Bob Flanagan's pain journal
How can pain heal?
How can suffering push the boundaries of compassion?
Was this guy just complaining or was he on to something?
He died drowning in the fluid of his own lungs. He used his lifelong terminal illness as a medium for voice and art. Some might call it masturbatory, but I think it lives on the in the trenches between total self indulgence (I mean, what/who doesn't?) and total humanitarian effort. That makes it edgier somehow. The conditions of his emergence make possible this kind of art. Only a nicely privileged white guy would have the balls to spend years of his life exhibiting and flaunting his pain- and because of that, we learn something. About him. About ourselves. Thanks Bob.
Showing posts with label Art. Show all posts
Showing posts with label Art. Show all posts
Wednesday, July 25, 2007
Saturday, June 30, 2007
Lines in the dirt
When we left the hospital three days ago we left a seventeen year old in active labor. She was 9cm, fetal heart was great, and we had spent the day laboring with her. She was open to walking the halls, singing, massage, and we spent moments between active pushing as her doulas. She had a group of women with her, her mama and her father’s five other wives- also her mamas. We assumed we would arrive in the morning and get to meet her baby. Instead we were told she had needed a cesarean and the baby had died. The story from the Doctor was that he had been called in the morning because her labor was obstructed. The story from the women on the hall was that she had become fully dilated around 10 at night but was having trouble pushing properly. The midwives told her they would hit her if she cried and to call them only if the head was coming out. Then they went to sleep. At 4am, her mother woke a midwife in a panic. Her daughter was asking them to bring a hoe, which in Acholi culture is a sign of death. Sure enough, the midwives checked and the baby’s heart rate was dangerously low. The head had been in the vaginal canal for 6–8 hours. The doctor was called but he did not pick up his phone. Another was called but he said he would not come until morning. A 9 in the morning a cesarean was done, and the baby was dead.
We spent the day trying to find out the real story. In the report book it stated that the mother was ‘found’ in second stage of labor and that the baby was already dead. I know this is not true. Aimee and I (but mostly Aimee) labored with this woman and her live baby all day.
When we visited her, they had not yet told her that the baby was dead. Instead, the doctor told her the baby was very sick. His explanation was that he needed to prepare her, the shock of finding out her baby had died would be too much, so this lie was to ease her into the loss. She lay on the bed with a puss filled incision, her eyes darting back and forth, her breathing shallow, her pulse quick. We sat with her and cried with her and when she asked us to please make sure her baby was ok, we didn’t know what to say.
But I did know the hospital, the current system, was responsible for this babies death. Neglect and lack of action. I felt an anger that was deep. A sense of right and wrong violated like a line drawn in the dirt, blurring and more and more people step on it.
Day two. We return after a sleepless night to find this mother in septic shock. She learned her baby had died, shit herself and cried until she passed out. Now she is completely unconscious, has a raging fever, her stomach is distended, her breathing is shallow, lungs filled with fluid and her eyes are rolled back in her head. She will die unless she is transferred to another care facility. She too, is being neglected. The lack of management in this hospital mixed with apathy and trauma of staff makes for a standard of care, a culture of care, that is dangerous. The midwives are as traumatized and sick as the patients.
We spend the day arranging an ambulance to another hospital. Aimee pays for the gas. The family stands vigil around this young mama, they lay a bible on her head and pray and pray and pray. I begin to cry and have to step out of the room. She is only seventeen. We get her in the ambulance. All six mamas, her brothers, her husband, Aimee and I crawl in with her. She is on a straw mat on the floor of an old ambulance that has to be roll started. We have to straddle her to hold her still as we crawl through the unpaved and bumpy streets. A stop for gas and a half hour later we arrive at another care facility where she is immediately attended to with IV antibiotics, clean equipment, two doctors and three nurses. She is transferred to intensive care with a fighting chance for life. For the first time in two days I feel like I can breathe. This hospital has no more supplies, but strong management and a culture of caring.
