An unfair world

Hello all. Sorry for the delay in between blogs, but internet access is difficult. Now, my computer has decided to stop working all together, so I'm having to bum other people's computers now as well. Such is life overseas! Actually, there's an IT guy here, so I'm going to take it to him to see what he can do with it.
Yesterday was tough. I was working in the OB outpatient clinic, and I saw a woman I had seen last week. She is currently pregnant with her 5th pregnancy and has no living children. She has made it to full-term with all of her previous pregnancies and has had deaths of her children either prior to, during, or immediately following labor. So, when I saw her on Wednesday, I was determined that we would get her a successful outcome. We sent her for testing of the baby, which looked good. She was only 35weeks at the time, and here, they cannot do much for premature babies. So, we decided to do close testing and instructed her well on monitoring her babies movements. We decided we would electively deliver her once she reached 37wks. Turns out, we should have just delivered her that day. She came back yesterday for her testing and the baby was dead. I sat there dumbfounded when the midwife handed me the ultrasound report. Did I miss something? Should I have done something different? More importantly, how is this poor woman going to deal with this in a culture where women's only worth is found in their children? My heart broke for her as before my eyes she went through the stages of grief - denial, wanting a 2nd opinion, and then finally it hit her. As she sat there crying, I just wondered "Why Lord?" I know that He has a reason for everything, but sometimes I just don't understand. We are not allowed to pray with the patients at the hospital, so in my heart I said a prayer for her and I got her phone number so that I can call her. Her name is Malalai - please remember her and her family in your prayers as they go through this difficult time.
Now that you're thoroughly depressed - I did have a bright moment this morning. I was checking email and I found out that my "nieces" who are 2 1/2 and 1 1/2 were both asking about me last night. What a joy to hear! By the way, for those of you who were following Anara's story through her surgery, she is doing great and now home. You can go the Hubartt family link on my blog to read more.
Hope you are all well. I'm about halfway through my time here - look forward to seeing you all when I get home.

My First Delivery

OK - I finally have time to blog. Today was a good day! I spent the whole day in the OR (operating room) with the GYN team. I didn't scrub, as they don't get to do many cases. But, it was good to observe and be able to give suggestions here and there. I also was able to see my first delivery - I just haven't been in the right place at the right time so far. It was a lady that I had seen a couple of times in the outpatient clinic and had sent in for induction yesterday. So, it was nice to see her deliver a healthy, and very large, baby boy. All of the routine deliveries here are done by the midwives, so it was interesting to see how they do it - not too different from how we do it. The only stressful thing for me is that there is no monitoring of the baby during labor. I just kept thinking - wouldn't my call be easier if I didn't have to worry about whether or not a baby was crashing? :) The other thing I realized, as I went back in later to see mom and baby, is how alone women are here. No men are allowed on the maternity ward at all, not even during the postpartum period. Besides a midwife being present for the delivery, no one was there to be with her, to comfort her, to rejoice with her over the life of her new child. She just looked so alone - not quite the joyous scene you usually find in a delivery room. I'm sure that they are used to it, but it sure did make me sad.
I've seen other interesting things here as well. A lady was transferred in from a province about 4 hours away in a semi-comatose state. Two days after she delivered, she complained of a severe headache and then had a seizure. Following that, she couldn't move the right side of her body. She was supposed to come here that day. Instead, her family took her to a mullah (an Islamic holy man), who beat her to try and beat the evil spirits out of her. She is now clinging to life and almost completely unresponsive. It just breaks my heart that if these people would have better access to care, things like this could be avoided.
So, things have been busy. The OB fellows here (have finished residency, getting one year of extra training) are full of questions and eager to learn. They want me to give lectures on all kinds of things, most of which I can't give off the top of my head. So, this weekend (Friday and Saturday), I will be working on lectures. I am forming good relationships with them, though, and hope that I am more a help than a hinderance.
It is starting to get cold here now. At night it is in the 30's and during the day in the 60's. Thankfully, we just had heaters installed in our rooms yesterday.
So, that's what's going on with me. I hope everyone is doing well. Keep the comments coming - it makes my day when I read them.

