SO, after a challenging nights sleep (dogs barking and party music all night) we were up and off to a talk given by Margret Evans – a specialist in infection control(who first came to Goroka as part of THF 11 years agao). She was talking at the Grand Rounds to doctors and nurses. Most infection control is about minimising cross contamination – hand washing, instrument washing, consciousness about patient contact and how you use instrument between patients and then keeping the wards clean. The use of simple soap is better than antiseptic (just don’t use antiseptic!) for cleaning and making sure that surfaces and spaces are clean.
This all sounds simple enough, but in a hospital where; it is difficult to find a cloth, which has unreliable water supply and other funding issues – this can all be a challenge. But an important challenge to tackle considering infection is the major cause of death in the community and within the hospital. A doctor made an interesting point - in PNG seeing is believing - so bacteria is a hard concept to understand.
We then met with Joseph Apa (Eastern Highlands Provincial Health Authority CEO) to discuss how we can continue to support the district. The EHPHA has put together a new model of care with the aim of strengthening Primary care services within communities. Their goal is to build 72 new Community Health Posts through out the 24 Local Level Government districts (3 to a district). These CHP will staff 1 nurse and 2 community health workers and doctors visiting on out reach trips. They will service as mini hospitals (including a labour ward). This is a huge task, but there seems to be money at local levels available and these facilities will be wanted by the local communities. It would seem that this is where our services could be of most benefit. We will visit one of these CHP on Monday.
After a coffee we headed to the antenatal clinic, but the day was completed. On Fridays they run couples counselling – that includes family planning, looking after the baby and family responsibilities. This is apparently a popular program and the men who come respond well.
So we headed up to the labour ward. Four women were in labour. I felt a little overwhelmed, but Marie put me to work. I rubbed backs, cleaned the beds and helped to deliver. The women were amazing – no pain relief and they worked through it.
Naomi, 18, having her first baby was calm. Her labour had been going for most of the day. Marie called me over to help push. She worked very hard and pushed, but the baby was in no hurry. Finally, the head came, but the chord was around his neck. Thankfully Marie was there. It took some time, and some manual . . .. . . and resuscitation. Finally, the cry and time under the heat lamp. Within an hour he was with Mum and feeding.
Warigame, 40, having her 5th child. She went into labour yesterday in her village Aivo. Due to the baby being posterior she was sent to the hospital in the ambulance. She was in immense pain. I spent time rubbing her back, knowing how intense her back pain. She told me that she was ready to push. A doctor arrived, she moved back up to the bed and the baby came.
Anita, 17, having her fist baby was having very strong contractions. She was loud, but controlled. When she was ready to push she was ready. Once the head crowned the baby literally fell out of her. Marie caught it!
Stephanie also had had her baby – she was very relaxed following the birth. It was her third child. I talked with her. She gifted me a bilim and said she would name her baby after me – fancy that!
The women came with their own items for their babies. What they bought were all the items that we put into our Mother and Baby packs.
What a day!
The women all consented to us using their photos. They were very happy to share their story.