Day 23

I guess I never really finished up yesterday– Nikki, Maci, and I headed out to Camps Bay for some Tuesday night karaoke at Dizzy’s. We met up with Skylar and Elijah, two of the Mercer interns at the clinic and caught up on what we had missed while shark diving. The answer? Nothing much. We sang “Take Me Home, Country Roads” then Elijah absolutely murdered “Drop It Like It’s Hot”. What a wonderful night!

But TODAY, we finally broke the dry spell at the clinic! After about an hour of paperwork, Nikki, Maci, Skylar, Madison, and I all started shadowing Dr. Prinsloo, the neonatal specialist who comes in every Wednesday. While this was fun, watching her check out all of the preemie babies, we crowded her a little bit so I went to hang with Elijah in the labor ward. Lo and behold, 10 minutes after I arrived, two mothers began pushing (one who was much louder than the other).

One woman (the loud one) didn’t speak any English and barely any Xhosa so we really had a tough time communicating with her. She kept pushing when, in reality, she wasn’t ready push which could’ve been very damaging for the baby. Eventually, the sisters got her to calm down and just lay on her side until the baby was ready to come out.

However, the woman next doorway ready to push and that baby was ready to come out. After a few painful minutes and some coaching from Elijah and me (wow, this really makes me sound so much more qualified than I am?), she gave birth to a beautiful baby girl! We cut her cord, measured her, warmed her up in the incubator, then gave her back to the mother to begin breastfeeding. The only problem was this mother was a first-timer and, unfortunately, had inverted nipples, meaning that the sisters had to use a syringe to pull them out. During this whole process, I was lucky enough to be the designated “baby-holder” (my favorite job) and got to bond with this little bundle of joy. After handing her back to the mother, I decided that this was the perfect way to introduce my new baby hat concept. As a way of thanking the mother for letting students deliver her baby, I gave her a pink baby hat knitted by yours truly. This woman was so grateful and even let me take pictures of the baby with the hat on :’). Those are featured in the gallery.

The rest of the afternoon was relatively slow but that birth made this past 1.5 weeks of waiting all worth it. I returned home for a classic afternoon of going to the gym, calling home, etc. This time, though, I got to talk to my brother, Russell, who just returned from a 2-week wilderness adventure! As fun as SA is, I’m definitely missing my family. On my way home from the gym today, I finally decided to try Nando’s, a large chain restaurant in Europe and South Africa specializing in their roasted chicken. I got a leg/thigh with mild peri-peri sauce and thought it was pretty good! 8/10, convenient and tasty!

I spent the night hanging out with Tess, Morgan, and Sarah, listening to Big Bootie mixes and admiring the beautiful view out of their 13th floor window (we’re only on the 4th floor, facing another building). I’m on this new kick where I’m trying to go to bed earlier so I’m off to the snoozer at approx. 10:30… progress? Xhosa word of the day is “hat”: umnqwazi (there’s a click in this one! and I can do it!)

Day 14

Today was the definition of “hurry up and wait”. The maternity staff always rotates and one staff works Monday, Tuesday, Friday while the other does Wednesday and Thursday. Today, we had the staff who lets us do all the deliveries but not much of the paperwork. Unfortunately, nobody was in labor so it ended up being a pretty slow day. This would’ve been fine if I had a book or something but my silly self brought a book where I only had 20 pages left and finished it during the ride to the clinic. Side note– the book was “Sorority” by Genevieve Sly Crane… there wasn’t really a plot it was more of a fictional exposé so it was fun to read and felt low-key trashy but the quality writing was incredible? 7/10, would still recommend. Anyways, I was left to my thoughts and my Candy Crush but it was a wonderful day nonetheless. One of the Mercer interns left last week for a family emergency and another one arrived today so we had fun getting to know her and just hang out together.

However, after a very slow morning we decided we needed to do something. I ended up heading over to the dentistry unit to see if they’d let me observe. Luckily, a (particularly beautiful) dentist let me watch him do lots of tooth extractions. Though I’m fine with blood/other medical procedures, something about cracking teeth and dental tools has always given me a fright. I stayed for about an hour, watching children and adults alike with tooth pain get numbing shots then having every painful tooth removed. He said about 95% of patients come here for extractions with the other 5% being “patches” (cavity fillings) and cleanings (rare). As interesting as this process was, I scooted out after about an hour.

After we returned for lunch, a mother went into serious labor around 1:30. This woman had been sitting on a bed for a while but, as she told me, “I’m trying to push but only the poo poo is coming out!” Disclaimer for anybody who has not yet given birth/is nervous about it: 90% of women poop in labor so when it happens to you, know you are NOT alone (in fact, you’re normal). This same woman kept wanting me to clean it up for her but didn’t know my name so she continually shouted “White Woman!” every five minutes for an hour. It has become my new identity within the clinic. She begged me for an “operation” saying that she didn’t want to push anymore but, unfortunately, that’s not an option at our clinic.

