A Baby Explosion

Our sick baby ward (like a Neonatal Intensive Care Unit -without the technology) was designed to hold 12 babies maximum. Two weeks ago we squeezed in 19, it was unbelievable. There was no room to move, everywhere you looked it there was either an isolette or a bassinet. All week we had been approaching our limit and then on Thursday night there was a baby explosion. We hovered abound 16 babies, hoping no more preemies were born but then it seemed our luck ran out; one set of twins and a single preemie.

When I review our trends, we appear to be having the same number of births at the hospital but the number of premature babies is higher. We average about 200 deliveries a month and for March we are right on track. I don’t know what’s in the water but things on the maternity ward and in the sick baby ward are insane.

The staff has been amazing! A few days ago we identified an overflow space –a large storage room incase we needed it. Thankfully the room is just down the hall from the current space. Thursday late morning, the facilities staff moved everything out of the storage room, added a few more outlets and the housekeeping staff came by to clean. Shortly after 6pm and we shifted five babies over.

Having such a quick change in our census made a minor staffing problem on the ward to a major staffing problem. Typically we staff two nurses in the sick baby ward, which by western standards we should staff more. This was the staffing plan I inherited and since I have arrived we have been looking for ways to have a better nurse to patient ratio. But I am having little success in hiring someone who wants to work in this ward. Thankfully the staff volunteered and everyone picked up some overtime during this week.

Thankfully, with the overcrowding there were no negative outcomes. We did not see any baby develop an infection and the one baby who passed away had a cardiac defect that we could not repair. It was a true miracle.

The overflow space was open for a week and now we are back to our “normal” 10 babies –THANK GOD!!

Safe?

Answering the question “do I feel safe?” is a complicated one. I have spent almost six months in country and if I am counting correctly there have been four “major” events in that time. In some ways I’ve become cynical as I try to cope with the fluid security situation. However I am starting to wonder if maybe I have become like the frog in the pot of hot water and I’m not noticing that the water is starting to boil. When I talk to folks who have been in country for a lot longer then me they say this is status quo, one event every other month or so. I think they mean for this to be reassuring.

Now when I made the decision to come, I was as aware as one could be about the security situation. In pre-field training they encouraged us to decide ahead of time what situations would cause us to evacuate. I gave it some thought but didn’t develop a list of what that would look like. Maybe foolishly I figured I’d just know when it was time.

With each event I wonder, “Is this the event that will send me home?” Today was the first time I actually felt and heard the impact of an explosion. I’m not sure I can articulate the sound or describe what it felt like. I was sound asleep and woke up with a start to a terribly loud boom. Then it was followed by an eerie moment of nothing. Within seconds I was out of bed, putting on clothes and shoes I could run in if I needed to. We headed to a room with no windows and waited. We waited for about an hour.

Everything is back to normal except we are on lock down for the rest of day. Left to go about doing things inside and “the travel situation will be re-evaluated tomorrow.”

So here I am, wondering, “do I feel safe?” Today even after what happened, I can say yes. Not as confidently as I would have yesterday but I don’t think this one will send me home.

Texas Hold 'Em

I have learned many things since I have lived here. One of the most enjoyable skills has been learning how to play Texas Hold’em. When I was living with some other folks, they taught me how to play. Now we play about once week; it’s low key, fun and truly no pressure. No one talks work; we joke around and chat about current events. Everyone wants to win but the real goal is not to be the first one out.

Prior to coming here I had played once, maybe twice so I was a little apprehensive to join the game. Especially since the first night I played I was the only girl. But the guys were great and gave me a little cheat sheet of what cards beat what. Their support and encouragement ended when I won the first two nights I played. Especially the second night when on the final hand I went all in with a pair of nine’s. I wouldn’t always recommend that strategy but that night it worked for me.

Truly for the social aspect of life here, poker nights have provided me with something to look forward to. Those folks have become good friends and I am going to miss living there. However am grateful that I can still go over and play.

A Patient Story

This was the best thing I did last week. I spent about an hour in our fistula room, talking with the patients there. We have six beds for women who have been diagnosed with having a fistula (a hole between either the rectum and vagina or between the bladder and vagina). This condition can occur after severe childbirth when adequate medical care is not available. The women who have a fistula can experience a lot of social isolation and it will significantly reduce the quality of their life. It was in our fistula room that I met Gulsum. She is 25 years old and lives in a rural village about eight hours outside of Kabul.

