Obs and Gyn

Abasi took a weekend trip with friends to Ruaha National Park and returned to start his rotation in Obstetrics and Gynaecology. It was something of a hectic time. As he wrote…

“Well this is one of the busiest departments at Mbeya Zonal Referral Hospital as it serves 400-500 new patient’s every week. Once you are there you have 4 weeks at the postnatal ward, 4 weeks at the Antenatal ward and 3 weeks at the Gynaecology ward. With all that you are subjected to a roster that requires you to attend patients at the Outpatients department(OPD),Antenatal clinics, Fertility clinic, Labour ward, ICU, and operating theatres.
I started with Postnatal ward for a whole month and my main job was managing post operative patients, managing post partum haemorrhage cases and caring for post spontaneous delivery mothers. In the ward we could have up to 90 mother who gave birth and we had to do ward rounds (minor by ourselves, daily and major with specialists with a few chosen difficult or special patients twice a week).

It was not easy as they were only two to three doctors and we had to attend every single patients and discharge those who had recovered. We would do up to thirty discharges a day and once we had gone for lunch we would find almost the same number or more of new patient’s had been admitted to the ward either directly from labour ward or from the operating theatres.

Luckily I was not assigned to any night calls for three weeks as I was new and a new timetable was in play.
After three weeks things started happening especially on my first call. I was the first on call for the first time and due to the size of the hospital, two doctors will be first on call. I went to the hospital as usual at 7:30am to attend the morning meeting which is a must and we have our names called out and sign our attendance. I then went to the ward and did all the work but from 3:30pm we were alone. I had to see patients who were still there at OPD alone up to 9pm. The other doctor who was with me and had more Obs and Gyn experience than me was really lazy and annoying. He went home and came back really late and he was of no help at all. As soon as I finished seeing all of OPD patients, I was called in the ward to review a patient who needed an emergency caessarian section, so I ran to the ward, reviewed the patient, took blood samples for a full blood picture and cross-match, then ran to lab, prepared the operation list, where I was supposed to send a copy to central sterility department and a copy to the operating theater and one copy would remain in the ward. After all that I had to go the theater scrubs and assist all the C/S. As soon as we were done I was called to the labour ward, over there I found that all the nurses were really furious as they called the other doctor to reviews patients in labour and with complications, but when he went there he talked down to them and made them look stupid. On top of that there was a patient who was really fat, and the nurses took ages to find a vein for fluids to run. When he reached there he was told that the same patient had obstructed labour so he wanted to prep her for surgery, he went to the same vein took some blood and somehow disturbed the vein to the point it was swollen and useless. He left the patient without looking for another vein.

Nurses were mad so they didn’t do anything and by the time I reached the labour ward and mind you it was my first time in that hospital the atmosphere was really bad. The nurses were so mad, I greeted them but got no reply. They told me that all the patients supplies had run out( Ivs, cannula, fluids, syringes, and giving sets).So I sat down to do the orders from patients files while more than 10 patients required a doctor’s review. While still doing that the other doctor and the nurses had a fight because of what he did. He didnt care and replied really bad to them. They kept quite but didn’t want to do anything. Three patients were actively delivering at that time. I helped and all of them suffered perineal tears. The nurses wanted me to repair them. (The good thing is I had very good teacher and I paid attention on my clinical rotations and did a couple of perineal repairs in med school). So I took all the requirements and stiched all the patient in a dim light alone for a few minutes. I was done and nurses didn’t say a word as many intern doctors including the one they were fighting with had difficulty doing the same thing I did. He left, but I stayed to help. We did several deliveries together and by the time it was almost morning all of us were laughing and happy and the mood was clear. I was joking with them and they really liked me. They told me face to face that I was a good doctor. I felt really happy. The nurses planned to teach the other doctor a lesson that he needed them. I dont know how that went, though I tried to explain that we are different and everyone does things according to how their conscious is. So my on-call went successfully though I was really tired.I had couple of night calls every week after that and all were successful.

Last week after I had asisted over 15 c/s, a total abdominal hysterectomy, and other many obstetrics surgeries I was given a chance to do my own operation by my self as a surgeon. I was really excited and thank God it was successfully. I did a c/s for 35minutes delivered a health baby and repaired the mothers womb very well. My senior doctor was happy as I’m pretty fast for an intern. She told me other interns would use an hour for their first surgery. I thanked her for the opportunity and brought her apples the next day. She was so happy. From that experience I did one more c/s with a different doctor. I am seeing my self doing more c/s in the near future. Almost all staff at the operating theater and surgeons have grown found of me and that makes me so thankful to them. They taught me a lot. I left them my number to call me in case the get any procedure at any time where there will be short of staff, which happens all the time. Sometimes they do more operations than they should do because its a referal zonal hospital. I get to go to theater more often now than I should usually go. I spend all of my extra time a the hospital and I stopped going to gym and sometimes I don’t finish church services on Sunday’s….”

Of course being an intern, money is tight and prices rise. The new president is on an anti corruption drive but, as this is pushing up prices, Abasi has had to economise. He now no longer goes to the gym but does push ups at home. His father has been unwell so that has cost money for doctors and medication. Abasi is thinking of bringing him down to the hospital.

He’ll certainly get some great personal care from Abasi then…