Guardian for a Day

Every now and then, God throws me a bone, so to speak, and today was one of those days!

When a patient enters the hospital he/she is usually accompanied by a guardian .     The guardian is responsible for bringing the food, clothing, linen and supplies for the patient and stays with them for their hospitalization. They sleep, eat, and cook in a central pavilion adjacent to the hospital, otherwise staying at the patient s bedside for their stay. A guardian can be a family member, a friend, a relative. The patient without one is helpless.     Guardians wash the linens, clothes, and assist with bathing and at times other patient procedures.

My first official day of clinical teaching began today now that the tedious process of orientation is complete. Five of my six students showed up and were so excited to receive the goody bags I had prepared for them; a pair of scissors, a hand towel, a highlighter, and some candy. Included in the bag was the list of expectations of their clinical performance that we read together before they were able to dive into the bag and enjoy it!

One of my students, Veronica, was due to have her baby yesterday but appeared for clinical today, not feeling great. She admitted to me she was having contractions so I sent her over to Labor and Delivery for an exam. Her student escort returned without her so I went to check on her. In very active labor, she had been admitted and was 4 cm dilated (out of 10).

The labor room is a 40 x20 foot room with mattresses on the floor and about 8 beds lined up against a poorly painted and faded gray wall, very grim. There is no privacy for the patients in active labor. It is all hanging out so to speak with guardians in attendance to help and some students to take vital signs and monitor progress. They have an initial exam and then are examined 4 hours later, really?  There is no pain medication, no epidural, no cozy shower or tub to lounge in. No TV, no distraction, no husbands present.

Stripped down to her chitenje (the long piece of fabric they wear everywhere) Veronica lay on her cot, clearly having contractions about 90 seconds apart. I offered to stay with her as the guardian was not at the hospital yet. She quickly accepted and I assisted her by rubbing her back during contractions. She was in agony and asking for medication. I continued to stay with her, encouraging her.   I prayed for her and the baby, very important here as even the surgeries start with a prayer.

The concept of coaching, deep breathing, visualization is simply not done. Not even timing of contractions. They listen to the fetal heart beat through a horn shaped instrument on the abdomen, no fetal monitoring.

Long story short, she went very fast, 2 hours to be exact, and I got to go all the way with her. The delivery bed is a plastic massage type table covered in clear plastic (cleaned after each delivery, recycling at it s best). The patient brings their own trash bag that is cut open and spread on the table over which a chitenje is laid.

She got her IV, pushed twice and baby girl was born, 3 kgs, beautiful! What a gift to be trusted with that level of intimacy from an almost complete stranger.     I was the only one in the room crying!

Later after things had calmed down and she was cleaned up and baby brought to breast I went to the University to get mom and grandma some food. Grandma had arrived 10 minutes after the birth, the guardian with no food! Returning with 2 heaping plates of food, both mom and baby were doing well, though tired.

When I asked the name of the baby, she looked at me and said, I have named her Mindy, after you, because you helped me so much

Needless to say, I lost it and was a weeping mess for the next 10 minutes. Yup! Mindy Trinity Mpuma

After work I went shopping and bought her some outfits, a blanket, and some booties. Tonight I baked a banana bread and will bring that and some hard-boiled eggs for their breakfast as I don t think they have anything to eat for morning.

Today I have the amazing gift of a namesake in Malawi, a baby girl that I had the privilege of tending to at her birth, from a woman I have known for only hours.     I am humbled and grateful, and God is good, all the time.