After having her second child, she noticed that she was leaking urine. Over the next four months her husband took her to see several village doctors. One of the doctors recommended a hysterectomy and her husband approved (typically a husband or a woman’s father will give consent for surgery). Gulsum had the surgery but the problem didn’t go away. She thought she was "finished for life."

Gulsum was taken to see one more doctor. This village doctor had recently returned from spending one month training at my hospital. He saw Gulsum and explained to her about a surgery that we offer that will fix her problem. She was so excited but told him she didn’t know how she would be able to afford the surgery. Then the doctor explained that our program would cover the cost of the surgery and the cost of her transportation back and forth to the hospital.

She is recovering, the surgery seems to be a success and she should be going home soon. While her and I spoke, she was beaming. Her excitement was contagious as she explained that she was now “dry” and how "this hospital gave me life again." It's stories like this that remind me why I am here.

T.I.A.

In the book Stones into Schools, Greg Mortenson describes Afghanistan as “a place where life is often messy, confusing, and unfair – and where events almost never conform to the script that has been laid.” In the four months that I have been in country, I can testify to the truth of this description. My team has coined the phrase “this is Afghanistan (TIA)” as a means to assist us in coping with the messy and confusing aspects of life here.

My most recent example has been the visa process. I arrived in September with one visa, which as it turned out was no longer the correct visa to have in order to get a work permit. The unofficial explanation for the change “TIA.” As a result several of us had to leave the country to get the correct visa. None of us minded because who doesn't mind a surprise weekend in a warmer climate. We had to leave because you cannot renew your visa in country without a work permit. The visa I was given expired in a month, which because of TIA a month isn't enough time to be issued a work permit and a new visa. So off to the consulate to get another visa. No worries, this is my 3rd visa.

But for some reason, this time did not go according to script. The only reason I have for the complicated process; TIA. After visiting two embassy’s and pleading my case to anyone who would listen, I was granted a visa; which as they say here Enshallah (God willing) this is the right one and can be renewed in country.

Sometimes a picture is worth thousand words. Thankfully it all worked out and I am back at work.

New Year’s Eve in the Desert

Happy New Year!

Spent the past week in Dubai and it was great fun. Went to the beach, swam in the Arabian Gulf, shopped my heart out, and visited the aquarium. For New Years Eve, we went on a desert safari. It wasn’t everything I expected but it was fun.

The ride out to the campsite would have consisted of more dune bashing if the women in the front seat wasn’t carsick. We were told the food at the campsite was going to be a BBQ, but it was Indian, as was the music. The dance floor could have been one you would find any where in the States except it was filled with people of all ages. The air was cool and the sky was clear, it really was a nice night to be outside. We opted out on the camel ride but enjoyed getting to know the other people at our table. It sure was a memorable way to ring in 2010.

The first photo is of the beach we went to. You are not allowed to take pictures on the beach but can in the park that is attached to the beach. The second picture is of the park attached to the beach and in the distance you can see the Burj Dubai (now called the Burj Khamira; aka worlds tallest building).

A weekend away

Two weeks ago four of us had to go to Dubai to straighten out some visa issues. It was a little hassle but thankfully we all seem to now have the correct visa. Hopefully the last few things that need to come together will. Worse case scenario I’ll be home sooner then planned.

It was so interesting to be in Dubai. In a lot of ways it is the polar opposite of Kabul. There is construction happening everywhere you turn. The buildings are tall and the equipment is modern. It was impressive to see all the tall buildings.

This was my first trip out of the country and I was amazed at how homesick I started to feel and for things I didn’t know I was missing. We were in a mall and I recognized the music in the background, which seemed so odd. Plus it was so exciting to be in a mall and to able to use a charge card. At one point we walked out of a well known furniture in the States and felt particularly homesick. When we looked up at the next store, it was called "I want to go home." The irony was to much.

Other items I noticed, the smell of fresh cut grass. I was surprised at how green Dubai is and it really isn’t that green but the medians have grass, which is something I haven’t seen in a long time. The hotel had a mini-gym and I was able to run, again I haven’t been able to run since I left. One of the women who traveled with me said she hasn’t seen someone so happy after going for a run. I can’t say I was as happy the next day, my legs hurt but it was so worth it.

We were able to walk around outside. I spent the first day or so feeling like I forgot something and then I realized it was my headscarf. Guess I have adjusted to wearing one. Walking down the streets you heard many different accents and a few different languages. It’s like a mini-United Nations.

Being there for a long weekend was a great respite. I am looking forward to heading there again in just over a week. It will be fun to spend New Years there and really get to explore what there is to do.