Nausea

This morning Annie and I went to Kumi Hospital which turned out to be a Hospital run by the Catholic Church (at least I think it is the Catholic Church). We arrived early enough to attend devotions in the hospital chapel at 8am. From there we went to the administration office where we showed our letter of introduction and were surprised to find that we were not expected. However, the secretary kindly took us to a very nice doctor who said we could shadow him for the day.

We started out rounding on the patients who were in his section of the hospital. We went through about 30 patients in an hour and half. About 3 of the patients were living with HIV; several had typhoid (yikes! I don’t want to get that again!), and then rest had malaria.

(It was at this time that I remembered the DOWN SIDE of a Lush Green Paradise. It is that if everything is lush and green then it means it rains a lot. If it rains a lot that means there is a lot of water around. If there is a lot of water around there are LOTS AND LOTS of mosquitoes and other bugs. If there are lots of bugs and mosquitoes there is LOTS mosquito born diseases such as MALARIA! Darn!)

After rounding, the doctor asked if Annie and I would like to observe surgeries with him. We said we would love to observe surgeries with him. We went to the surgery theater and changed into scrubs. As we were walking into the operating room, he asked if Annie and I would like to be the assistant for the surgeries. We said “yes” and Annie asked if I wanted to go first. I said sure and started to scrub in. The doctor was across the room while I was washing my hands carefully trying to keep my hands above my elbows so they would be cleaner. It was at this time that I realized that I didn’t even know what the surgery was that I was going to be assisting on. I heard Annie ask the doctor, but they were too far away for me to hear the answer. I then crossed the room, dried my hands with a sterile clothe, and put on double sterile gloves. I walked up to the doctor who had just approached the patient. It was a woman who was already under anesthesia with her legs positioned so her pelvis was available. I approached the doctor (who is not very talkative) and quietly asked what procedure we were going to do. He didn’t appear to hear me, but instead started draining the woman’s urine with a catheter-like tool and then inserted a tool in the woman’s vaginal canal and asked me to hold it placing downward pressure. I asked again what procedure we were going to perform and the doctor quietly said, “An evacuation.” It was starting to dawn on me what that meant, but I still didn’t understand until the physician inserted a loop-like tool into the woman’s uterus and blobs of flesh and dried and fresh blood started falling over my gloved hand holding the tool. It was really gross. I asked if the material was fetus and the doctor responded, “yes, it is the product of conception.” I was very confused. Here I was in the middle of Uganda assisting a Muslim doctor in performing an abortion in a Catholic Hospital in a country where elective abortions are illegal. More blood and tissue kept falling over my gloved hand I started getting really nauseated. I tried to take some deep breathes, but my stomach just got tighter and tighter. As I watched some more tissue and blood drip over my thumb I realized that I was about to either faint or vomit. I then decided to tell the doctor that “I was somehow not feeling so good” and a nurse came over and took my place. The brought a chair for me to sit in and everybody responded by telling me everybody gets a little nauseated at first. I didn’t vomit, but I definitely felt like I was going to for about 5 minutes. Annie very bravely took my place for the next procedure and did an awesome job.

We asked the doctor afterwards why he was doing the abortions. He said that elective abortions are illegal in Uganda (a very conservative country where children are considered a sign of wealth and blessing). However, the women that we operated on today had had incomplete miscarriages due to natural causes and that they had continued to bleed and had developed a fever indicating that the left-over dead tissue had become infected. Thus, cleaning out the remaining tissue and giving the women antibiotics was probably going to save their lives. Therefore the tissue and blood that was falling over my hand was the remains of a fetus or placenta that had incompletely miscarried several days ago. Still, not the most pleasant experience.