Mami, where your baby hat?
I have finally found 5 minutes to write something - although you can bet that having been asleep now for 4 hours, he is due to wake up any minute now.....
So, the longer version of having a baby in the Turks and Caicos Islands.
I was in the Myrtle Rigby Health Complex, built by the British Government in 1994. The maternity ward was built for 5 beds (going by the positioning of the curtain tracks), yet there were 7 of us in there at one point. The Maternity ward consisted of one room, plus the delivery room (which doubled as the incubator room too), a bathroom (1 bath, 2 steel toilets, 2 tiny steel basins - one of them out of commission on account of a cleaners trolley being in the way) and the nurses station which was right by the door and squeezed in between the beds. So it was a cosy, intimate place to be! My bed was stuck between a wall and the curtain of the adjoining bed, so every time the doctors/nurses came past to examine me they had to struggle with the curtain and fashion some sort of screen at the end of the bed - although when you've given birth any sense of personal space and decorum go out the window!
There were windows right around the ward, but the hurricane shutters were closed so there was precious little natural light in there - but also no curious on-lookers either (the hospital is all at ground level).
I turned up on the ward at 2.30am on the Monday morning - we had to wait for someone to come open the door (it had a security key pad on it) and then I was whisked from 21st Century Provo to a parallel universe operating much on the same level as "Carry on Matron", or what I imagine a nursing home of the 1950s would be like. Sister (Guyana) briskly ushered Osh and Nicky out the door (strictly no-one in the delivery room and no children on the ward at any time) and instructed them to go get my bag. She was tickled pink to discover I was Elizabeth Mary and referred to me as that for the rest of my stay (don't forget that the West Indians are very God Fearing). Of course Isaac was being in a hurry and whilst the bag was mostly prepared I'd not told Nicky where it was - but between him and Osh they sorted it out and returned it, just in time to say hello to Dr Roberts (Dominica) who had arrived to do the C-Section. Looking immaculate as always at 4am! I was a little nervous about telling the nurse that I was supposed to be having a section - you can imagine that on the NHS deciding to have a section on account of previous 'traumatic' labour (the Dr's word not mine) and then still demanding that c-section having gone into labour spontaneously would have been met with short shrift. Not here though. I said I was hoping for a C-section and the on-call Dr. was promptly called....now that's what I call service!
The operating theatre (just the one) was just across the corridor and I was wheeled in, with the contractions happening frequently now (don't worry, no gory details here!), and I was, I confess, terrified! I was on my own - save for the medical staff (mostly Filipino), shivering uncontrollably (fear and the AC) and very very miserable. As they gave me the spinal anaesthetic I really really wanted to be anywhere but there. What happened next is a bit of a blur.....I think I remember someone showing me a baby....and the next thing I remember I was back on the ward, unable to move (frozen legs) and very very drowsy. Turns out Isaac was fast asleep in his little fish tank by the bed - and there he remained for much of the day because I discovered soon enough that moving was bad enough - sitting up and lifting a baby was a whole other matter.
That night not much sleep was had - you can imagine that on a small ward next to the nurses' station the lights were on all night, and there was a constant stream of women giving birth so the noise was rather primitive all night (for the anthropologists out there, the Haitians are prone to sing hymns in creole, the Turks Islanders are more quiet!) That first night (Monday), 2 women gave birth, Tuesday during the day a woman due for a section the following day was turned away and told to come back later as they had no beds (that could have been me too.....), a woman turned up in stage 2 labour and looked like she was going to give birth there and then at the end of my bed, that night another 2 women produced babies and a woman vomiting blood was admitted. In fact Tuesday night was utter bedlam. The poor woman vomiting blood was admitted at about 1am - at this point the ward was full, so her bed went along the bottom of my bed (which was unfortunate as the one bodily function I can't stand is vomiting.....). How the staff on duty coped is beyond me: not only were they dealing with this woman (7 months pregnant) but they were delivering babies at the same time! Wednesday during the day a set of twins was delivered, Wednesday night was quiet (thank heavens). In total, I think I counted 9 babies born over the course of 4 days: 1 white baby (that was me!), and slightly more Haitian babies than Turks Island babies (probably in the region of 65% Haitian, the balance Turks Islanders).
