Tuesday, February 23, 2016

The Purple Slip

We started our work at the clinic the day after the new crew arrived. We were eager to get started, I was eager to use my nursing skills. We were divided into 3 groups. The first group would help check people in at the registration and the second group would handle any of the HIV cases, pregnant women or pediatric cases, the third group had everything else. I was in the second group.
Bed on the right is the bed patients deliver in
Delivery sets and instruments they use for delivery

We found out early in that the nurses/midwives do everything, they prescribe the meds, they order the testing, they deliver the babies and treat the patients, they are OVER WORKED! In the states I would never in my life order meds or lab tests without the order from the physician, but in rural Kenya the nurses are the eyes and ears of the doctors. Doctors in rural Kenya are few and far between. Now granted they are not dispensing narcotics, mostly malaria meds, antibiotics and HIV medications and the tests they order are malaria, HIV, STD, and other infection related tests. The midwives  administer labor related drugs, of course they are midwives, but not in the same sense as our midwives in the US.  

Most of the patients we had during the day were malaria cases and mostly children. Malaria is the number one killer of children under 5 in Africa, the effects can be devastating. Malaria isn't a one time disease, you can get it over and over again, you get fever, diarrhea, vomiting, chills and headache. You can see where in a small child this can be deadly. There was one child admitted in the ward that was on an IV for hydration and antimalarials. Malaria tests were done in the hundreds while we were there. 
There are days of the week that are dedicated to pregnancy and days dedicated to HIV patients. That day was an HIV day. The pregnant women that we're HIV+ came in, we did weights and calculated BMI on them, made sure they were taking their meds correctly, did measurements on their belly's to make sure baby was growing correctly. I laughed, in the states we use a measuring tape and measure from the pubis to the top of the uterus, there the midwives use the finger widths above and below the belly button, it's hard to explain, but when I followed their measurements with my tape they were almost always spot on. I had also brought a pregnancy wheel to help calculate out due dates. This was a different concept to the nurses, but they were amazed when I showed them how to use the wheels and that my calculations went with their measurements. It just goes to show you that sometimes the old methods still work just fine.
Mid day we had a laboring woman come in with her husband. Her name was Alice, she had walked the kilometer from her home to have us check her. She was in early labor so we sent her out to walk and come back in 3 hours for a recheck. It was her second baby, I was just excited to see a possible birth! When she came back the midwife asked me to go ahead and check her and I did, she was 3 cm, she had made change, but not enough to say she was going to deliver. The midwife checked after me and he said she was only 1cm, I laughed, I would bet every dollar I had on me and my first born that she was not 1cm. Cervical checks are somewhat subjective but the difference between and 1 and a 3 is the difference between one finger width and 2 finger widths side by side, I told him I disagreed. As it got later in the the afternoon we rechecked and she was now 5cm, Alice was amazing, I think all women who labor naturally are amazing!  She walked and rocked, breathed  and moaned her way through labor. We were getting ready to leave for the day when they decided to go ahead and break her bag of water. I knew better, but I went ahead and stayed with my group and headed to Wayando Beach Club with them for dinner and to talk about the day. 

We weren't there 5 minutes when Teddy got the call that Alice was going to deliver. Quickly, Dennis loaded us in the bus and floored it back to the clinic, he was honking and we were waving kids and goats and cows out of our way...we were on a mission!
We pulled into the clinic, Dennis wasn't even stopped when I jumped out and bolted up the hill, crashing through the door of the maternity ward and opening the door to the delivery room... I peaked in and there I saw the new born being placed on mom's chest and wrapped up.....I missed it... I was so bummed. Linnet, the midwife asked if I wanted to weigh the newborn, I gladly accepted the task. I went to grabbed the beautiful little girl and noticed the beautiful lavender eyelet fabric she was wrapped in and made a comment about how pretty it was, that is when Linnet informed me it was the mother's slip! I weighed the little girl and then we grabbed some blue medical towels we had brought to clean the baby up and give her back to her mother. We helped get Alice off the delivery table and out to the ward and into a bed where she could rest holding her newborn daughter, from there we helped clean up the delivery room so it would be ready for the next one, that I WOULD NOT MISS!
The baby that started it all, she is in blue medical towels in this photo,
I regret never getting one of the slip.

Alice and her beautiful baby! I'm not sure who took this photo but we have since used it with the Purple Slip Campaign.

We left and joined our group and had dinner and went back to our hotel. I couldn't stop thinking about Alice and her baby and that purple slip! God spoke to me that night, I'm not sure if it was in a dream or just my time journaling but He spoke to me.  I was upset because I had missed the delivery, but as I look back, that was God's plan all along.  When I got up the next morning, I looked for my small fleece travel blanket that I had brought on the trip, I mostly used it on the plane to keep warm. It was blanket that my daughter Samantha had given me when she was younger. It originally had the name Kayla embroidered on it, Samantha carefully removed the l and the a and it now said Kay and she given it to me for a Mothers Day gift I believe, it didn't matter, it had a more important purpose from here on, it was my gift to Alice for her baby. We went back to clinic that morning and I immediately went to the maternity ward to find her and give her the gift. I told her I knew it wasn't much and yes it was used, but I wanted her, I wanted her little girl to have it, to know that there was love and warmth in this gift and that she had made an impact on my life, that would forever change me.  At the time I didn't know just how much, but in future stories you, my readers will see.
I have told and retold the story of this birth and the purple slip hundreds of times now, and the significance of that simple purple eyelet material grows greater and greater each time.  Never doubt God's timing even when you lay everything out and plan, His ways are better. Had I just been there for the delivery with my blue medical towels, I would have never seen the need, it would have just been watching the miracle of birth in another country. That purple slip pierced my heart and let compassion for complete strangers flow free. Not just any stranger, but that of pregnant women in rural Africa. Women who want the best start for their newborn child but aren't sure how to do it. As a result the Purple Slip Project was born, of course it would be several months after this event happened but the impact this program has been immeasurable. If you would like more information about what the Purple Slip Project is and how to get involved please go to www.projecthumanity.com and click on the Purple Slip link or email me at kay@projecthumanity.com