I Performed a Pelvic Exam. Yeah.

So, at the end of five days and a very bumpy four-hour ride in a sept-place, I am officially back from Ndaufanne. Huzzah!

As per the last post, I was in Ndaufanne (about an hour outside of Kaolack) in order to look at health care in Senegal, mostly due to the fact that I checked the “healthcare” box on the placement form because it looked interesting. Let it never be said that my decision process is a great one.

The story of what happened in Kaolack is a boring one (short hour: ungodly early sept-place ride, a lot of waiting, really good chebu jen at APROFES). However, on Tuesday I was sent away with a clump of girls to go be village-placed. We were all under the impression that we would be dropped off together, which made it somewhat startling when there was about an hour of savanna between each of us. Everyone else in the group was in an electricity-less village where no one spoke French.

However, I unintentionally placed out of that experience with my choice of area–pretty much all of the health care providers in Senegal speak French, since they’re university-educated. Though a lot of the conversations around me during the week were going on in Wolof, I was never more than two feet away from an obliging translator. Everyone was incredibly nice. In addition, because I was living with the clinic’s doctor, I had electricity to spare. It was pretty sweet.

The internship was alarmingly well-organized (particularly by the standards of my program, where we are often forgotten about for long intervals of time by the people we’ve been given to). The first day, I went on rounds with the doctor I was living with. Nothing very exciting happened, though I did meet my least-favorite patient of the week. She was a little girl, maybe three or four, who–when I walked in with my doctor host–was in the middle of getting a spinal tap and screaming in a way that I have never heard a child scream. The thought was that she either had a traumatic liver injury or menengitis (the spinal tap being a way to find out in lieu of other diagnostic equipment).

She was still at the health center when I left three days later, and still just whimpered when the doctor moved her around. It was one of those things where you know everyone involved is well-intentioned, but it doesn’t change the fact that there’s a small child screaming for her mother every time the health care professionals get anywhere near her.

The next day was Independence Day in Senegal, so my host was off work. She tossed me into a car with the other cinic doctor, and off we went to a celebration hosted by the local village association. (I believe we were guests of note, since we had chairs.) There was a Wolof-language skit about rural taxes (hilarious, I was told), lots of drumming and dancing, and an obligatory somewhat-dweeby twaekondo demonstration. Though sweaty, it was a fun time and an experience I never would have managed on my own.
On my second day of clinic work, I was sent off to shadow the OB/GYN staff, all government-certified midwives. They were great fun, in part because they reminded me of various nursing staffs that my mother has introduced me to.

However, the shadowing went to a weird place.

For example, during a obstetric pelvic exam that I was watching, the midwife who was dealing with me pointed at the box of latex gloves and gestured to put one on. “Tu vas faire la touche!” I looked somewhat askance. She repeated the request, apparentlya assuming that my hesitation was due to a language barrier rather than a desire to not start my day by putting my fingers in another person’s vagina.

I did it, of course, because conflict scares me. Once my fingers were in there, she gestured that I should feel around with my pointer finger. “You feel a hole?” It was at this moment that I realized that a) my medical French is limited and b) I know the French word for “hole” for some reason. As best I could tell, she was telling me to stick my index finger into the cervix of this woman, which seems like it was probably going to be uncomfortable.

I did that, as best as I could tell. The midwife was delighted. “The lump is the baby’s head!” I withdrew my hand as soon as she wasn’t looking, somewhat alarmed.

She made me do this one more time before I escaped to another midwife. She, however, was interrupted by a coworker coming in to show me the carts that the health center uses to chart birth progress. I said it was very interesting (it was) and said that I’d never seen a birth. This midwives both found this hysterical. The woman with the charts dug a scrub top out of her purse and ordered me into the birth room.

And that was how I found myself in the room where–as I saw two very quiet strangers shit themselves–two babies were born. That was nice. The delivery of the placentas, though expected, was less so. The part where the midwive stuck her entire forearm in a woman’s vagina to help deliver the placenta was traumatic. (It was my very own personal “I was there in the room,” ie the monologue no one likes because birth is kind of fluid-filled.)

So that was a busy day.

After that, I got an easy last day at the clinic. I was stuck outside to watch a busy baby vaccination drive. Every week, women bring their babies in for state-funded vaccinations–they happen as newborns, and then every three months after that (with the last being at nine months). The whole thing is tracked in a notebook that the mothers are given when their baby is born, and is managed by health care workers so that even illiterate or transient populations can have their kids vaccinated. It’s very cool. (The part where I was older than 1/2 the mothers I saw was less cool. Despite Senegal’s marriage age laws being similar to the US’s, the area’s big on illegally-young marriage.)

And with that, the APROFES volunteer rolled back up to take me to Kaolack, where I enjoyed a godforsakenly-hot sept-place ride back to Dakar. Though I don’t now that I got a taste for village life, particularly, I had a lovely (if somewhat bloody) time at the health post with a lovely bunch of people. Yay, tarranga!

One thought on “I Performed a Pelvic Exam. Yeah.

  1. That was hilarious! As a nurse I have seen one baby delivered while I was in nursing school and it was traumatic for me. You have way more OB/GYN experience than I will ever have.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s