One of the benefits of being all of 10' from the nurses' station was that life was never dull: many of the nursing staff are Guyanese, there was a Nigerian nurse, a Keralan nurse, probably a couple of Jamaicans (although I'm not good at distinguishing one accent from another yet) and all the SEN staff were Turks Islanders. The banter between them was very entertaining, especially for someone interested in linguistics. I was endlessly amused at the Guyanese habit of saying we instead of our and she instead of her - so a nurse would be asked to 'go take she temperature' or one of them would say 'they came to we house'. Also, being so close to the nurses' station, my medical knowledge increased 4 fold. Turns out the woman admitted vomiting blood was suspected to have pre-eclampsia, this was then ruled out and they thought it might gastritis. The doctors, however were puzzled by the 'coffee grounds' she was vomiting which was apparently digested blood which indicated something serious going on inside. They attempted to insert a gastric tube which she refused (all this was going on feet from my bed - nothing like on ER when those tubes just slide down!), they then told the husband (both Haitian, he spoke good English, she was able to yell "stop", and a variety of obscenities in English but little else) that either she consent to a tube being put down anaesthetic, or they would have to discharge her (there being nothing they could do for her if they didn't know the cause of the problem, plus it being a health and safety nightmare what with digested blood all over the place). She agreed and off she went to theatre - 1 hour later she was back with the tube, but at 5am she pulled it out. The nursing staff were seriously cross with her at this point and boy did they let her know it. Not because it was more work for them, but because they genuinely cared about her and couldn't get her to understand that a modicum of discomfort might just help them help her. They weren't helped that she was sure that the tube into her stomach would harm the baby.....a low level of education wasn't helping anyone at this point.
Another consequence of the nurses station being on the ward was that visiting hour sometimes never happened - whilst the rest of us were privy to everyone's medical history, the members of the public were not allowed on the ward whilst the doctors were there (Dr Roberts plus Dr Naira (Nigeria) and Dr Guzman (Cuba)). This rather explains the security key pad on the door and the very hefty security guard there to eject cheeky visitors and to calm the rabble outside on the couple of occasions that visiting hour never happened. Sister (a different one each shift) ran a very tight ship and wasn't going to stand for any nonsense from anyone - mothers included! What I also discovered was that these were no ordinary nursing staff: one day they might be on maternity delivering babies, the next day they could be in A&E dealing with RTA, the next day on the general ward dealing with all manner of problems. Their level of skill was astonishing, but because there was a comparatively small number of staff, over the course of 4 days I got to know them all - and every time they came back on shift they knew who each of us was, and remembered a little bit about all of us. This was certainly not my experience from British hospitals were you are simply another nameless patient. Even the 3 cleaners (who religiously swabbed the decks at 6am, noon and 6pm) were friendly and remembered who all the mothers were. The staff work in incredibly difficult circumstances (at one point there was 1 digital thermometer in the hospital that was working....and it was on the maternity ward!) yet are always polite and cheeful and kind. In short, the attention I received in there was second to none. I would not have wanted to give birth in there for the first time, and its not the place to be if you are after 'natural' child birth (sister was a great believer in strapping you to a table and attaching the monitors - mostly because there simply wasn't room to wander around) and not the place to be if a major emergency comes about.
I was discharged Thursday - but my repeated suggestion that Isaac was jaundiced finally paid off and blood was taken from him Thursday morning. The blood testing machine in Provo isn't working, so the samples were sent to Grand Turk - they got there at 2.30pm and at 6.30 the result finally came back showing that he had very high levels of biliruben (dying red blood cells that make you yellow). Dr Ventura (Filipino) wanted him to stay under the lamp - although she conceded that it wasn't the most efficient lamp available and if a very sick baby was born they'd have to take him off the lamp to make way for the sick baby - Nicky suggested I discharge the both of us and make use of the natural sunlight. Which is what I did - although discharging Isaac against medical advice was a little scary.
That night, I slept in the dark, in my bed, after a lovely lovely wash and slept probably the best night's sleep I have ever experienced. I was back in the clinic on Wednesday for Isaac to have his BCG against TB (rife over here) and he had another blood test, which showed his levels were still elevated, but declining. It was ironic that Dr Zoe had expressed surprise that I'd taken Isaac to visit friends 2 days after coming out of hospital (I declined to tell her we'd also been to the beach and the supermarket) and yet said that the only place to get the BCG was the government clinic - a four hour wait surrounded by the sick was presumably safer than taking him to IGA to buy milk! The clinic was interesting, as always, and the number of women coming up to me and decrying the fact that Isaac didn't have a hat on was amazing. To me, it was 28 degrees, pleasantly warm, to them, I was a feckless white woman who clearly didn't see that he ought to be in a hat, booties, gloves and swaddled in a large fleece blanket to ward off the cold weather! Poor Isaac was the white baby on the ward dressed in Osh's cast-offs where as all the other babies had brand spanking new baby sets to wear....conspicuous consumption I think they call it.
So here we are nearly 3 weeks later: Isaac is very much less yellow thanks to frequent exposure to the sun (trying hard not to fry him to a crisp too!), feeding well and sleeping a lot. He is putting on weight and is noticeably longer than last week. I've lost count of the number of people that have expressed surprise that I gave birth at the clinic - commenting that I must be brave or mad. Secretly, I'm very proud that I had the courage to do it, and I've certainly earned a huge number of brownie points from the Turks Islanders - as a rule those that can, pay to leave the country for their babies.
posted by Elizabeth Turner @ 10:00 PM
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