Quick Note

Hello all! This will be very quick as I'm about to miss my bus. Just wanted to let you all know I'm alive and well (in case you heard about the bomb about 45 minutes north of here). We didn't even know about it here except through the news. Things are going well. There's just very little time to be on the internet as I can only be on it here at the hospital. I'm planning on writing a blog tonight and posting it tomorrow, though (it will be tonight for all of you). Thanks for all the prayers - keep 'em comin'!

A little overwhelmed

Hello everyone. Well, I have survived my first day of work at the hospital. It really wasn't that bad except for not being able to communicate and trying to learn a new system.
Backing up a little bit, the team flew out on Friday, after multiple mishaps trying to figure out when their flight actually left. I moved into the CURE guesthouse - where I have my own room with a double bed and a balcony. Some of the comforts we had at the other guesthouse, however, are missing here. No one to do my laundry, electricity only a few hours/day, and lukewarm showers with no water pressure. But, I have certainly survived worse and I know that it is still leaps and bounds better than what most people deal with on a daily base here. The house is pretty full right now - 2 family medicine residents from Oklahoma, an orthopedic surgeon and his wife who came here from spending 6 weeks in Africa, a Brazilian pathologist and a nurse who is half German and half Afghani. Oh, and a pulmonologist from New York who is originally from here. What a melting pot!
On Saturday, I went with the Afghan doctor to a teaching hospital that is associated with the medical school where he trained. He gave a lecture there (slides in English, but he spoke in the local language), and I was able to pick up some things. After that, I was invited to his niece's home, who is a FM intern at CURE, for lunch. It was wonderful! I got to experience home life in Afghanistan and we were served a feast, which we ate sitting Indian style on the floor. It was wonderful to really experience the culture.
Which brings us to today. The work week here is Sunday through Thursday. I spent all morning in the prenatal clinic. It was very busy and I saw lots of new patients. I had an "interpreter" who could speak only a few words of English for the majority of the morning. So, it was just a little bit frustrating. By the end of the day, though, everyone was asking to see the foreign doctor. I'm sure this was very frustrating for the locals, who are just as qualified, if not more, than I am.
I think it will take some getting used to schedules, etc, but I am really looking forward to the next few weeks. I must admit, though, I am a little homesick. I'm hoping that getting into a routine will help that.
I love and miss you all. Keep praying!

All by my lonesome

Good morning from Afghanistan! Yesterday was a good day. Our Afghan friend got us into Rabia Balkhi which is the largest maternity hospital in Afghanistan. It has received US support in the past. They were very welcoming and answered all of our questions. We are looking into starting a midwife training program, as midwives are key in this country to taking care of women and babies. They were very helpful for us. We asked about their needs and they have a lot. Their support pretty much just comes from the government and it is minimal. They need anesthesia machines, mammogram machines, pap smear supplies, probes for vaginal ultrasounds, laparoscopy equipment. So, if there's anyone out there who knows how to get their hands on some of these things, please let me know.
Then we go to tour the hospital. I was once again humbled as I saw protocols hanging on the walls that were right on with what we do in America. They really are trying to provide good health care, they just lack the resources they need. We saw 3 women who had just delivered. The midwives told us that it was a slow day, as they usually deliver 1500-1700 babies/month (not including operative deliveries)! We hope to establish a relationship with this hospital as well.
For lunch, we took all the teachers from the school up to the Intercontinental Hotel for a beautiful lunch buffet. They really enjoyed it and we spent a lot of time talking with them and learning more about their lives. Then, in the afternoon, we took all of the medical supplies we had brought over to CURE. They were so excited about them and were impressed at the amount (we pulled out some to give to Rabia Balkhi hospital). I'm really looking forward to getting started there.
But, there is one sad thing about today - the group from my church is leaving. It has been great reconnecting with them and it will be hard to see them go. I am thankful, though, that I have had this week with them.
One other piece of news - an internist that I know from home (Dr. Dee) was planning on coming over for 3 weeks and flying back with me. I found out the day I left that she was no longer coming, and I was pretty bummed about this. But, not to worry, I got an email today that her trip is back on. So, that's something to be happy about!
Hope everyone at home is well. Amanda, it was great to talk to you last night. Mom - try answering your phone!