Friday, April 29, 2011


A shared meal with ladies of the Green City church back in July 2010. Roda is the one with her hand on my shoulder.

In my first month of life in Doro Sudan I accompanied SIM team members to a church in a town called Green City about an hour's walk away. After the service we were welcomed into the tukul of a woman named Roda. She was only the second Maaban woman here that I met who spoke some English--though her English isn't much better than my bit of Arabic...

Anyway, I really felt like we connected, but the next couple of times I visited that church I did not see her. Today I was working in the clinic and saw her so I greeted her warmly and sat down with her on the cot where she was waiting to be assessed. She was there to be seen for complications in pregnancy and possible preterm labor but I would never have known from her demeanor. She was so delighted that I recognized her that she grabbed hold of me and didn't let go for a while. She took off the handmade bracelet on her arm and put it on me and then sat arms linked with me. As a touchy feely person I just ate that up! The Maaban are not big huggers, but they are hand holders. I appreciate the touches I receive so much! This is the way here--we can become close friends after only one meeting and pick up where we left off. : )

Her medical condition is very troubling. On Wednesday she had been carrying a load of heavy wood on her head and began leaking what she though was amniotic fluid that day as well has having abdominal and lower back cramps. The leaking continued but slowed on Thursday and she arrived in our clinic on Friday after an hour's walk--a long walk is the last thing a woman who is threatening to miscarry needs--but here it is almost completely unavoidable unless the patient has connections with owners of the few cars in town or can afford the equivalent of about $8 to hire a donkey cart--but few of the common people have money like that.

We assessed the fetus to be at seven months gestation and were able to find a strong fetal heart tone after a couple minutes of searching, as she is not carrying the fetus in the normal position. It was such a relief to be able to tell her we found the heartbeat. In the States we would have the ability to test the fluid leakage to see if it is indeed amniotic fluid. If it is--she is at high risk for infection and very high risk of preterm labor and miscarriage. In the States an infant born at this time would be kept in the newborn ICU for several weeks and most likely live, but there is not such ability to care for such a premature baby here.

If I were a physician or a midwife I would have done a vaginal exam to check to see if her cervix was still closed. I may have been able to ascertain this myself, but in the event that it isn't and she really is leaking amniotic fluid, I could have put her and the fetus at greater risk.

She has been having pain with urination so I'm hopeful that the leaking was not amniotic fluid but a complication of a bladder infection. We prescribed an antibiotic for an infection and I put her on bed rest for three days instructing her that someone else MUST do all the water and wood fetching, cooking and caring for the children. The people here live in community. there are no families who work or eat alone so there will be others to help her. However, there is enough work for all 8-10 women in each little community of tukuls so her work will be missed. Oh how I pray her little one is OK. She has three living children and has not had any miscarriages--which is quite rare here. Most women have had at least one or two. I hope she does not have to experience that.

If she does have a miscarriage she probably will not seek medical care, although I told her to come back to the clinic if the leaking continues or she begins to bleed. The women here are accustomed to handling such problems on their own at home and are expected to recover quickly both physically and emotionally. Oh how I wish I knew more about women's health. We have a mid-wife joining our team later this year. We are so grateful. I hope to learn much from her!

Please pray for Roda and her unborn baby.


At 1:32 AM , Anonymous jane corbett said...

Dearest Sheila, so lovely to receive your blog, you are very much in my thoughts and prayers. So much of the news that is coming from S Sudan is very concerning and we have lots of prayers being said in prayer groups and our churches. As I said before when I wrote having read your blog, I just long to be there and not here!! I will be thinking of your lady and her unborn child and I really do hope that the midwife when she arrives is a wonderful teacher, so that you can soak up her knowledge.I gather Tabitha has left now - you two lovely girls were such a joy to meet in March.
Keep safe and I pray you will be guided by Him as you make decisions with all the patients who come to you.
Love and God Bless Jane


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