Returning to the hospital much has happened. A woman has died of hemorrhage. Another woman who we worked with earlier in the week has had a cesarean and her baby is dying on a table. I feel the trauma of the day in my body. My neck begins to spasm and I am tired. I place a shaky hand on the baby’s forhead, she has a raging fever. The nurses seem indifferent. Please I beg of them, call the doctor, this baby needs help. They stare at me blankly, it is night time. They will get in trouble if they call the doctor unless it is an ‘emergency’. A dying baby girl is not an emergency. I hold this baby and with a broken bulb syringe spend time suctioning bloody mucus that has already become infected. I drip clean water into her mouth and place cold washcloths on her forhead.
I felt the urge to lick this baby, like a cat, take her, inflamed, in my mouth , soften and clean, until it doesn't hurt anymore.
The baby gasps, I think she has died, and then she breaths again. Softer.
Here I am, miles from home, in Uganda, where the dirt and the heat
blend my sweat with my tears
my hands
her skin
desire to lick
take her in my mouth
that urge
to draw closer
saliva
and moist cheeks
dried by the sun
and I wonder
if it will ever be right
or if it ever was
and how I come to know myself
enough to
figure out
the difference
between the spaces
the difference
between a lick
that heals
a lick that cleans
and a lick that draws lines in the dirt
I send out a text for those closest to me to pray for her. The response is enormous. My father is holding the torah for her. Clare and James are sending Reiki. My girlfriends are praying. My community is so rich.
When I get into bed though, sleep cannot find me. I feel panicky. My back hurts and the foam mattress feels absorbs my shape, my tears, my sweat. I finally sleep and wake to a cold shower and strong coffee. Human resiliance is truly amazing.
The line between right and wrong is a relative line depending on which side you stand. I feel the pull to understand and the pull to trust my instincts because it is the only way that I know how to function.
We spent the day trying to find out the real story. In the report book it stated that the mother was ‘found’ in second stage of labor and that the baby was already dead. I know this is not true. Aimee and I (but mostly Aimee) labored with this woman and her live baby all day.
When we visited her, they had not yet told her that the baby was dead. Instead, the doctor told her the baby was very sick. His explanation was that he needed to prepare her, the shock of finding out her baby had died would be too much, so this lie was to ease her into the loss. She lay on the bed with a puss filled incision, her eyes darting back and forth, her breathing shallow, her pulse quick. We sat with her and cried with her and when she asked us to please make sure her baby was ok, we didn’t know what to say.
But I did know the hospital, the current system, was responsible for this babies death. Neglect and lack of action. I felt an anger that was deep. A sense of right and wrong violated like a line drawn in the dirt, blurring and more and more people step on it.
Day two. We return after a sleepless night to find this mother in septic shock. She learned her baby had died, shit herself and cried until she passed out. Now she is completely unconscious, has a raging fever, her stomach is distended, her breathing is shallow, lungs filled with fluid and her eyes are rolled back in her head. She will die unless she is transferred to another care facility. She too, is being neglected. The lack of management in this hospital mixed with apathy and trauma of staff makes for a standard of care, a culture of care, that is dangerous. The midwives are as traumatized and sick as the patients.
We spend the day arranging an ambulance to another hospital. Aimee pays for the gas. The family stands vigil around this young mama, they lay a bible on her head and pray and pray and pray. I begin to cry and have to step out of the room. She is only seventeen. We get her in the ambulance. All six mamas, her brothers, her husband, Aimee and I crawl in with her. She is on a straw mat on the floor of an old ambulance that has to be roll started. We have to straddle her to hold her still as we crawl through the unpaved and bumpy streets. A stop for gas and a half hour later we arrive at another care facility where she is immediately attended to with IV antibiotics, clean equipment, two doctors and three nurses. She is transferred to intensive care with a fighting chance for life. For the first time in two days I feel like I can breathe. This hospital has no more supplies, but strong management and a culture of caring.