After some more consoling and even more “White Woman” calls, she was ready to push and I could feel the baby’s head. However, she was only about 5cm dilated and the possibility of a baby coming out seemed nearly impossible from an outsider’s perspective. The sister-on-staff told us to go for it and get her pushing so we set up around her: Nikki lifting the head and shoulders, Skylar on the abdomen pressure to push the baby down, and me on the pulling/catching side with Madison (new intern) watching from the sideline. After a few pushes and a lot of stretching, the baby was out and breathing (and mama only needed 1 stitch!). It cried for about 10 seconds before going silent which meant we had to start hitting/flicking it to keep it crying (and, therefore, alive). This baby was alert, looking around, and clearly breathing, but it just didn’t need to cry. It was precious. After cleaning him off and weighing him, I got to hold him for 15 minutes while the others dealt with the mother/cord/placenta. Highlight of the day, for sure– he was biting his fingers, staring at me, and sticking his tongue out like a pro.

We headed out to the parking lot as soon as we got ourselves cleaned up (baby fluid/blood literally goes everywhere) and hopped onto our shuttle where the driver, Luvo, immediately asked “how many babies?” He’s the best. I headed home, hit the gym, then went out to dinner with some new friends from the Safari before jumping into my glorious bed. Tess (roommate) is living out in Franschhoek in her boss’ guest house so that they can work every day for a week (it takes him an hour to really get into Cape Town so they don’t get to work much) and I’m a little bit lonely but it’s nice to have some space for the first time in a while. One Mad Men episode in and I can already feel myself fading so it’s time to peace out. The Xhosa word of the day is “remove” as in a tooth: khupha.

Day 9

WOW, today was crazy. During my last week in the maternity ward, there have been an average of 2-3 births per day. Today, however, SEVEN BABIES were born! Seven! Our first task this morning was to take the blood pressure of all of the mothers-in-waiting. Not only did they fill the chairs but they also had to be hoisted onto some extra beds in the post-natal area… these mamas were all about to pop. Around 8:30, one of the sisters handed Nikki and me a pair of sterile gloves and said “When this baby comes out, you’re the ones who are catching it.” In that moment, I knew today would be something special.

As the day continued and the three other Mercer interns arrived, the five of us were very lucky to directly assist the nurses and play a large role in some of the births. While the nurses were always on-hand to assist us when we needed help or guidance, they are so excited about the prospect of teaching us how to do what they do which has been really fun. After just a week of watching deliveries, we were literally elbows deep, doing things you wouldn’t dream of doing in America until you were at least halfway through Medical School. From pep talks to the mothers all the way to writing the birth certificates, we were hands on at every step today. This was a huge turning point for my ~adventure~ so far in South Africa and the first time I could really see myself pursuing a career as an Obstetrician… a fun thought!

Obviously, this post would not be complete without talking about the wonderful mothers who let students talk them through / deliver their babies. They were extraordinarily welcoming and agreed with the nurses when it came to promoting learning. They were excited that we were helping them and getting something out of it as well. The mothers today were also the most social of any day so far. They laughed and talked with us about how they would “never again” have a child even though the midwife claimed she’d see them “on the same bed this time next year”. Also, because many women here don’t have ultrasounds before giving birth, some were happier than others about the gender of their babies. One mother was disappointed it was a girl because “I already have one of those and don’t want to try again” lol. Being the person to hand them a newborn and see their reaction as they find their own resemblance in a little one is like nothing else. Being a part of such an important moment for mother and child (their birthday!) and guiding them through an extremely scary and vulnerable time is what is so appealing to me about OB/GYN. I feel like it would never get old.

After work, I went with a group of Connectors to Bo-Kaap Kombuis in the historic (and beautiful!) neighborhood of Bo-Kaap nestled right below Lion’s Head. This restaurant offered a fantastic view and a delicious buffet-style selection of Cape Malay food. The Cape Malays are a South African ethnic group originally from the Dutch East Indies, brought to the Cape when it was settled as a Dutch colony. The menu included lots of curry, rooti, rice, and various meat pastries (samoosas). Absolutely delectable and yet another restaurant that I would highly recommend. Xhosa word of the day is “boy”, the gender one mother wanted her little girl to be: nkwenkwe.

