DILP Week 4 – Switching Hats in Maternity!!

Well what a difference a day makes! Because I had my “weekend” on Thu/Fri last week and worked Sat/Sun in A&E, it was very strange waking up the next morning and starting as the new girl again in Maternity. Quite the change!

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All I new for sure was that I’d get to hold some babies – I was HYPED

I didn’t expect it to be drastically different actually. In my mind, rushing into either A&E or Maternity would involve a certain amount of stress, drama and concern. In fact, during the 40 hours I’ve been diligently posted in Maternity, only 3 natural vaginal deliveries have taken place. So my expectation of blood, guts and placenta flying all over the show twinned with concerned Fathers pacing around and screaming Mothers rushing into the ward, hasn’t come to fruition.

Mary Cooke, a Lecturer from our University explained to me this week that during her time in Sri Lanka she learnt about the 4 arms of Sri Lankan healthcare. These 4 arms are divided into:

  • “Western” Publicly available care
  • “Western” Private care (Me)
  • Ayurvedic Medicine
  • Rural Folk Medicine

 

Public care, or the Sri Lankan version of the NHS is extremely thinly stretched across the country. My friends in Anurhadapura have been working (with Work the World) at one such hospital that has open-air wards of 60 beds which has one bar of soap for the entire ward. These institutions do an amazing job with what they’re given and treat a huge number of patients who otherwise would have to rely on traditional Sri Lankan remedies.

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Dhanvantari, God of Ayurveda

Ayurvedic Medicine has a history of over 3,000 years in Sri Lanka and is based around the balancing of 8 components to bring about physical and mental wellness. Treatments range depending on the ailment but can vary from “surgical” intervention to use of chiropractic massage.

Folk medicine is becoming increasingly rare as the country develops but involves treating ailments such as snake or insect bites, infections and such like using herbal and natural remedies.

Private Healthcare in Sri Lanka is the closest to hospitals in the UK you can get here. Therefor patients I see have a source of income that allows them to be there but again there are levels within this. For example the Presidential Suite on the top floor of my hospital costs around £350 per night and has wifi, cable TV, a kitchen and en suite guest room. Or for around £30 a night you can stay in a non air-conditioned room and still see the same consultants, doctors, physios etc.

For whatever reason, which I haven’t quite got to the bottom of yet, C-sections are overwhelmingly popular. I could not count the number of caesarians that have happened during this week compared to the lowly 3 vaginal births. I think it is considered to be less risky and carries fewer consequences than vaginal delivery and equally also demonstrates a level of wealth.

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CTG scan – this can show us if Baby is getting distressed during contractions or has a depressed HR

The first vaginal delivery I witnessed was in the first hours of my second day in our CTG room (Cardiac Tocograph – a scanner that is used to track the babies heart rate and the Mother’s contractions simultaneously). Usually Mothers wait for 20 minutes for the CTG to be taken then move into a normal room but in this instance there was no time to be wasted in moving this Lady. She delivered a beautiful baby girl at 34 weeks (full term being 40 weeks), and I was privileged enough to hold her hand and support her throughout the difficult delivery. Because of the hastiness of the whole procedure, when it became apparent she required an episiotomy the consultant Obstetrician only had a few moments to quickly inject some lidocaine before, seconds later, taking some sterile scissors to her perineum. I have never been so in awe of the strength and power of the female body.

Medio-lateral-episiotomy

Ouch – I’ve got no other words for it… at least none that I can write on this public platform

With, and I’m not exaggerating here, nothing more than a few high pitched gasps and squeals, even during her midline episiotomy, her glorious tiny little baby was delivered and I am very pleased to say, the little lady is still doing very well.

I’ve been trying to learn on my feet as much as I can about the processes of pregnancy and childbirth but I very much see why our Midwifery colleagues are always so hard at work. Things can change in an instant during labour and the differences between each case makes each birth spectacularly valuable to my rough and ready education in this area.

I could write all day about the differences I’ve seen in Maternity but I’ve got to save some juicy tit-bits for next week so I’ll finish up here.

But PLEASE ASK QUESTIONS!!!

I have an entire hospital full of people who are so helpful and open to answering any questions I have about healthcare, life and culture in Sri Lanka so please do drop us a comment on our Facebook page or email us at:

enhancingplacement@gmail.com

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