pet once, but that’s another story.) However the first night we spent at the clinic when I heard the volume of sounds just over our heads in the labor room, I got cold chills.

Of course, it’s the idea of their size, and the images that evokes more than the critters themselves. When they are making enough noise to keep you awake over your IPOD music coming through ear phones it does tend to produce some pretty scary thoughts. And then when that big noise moves under your bed…well, you get the idea. I’m sure you won’t blame us when you find out that one of our group quickly moved from one particular bed into another single bed already occupied by one of her companions.

Maybe what Wesley meant was not that he didn’t think the rodents existed, but rather that he could handle their existence when he had to. Or perhaps he was trying not to scare Buttercup before she actually had to face them, to give her a few more seconds of hopeful fantasy. Certainly we wouldn’t want to accuse the swashbuckling hero of lying or denial.

Because the bottom line was, when they had too, Wesley and Buttercup did both face the ROUS and defeated them.

There were huge other things to be faced in Africa too, much more serious than rodents. Dealing with the fact that every single woman we attended in labor had been mutilated by some degree of female circumcision was pretty tough. Seeing the lack of sterile technique bothered some of us more than others. Aggressive fundal pressure and what we perceived as rough treatment of the mothers in labor was difficult for most. The fact that there were HIV positive ladies receiving care at the clinic was extremely sobering.

Sometimes we had a tendency not to want to look at difficult things straight on and deal with them, because they were so awful. Or we would start discussing them with clinical detachment and take notes (one of my personal coping techniques). Or go along with certain practices of the local midwives when we really weren’t too sure about them.

For me personally, I’m still processing all the ROUS’s I encountered. Especially when I consider that this trip was a mere introduction to long term maternity work I plan to do in Africa, I have a lot to think about.

I have seen the enormous size of some of the issues I have to face. None of them has actually jumped on me yet. But I’m still walking pretty cautiously through the Fire Swamp.

‘Cause now I have seen with my own eyes what really does exist.

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