Day 4

This morning, we walked into the clinic and there were 5 mothers “on deck”, waiting in chairs until their contractions. After a slow hour, two mothers went into labor at once. However, both of them had very long labors. After a few series of pushes, one was transferred to the Khayelitsha hospital because of her “high-risk labor”. While the clinic offers many services, unfortunately it doesn’t have unlimited resources and must transfer many patients to the nearby hospital. While it is only a ten minute drive away, sometimes EMTs can take up to six hours to arrive due to high demand. Thankfully, in this case, they arrived after only twenty minutes. However, when I was working in the emergency unit, patients were waiting for at least two hours before being picked up. This follows a trend of townships being offered too few resources for the demand and population it’s catering to.

After the first mother was transferred, the second mother neared birth. The sister taking care of her gave her a hard time mid-labor because she wasn’t pushing hard enough and the baby was “getting tired”. For the first time, I thought I may see a stillborn baby. I was put into action as the “pusher”, using all of my weight to push down on the abdomen to force the baby down. I swear I thought I was about to crack a rib. About five minutes later, the baby was born but seemed to be stillborn with blue extremities. After about thirty seconds, though, this child came to life, absolutely wailing and thrashing around. Watching this little alien-baby-thing enter the world was still as amazing as watching it the first time. I don’t know if I could ever get tired of that. We were tasked with measuring the baby again and I got to put on the baby’s first “nappy”!

All other interns only work Monday-Thursday so we took a half-day and arrived home around 1 (instead of 4). Due to the early mornings, I took a nap that lasted 4 hours and may be the best decision I’ve made since I arrived in Cape Town. For dinner, I headed down to Camps Bay with some Connect friends and ate at a restaurant called 41. It was here I adventured out enough to try ostrich and it was INCREDIBLE! Definitely would recommend to anybody who has the chance to order it. After stopping by Café Caprice, we headed back to Bree St. to check out the nightlife scene (surprisingly dead for a Friday night) before returning home. That’s a wrap on the first week of work! Very excited for a fun weekend of exploration! Xhosa word of the day is “push”: dudula. Heard this one and an English version (“poosha”) a lot today.

Day 3

This morning I got up, made a wonderful breakfast of two eggs + yoghurt AND remembered my lunch! We’re making progress, folks. As soon as we arrived at the clinic, we were brought into the post-natal ward to watch as women received contraceptive implants after giving birth. These implants in the arm provide contraception for three years, so they’re ideal for women who don’t have the time to come in every so often for injections or don’t want to be responsible for daily oral pills. However, about halfway through the implantation, a woman sitting in a chair began having close contractions. Women don’t come into the labor ward until their water has broken but once they arrive they are asked to sit in a row of chairs until their contractions are enough that they need a bed. Since there are only three beds, the midwives and sisters prefer to keep them empty until the absolute last minute so that a woman with a long labor isn’t taking space away from somebody giving birth right then. However, this can be a problem when women wait until too late to leave their chairs. As this woman experienced major contractions fairly close together, the sisters tried to get her into a wheelchair to bring her to a bed. However, when she lifted herself up, the baby began crowning and, thus, she gave birth right then and there in the chair. After a large clean-up crew and some stabilizing support, she was able to get into a bed and breast feed / heal but it definitely started the day off with a bang.

Later in the day, once four other interns arrived, another mother gave birth with all of us watching. Honestly, I felt bad that her labor had become a viewing theater but she was very gracious about letting us watch. As the baby emerged and the sister asked for the time, every single one of us yelled “11:37”– our eagerness was palpable. As she cared for the mother, she let us weigh the baby and take its measurements (head circumference and length) then watch it as it laid under a heat lamp to avoid hypothermia. We showed the other interns how to feel the soft sutures of the skull and check for all of the other reflexes (balance, sucking, crying, etc.). Even after two days in the maternity center, we were learning a whole lot.

The day ended with a conversation between Nikki (Connect intern), the two Mercer interns, the “Jemster” (one of the nurses), and me. We discussed the differences in healthcare in South Africa and in the United States. It’s crazy that two nations can develop completely different systems that both have their pros and cons. Jemster was floored that the US had no government-run clinics or hospitals. Where we work, nobody pays for anything and it’s all government-funded. She was also amazed that we don’t have many paper files in America. She asked if “all nurses have to be computer technicians” to operate with that system which is an interesting way of thinking about the technological revolution in America compared to other parts of the world.