Returning to the hospital much has happened. A woman has died of hemorrhage. Another woman who we worked with earlier in the week has had a cesarean and her baby is dying on a table. I feel the trauma of the day in my body. My neck begins to spasm and I am tired. I place a shaky hand on the baby’s forhead, she has a raging fever. The nurses seem indifferent. Please I beg of them, call the doctor, this baby needs help. They stare at me blankly, it is night time. They will get in trouble if they call the doctor unless it is an ‘emergency’. A dying baby girl is not an emergency. I hold this baby and with a broken bulb syringe spend time suctioning bloody mucus that has already become infected. I drip clean water into her mouth and place cold washcloths on her forhead.
I felt the urge to lick this baby, like a cat, take her, inflamed, in my mouth , soften and clean, until it doesn't hurt anymore.
The baby gasps, I think she has died, and then she breaths again. Softer.
Here I am, miles from home, in Uganda, where the dirt and the heat
blend my sweat with my tears
my hands
her skin
desire to lick
take her in my mouth
that urge
to draw closer
saliva
and moist cheeks
dried by the sun
and I wonder
if it will ever be right
or if it ever was
and how I come to know myself
enough to
figure out
the difference
between the spaces
the difference
between a lick
that heals
a lick that cleans
and a lick that draws lines in the dirt
I send out a text for those closest to me to pray for her. The response is enormous. My father is holding the torah for her. Clare and James are sending Reiki. My girlfriends are praying. My community is so rich.
When I get into bed though, sleep cannot find me. I feel panicky. My back hurts and the foam mattress feels absorbs my shape, my tears, my sweat. I finally sleep and wake to a cold shower and strong coffee. Human resiliance is truly amazing.
The line between right and wrong is a relative line depending on which side you stand. I feel the pull to understand and the pull to trust my instincts because it is the only way that I know how to function.
Saturday, June 23, 2007
Questioning
This is hard. I feel quiet again. Like I cannot process enough to turn these experiences into words that are condensed enough to put forward as an offering.
E.M Forster believed narrative could be ‘truer than history because it goes beyond evidence, and “each of us knows from his own experience that there is something beyond evidence”.
There are not words to speak the body. Language is inadequate, lacking the depth of perception and affect to describe textured sensations such as sight, sound, smell, touch and taste. To narrate the body through words is in some ways is to miss it entirely.
Humans frame understanding of experience in terms of narrative account. When we try to understand why things happen, we put events in temporal order, making decisions about beginnings, middles and ends or causes and effects by virtue of imposing plots on otherwise chaotic events. Yet, the stories of the bodies that birth are separate from the accounts that the women give of themselves. I believe this to be a global truth.
It is not surprising that the dominant metaphors describing birth in the late twentieth century are characterized by mechanical images in which a woman’s body is fragmented into working parts over which she has little control. As Emily Martin in The Woman in the Body: A Cultural Analysis of Reproduction, phrases it “medically, birth is seen as the control of laborers (women) and their machines (their uteruses) by managers (doctors) often using other machines to help”. The canonical obstetrics text-book Williams Obstetrics encapsulates the mechanicity of the dominant medical view; it defines birth as “the complete expulsion or extraction from the mother of a fetus”. In every act of childbearing two stories are simultaneously produced, a story of what the ‘body’ does and a story of what the ‘woman’ does; the ‘body’ might dilate slowly while the ‘woman’ screams out for help. The body and the woman intersect and influence one another while still managing to maintain independent realities.
A traumatic day (for me) at the hospital- the necessary equipment just isn’t there. There is no suction. No suture kits. No sterile gauze. And I don’t think it’s that the midwives don’t care, but there is some sort of passive acceptance of the situation, so in an emergency it feels like everybody just walks away. Attempts to save babies or hemorrhaging women are half hearted and then the blame is placed on poverty and a lack of supplies. In truth, some of the supplies could be here. Sterile cotton wool and suture kits are in the hospital, there is just no consistent method of getting them from the supply room into the maternity ward. The suction device simply needs a new plastic tube in order to work…but nobody is advocating to get it fixed, even though a baby dies here once a month for lack of it working. I feel stuck in an impossible situation. Acceptance of poor conditions means nothing will change and my outsider perspective is received as hope for a handout. I can buy some cotton wool for the hospital, but it will be gone in a week. Sustainability comes with accountability. Where is the anger? I wonder. Perhaps to anger is also a privilege.
