My rafiki dropped me off and escorted me past the hospital gates. We ran into the “Administrator” on the walk path (I am using quotation marks because I am unsure of his true job description). They exchanged some words in Swahili and as a young woman in a green dress walked by he stopped her and asked her to orient me. He was headed to a mass for the blessing of the new operating theater. The old theater had been closed indefinitely due to poor conditions; however, with the help of outside donors, they were able to build a brand new building. (since it took me a week to find internet, be patient and I will add pictures soon!)

The lady in the green dress who was now tasked to orient me asked if the only ward I would feel comfortable with was ‘gyne’. She seemed to have an exasperated look when I responded yes quite firmly. So she took me to Ward 5: postnatal, antenatal, and labor and delivery. And then she left.

I eventually met 3 young female doctors. One doctor, I will call her A, looked about 30 weeks pregnant and quite bothered to be working at all, or at the very least working with women of a lower class. I followed A and about 3-4 nurses around the postnatal section. One woman called out the patient’s name and I assume a delivery date although all conversations were in Swahili. They went down the row, throwing each patient’s chart on her bed while muttering something in Swahili. There were no physical exams performed. I assumed this to be postpartum rounds.

Thankfully I was wrong. Perhaps it was a sign-out of sorts.

A nurse then grabbed me to do a repair on a woman who had delivered at home. It was a small second degree tear which I was able to do even with a needle the size of our looped PDS sutures. Luckily, I was able to give her local anesthesia. Instead of sheets; however, each woman is expected to bring their own fabric to lie on for exams and for birthing and for wrapping the baby after delivery. So after the repair, the woman gathered her things and proceeded across the room to the communal shower.

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Then I joined real rounds, which was terribly boring especially since I didn’t understand anything, and A had little intention of translating. We encountered one woman who seemed to be in labor. The staff seemed to ignore her pants and cries. After much back and forth in Swahili, A turned to me and said, “attention-seeker”. She then sternly told the woman to go to one of the labor rooms – I only found this out later, as she spoke in Swahili to the patient and from her tone it sounded like she told the woman to go somewhere else.

I tried to imagine how I feel when I get called to 3A for an “attention-seeker” and I gave A the benefit of a doubt. So we continued on… however, the warmth and stagnant air started to get ahold of me and I knew I needed to make a move or end up sprawled on the floor like a 3^rd year medical student. I quickly found the nurse who had asked me for help, requested that she show me the toilet, and she agreed. We went outside and she said, “I need to refill some tea first”. I felt myself needing to vomit and luckily there was a bench right beside me, so I sat and put my head between my knees. She saw that I wasn’t well and then pointed to the communal patient bathrooms. I vomited and then proceeded to join rounds again.

After rounds, the “attention-seeker” was dancing in pain, hugging a pole and had the labor shakes. Still no one seemed to pay her any mind. She asked for tea, and A told her to get some. She wobbled over, poured herself some tea and then proceeded to continue her labor dance.

She delivered shortly after.