After work (and gym, shower, talking to roommates, etc.), Maci, Nikki, and I headed down to Bree St. for the famous “First Thursdays”. On the first Thursday of every month, galleries, shops, and restaurants open with special hours and streets close down for patrons to walk around. We started with dinner at IYO burgers where their bunless burger salads with all sustainably-sourced ingredients blew our minds. This one is high on the recommendation list. Afterwards, we walked around for a while, checking out a bar called “The Man and the Machine” (an ode to men and bicycles), a Patagonia store turned lounge, an Aperol Spritz truck, a gallery called L99P, and, finally, Sgt. Peppers, a bar with live music and a lovely deck for looking down on Long St. This was such a cool cultural event with many of the locals walking around (all impressed with American accents) and a very lively atmosphere. After a long night, I’m finally ready to hit the hay. The Xhosa phrase of the day is “I don’t know”: Andazi.

Day 2

This morning was rushed, yet again. So much so that I actually forgot my already-packed lunchbox. Another great start. However, after a sunrise drive complete with Coldplay music and excitement I was ready to hit the ground running.

Nikki (another Connect intern) and I decided to place ourselves in Maternity because according to another one of our fellow interns, that is where it’s at. And boy oh boy did it deliver (pun intended). As we walked into the labor ward at eight, we saw a woman with her legs spread, ready to give birth. After saying hello to the sisters, we walked over to the post-natal clinic to meet the sister working with the plethora of mothers since Wednesdays and Fridays are when all newborns come in to have their weight and umbilical cords checked. However, when we returned to the labor ward at approximately 8:07 (just down the hall), the woman in the bed had already given birth to a beautiful baby boy. It was in this moment that I realized the immense strength of Khayelitsha women. Each one of them gives a natural birth and most do it without more than a grimace. Most births take place alone with just one midwife and the mother but these women deliver with quiet strength. Honestly, it makes most American labor stories seem trivial. The sister in charge at the labor ward showed us how to check the baby’s reflexes and physical health right after birth. She also helped us examine the placenta and feel the soft sutures on the baby’s skull. For the first time, I saw life being brought into the world (touched a baby only thirty minutes old!!) and it definitely made an impact.

After some coordinating issues with the other interns from various programs, I was placed in the ante-natal (prenatal) clinic, assisting sister Tsepiso with pregnancy checkups. Most of these checkups consisted of measuring the baby’s height while in utero (top of the head to pelvic bone, called SF), checking it’s heartbeat, calculating the gestation time, and checking the mother’s health. While I started just watching Tsepiso with her explaining her Xhosa conversations with patients to me in English, by the end of the day I was helping. She taught me how to feel around the stomach to locate the baby’s back to find it’s heartbeat, arrange the baby and calculate its SF, and complete all maternity paperwork, including charting the baby’s growth. Speaking of paperwork, a copy of the Khayelitsha maternity leave form is in the photo gallery. I know in the last post I noted my concern about the lack of technology, but filling out this paperwork helped orient me with their patient filing system. Each patient has one folder that contains every appointment record as well as, for expecting mothers, a maternity book recording every bit of data from initial booking to six months after delivery. The folder is complete with ID stickers/barcodes to identify papers, blood samples, etc. The system works exactly how a computer would and just requires a little bit of penmanship from each of the sisters. Instead of comparing this facility to American hospitals, I’ve started to see it as a high-functioning machine in it’s own right that always seems to get the job done.

During Tsepiso’s lunch break, I went with a few Mercer interns and a sister outside to investigate some loud music and microphones we heard through the windows. Next to the clinic, the Western Cape Government was hosting a wellness competition for new mothers (and some fathers), promoting care for newborns in their first 1,000 days of life. The competition consisted of trivia for the mothers as well as informative interludes and rewarded the mothers with the most knowledge about caring for their babies. The winning mothers in different age categories were presented with tote bags full of supplies and big bundles of “nappies” (diapers). All mothers and children in attendance were in high spirits, dancing and cheering in the South African winter sunlight.

I returned to Tsepiso’s side discussing my interests, the concept of college + medical school vs. one professional school, and our plans for the summer (winter? honestly, I’m not sure at this point).  After we bid adieu and I waved at a few more newborns in the post-natal clinic, we headed back on the shuttle to Cape Town.

During my orientation, I was informed that the nearest laundry facility was right around the corner and doubled as a restaurant. As wary as I was, tonight I had my laundry washed and ate the most delicious pork + chive dim sum imaginable. If you’re ever in Cape Town, check out I Love My Laundry even if you don’t have anything to drop off. This trip was followed by another trek to the gym and another warm shower. Tonight, my roommates tried their hands at chocolate muffins using mL instead of tbsp and g instead of oz, but I’d say they turned out phenomenally. We chowed down while discussing the Taylor Swift v. Kanye West feud (#iykyk my opinion) and now we’re watching Brave. Merida quote to round out the day: “You control your destiny. You don’t need magic to do it. And there are no magical shortcuts to solving your problems”

New Xhosa word of the day: EyoMqungu – January (learned this while estimating conception and due dates… still not sure about the click in this one)