Well today, 4th of July, I delivered 2 babies.
I have recently been helping out one of the nuns that is a nurse in her shifts at the health post. Usually, I just help vaccinate babies, give out birth control, and give brief pre-natal visits (which solely includes an HIV test and measuring their bellies). I prefer this side of the 6-room health post because I get to play with babies and see super pregnant women who walked on foot for hours from deep in the bush (some of which are my old students who dropped out of school after becoming pregnant). The other side of the health post is where the sick people go. Who would want to deal with babies with diarrhea or old men with worms oozing from their wounds when they could play with healthy babies and laugh after watching super bush women stare at the scale and be scared to step on it or to stand on it completely in the wrong way? It is also awesome to witness women that, when asked how many children they have given birth to, say “João, António, Maria, Octávio” and then show you five fingers. Or to hear the argument that ensues among the women waiting with their babies in the hall after someone has responded to the question “when was the baby born?” with the answer “day 33.” Irma Laurinda (the nun who is a nurse) lets me give vitamin A drops to babies, administer the polio vaccine (again, giving drops to babies), and measure the pregnant ladies’ bellies. Many of the women have scars in sets of three lines or in patterns on their thighs and abdomens that I meant to ask Irma about as we walked home, but I forgot. I assume they are either part of an initiation rite for young girls or a “treatment” from a traditional healer. I will keep you posted. Irma says soon I will graduate to injections. Aside from the fact that I have absolutely no medical training, the fact that I am white and a college grad apparently deems me sufficiently qualified for such tasks in the eyes of the staff at a rural, supply-less health post in the middle of Mozambique.
But today, I delivered 2 babies.
Irma was on baby-delivery duty today so I tagged along. There were four women in the room, all laying there mostly naked on hard beds with no sheets, blankets, or pillows, and all moaning at different frequencies. In a mandate of utter cruelty, the women in the early stages of labor must watch the women in total agony two feet away. One woman was wrapped so tightly in her capulana to try to block out the noise and to attempt to not witness her inevitable fate, I thought she might suffocate. Another woman had come in to get a routine pre-natal consult and Irma realized this lady was about to give birth right then so off we went to deliver. This woman, I never knew her name since she didn’t speak a lick of Portuguese, had previously birthed 8 other children, 5 of whom were still alive. Now, the Mozambican bedside manner is nonexistent, so while Irma chastised the lady for being lazy and not “giving enough force,” I held her hand and told her I believed in her and all that other mushy shit I thought might motivate her through the pain. And had she understood a word of my Portuguese, perhaps I would have helped. But I do know she appreciated my presence on some level because when I had briefly run over to where another lady on the verge of giving birth was screaming on the other side of the room, she yelled something I didn’t understand and motioned for me to come back. So I stayed by her side and wiped the sweat from her face on the capulana she had brought with her to the “hospital” (giving birth in Mozambique is BYO because you must bring your own sheets, baby-swaddling stuff, and post-partum diaper paraphernalia). And finally, after crapping all over the bed, bleeding uncontrollably, and splaying fluid everywhere (which I realize is normal, but no one seemed too concerned about the fact that she was lying right on top of the mattress that the next woman in labor would use), my new best friend gave birth to a beautiful baby girl. “CONGRATULATIONS! IT’S A GIRL!” I yelled and she kinda grunted unhappily, not too interested in holding her daughter. I, on the other hand, ooh-ed and ahh-ed over the baby for about 45 minutes. Irma kept saying that the lady should name her Ana after me, but seeing as the lady didn’t understand us, I would bet that didn’t actually happen. But then immediately, with almost no warning, the other lady gave birth to a huge baby boy. “CONGRATULATIONS! IT’S A BOY!” I yelled, and the new mother, as this was her first, bluntly said, “A man? Damn. A man was what has made me suffer and now I have another man to take care of.” Point. Well. Taken.
Overall, it was awesome. I was there on a good day: all the mothers and babies lived. Apparently, that squigy ball thing that is used to take fluid from the babies’ noses has been misplaced for some time at this health post, and a lot of babies are dying because of it. Apparently, this is not something that comes in the monthly supply box. But not today did anyone succumb to this ridiculous and preventable death. (I have asked my sister to bring a box of these things when she comes to visit at the end of the month so the problem will temporarily be solved then). But the experience really made me think: here are these women, giving birth with no fetal monitors, no epidurals, not much sanitation, no doctors, no family members allowed in, no fucking sheets on their beds, squeezed in one room with all the other women in labor, with their vaginas out for the world to see through the windows, and they are birthing beautiful babies. At least a lot of the time. High-risk pregnancies are sent to the city, but still it is crazy to realize how natural the whole process is when in the US, it seems very scientific. When my new best friend’s baby had its head out, I literally froze, thinking “I can’t touch it, I don’t know what I am doing!” but I later realized that was stupid. I had on gloves and a mask and all I really had to do was gently ease her out. But I was concerned at that moment about not fucking it all up and wrapping the umbilical chord around the baby’s neck or something. Maybe next time I will actually “receive” the baby. Irma then regaled me over our late-afternoon “lunch” about women who routinely come running into the “hospital” bleeding everywhere and clutching a 20 minute-old baby: “I didn’t make it and gave birth in the middle of the road!” they yell. And about the women who give birth on their dirt floors because their husband and their friends are all out at the moment. She must cut the chord herself, and then trudge hours to on foot to the hospital. These stories and the poverty they represent, and not actually seeing all the blood and gore of a baby being born are what make me sick to my stomach.
Unfortunately, this was also the first day that a woman we had been giving a pre-natal visit to came back with a positive HIV test. I will never forget her face. She was young and beautiful, slightly cross-eyed from needing but never having had the means to buy glasses, and wearing a bright green shirt that said, no joke, “I am a sex god.” She just broke down upon hearing the news. In a crazy twist of emotions, this was only about an hour before I held a healthy newborn in my arms. As an education volunteer, I know people who are HIV positive, but unlike health volunteers, my daily work doesn’t revolve around it. So I was not prepared. But I don’t think that hearing someone deliver that news is something anyone is ever prepared for.
Last week, two of my favorite neighborhood kids, Gigantinho and Belsa, were in a motorcycle accident with their father. Gigantinho came away with just a wound on his forehead that is healing nicely. Belsa, on the other hand, has half of her face covered in bandages. The skin on half her face is totally off and one of her nostrils is mostly gone. As I told their mom, I am relieved that solely aesthetic parts of them were injured, but it is still pretty bad. The risk of infection and who knows what else with the not up to par care they received at the health center makes my heart break. Any sort of reconstruction is clearly a pipe dream and out of the question, and that is why any sort of skin ailment, burns, or a guy I saw with massive growths all around his face, are secondary to other complaints and illnesses. But they are kids, and resilient, and I am not too worried about permanent damage. It is still shitty and scary, and why you can get kicked out of Peace Corps for riding motorcycles.