Sister Rosemary's sister was describing to me a bridge she has to cross occasionally. It has no railings and she feels close to death every time she crosses it. She is upset about it. She feels the government should put up rails to fix it. Her daughter jumped into the conversation and said yes but mommy, they cross it every day so for them it is normal. You are an outsider so the conditions anger you, but for them, it is just the way things are. Is this what is happening in the hospital? Acceptance of sub par conditions because it is just ‘the way things are’? Is this what keeps a slave a slave? A victim a victim?
The women I have engaged with in the labor ward remain stoic with their emotions. Almost apathetic. The midwives work quietly and without showing a trace of feeling, except for anger. If a woman is not pushing effectively, the midwives will begin to yell and slap her into pushing. After the birth, she will return to her normal static state. Almost like New Yorkers in a traffic jam. The anger bubbles to the surface but then disappears after the incident.
Pregnant women walk quietly, kneel down on the floor as a sign of respect for the midwives when they enter the labor ward, and then often remain stoic throughout early labor. If asked how they are they will without exception answer ‘fine’. Some look a bit sad or scared, but of course this is my interpretation and may have no reflection of the actual truth. The hall is full of women who remain calm and collected, almost detached, until they are in second stage of labor and are allowed entry into the maternity ward. The moment a woman places her plastic sheet on the metal bed, it is as if permission is given to set the apathy aside. Many women instantly and almost inevitably begin to scream and wail and fling their limbs about wildly. They roll on the bed and ask for Jesus to save them. Eyes glaze over and women pee and shit all over themselves without seeming to notice or care. It is a dramatic performance of extremes and is staged by almost every woman I have witnessed give birth at Gulu Hospital. The moment the baby is born, the melodrama ends. Women become stoic again, show no interest in seeing their babies and at most may flash a smile or a quiet thank you to the midwives. The moment of possession is over. The scene of childbirth offers permission to emote, but it is a package deal when it is over, it is over.
I want to explore apathy. It doesn’t seem like an authentic human emotion. Children aren’t born apathetic. It is learned. Is learned the right word? Perhaps it comes into existence through traumatic experience and suppression of emotion. Maybe it is passed down and transmitted from mother to child, brother to sister. What purpose does it serve?
How can childbirth be a vehicle for processing emotion and raising voices?
I do not have answers. Only more questions. Which I love. I am grateful for the opportunity to see and to emote freely and to question, question question. What a gift.
E.M Forster believed narrative could be ‘truer than history because it goes beyond evidence, and “each of us knows from his own experience that there is something beyond evidence”.
There are not words to speak the body. Language is inadequate, lacking the depth of perception and affect to describe textured sensations such as sight, sound, smell, touch and taste. To narrate the body through words is in some ways is to miss it entirely.
Humans frame understanding of experience in terms of narrative account. When we try to understand why things happen, we put events in temporal order, making decisions about beginnings, middles and ends or causes and effects by virtue of imposing plots on otherwise chaotic events. Yet, the stories of the bodies that birth are separate from the accounts that the women give of themselves. I believe this to be a global truth.
It is not surprising that the dominant metaphors describing birth in the late twentieth century are characterized by mechanical images in which a woman’s body is fragmented into working parts over which she has little control. As Emily Martin in The Woman in the Body: A Cultural Analysis of Reproduction, phrases it “medically, birth is seen as the control of laborers (women) and their machines (their uteruses) by managers (doctors) often using other machines to help”. The canonical obstetrics text-book Williams Obstetrics encapsulates the mechanicity of the dominant medical view; it defines birth as “the complete expulsion or extraction from the mother of a fetus”. In every act of childbearing two stories are simultaneously produced, a story of what the ‘body’ does and a story of what the ‘woman’ does; the ‘body’ might dilate slowly while the ‘woman’ screams out for help. The body and the woman intersect and influence one another while still managing to maintain independent realities.
A traumatic day (for me) at the hospital- the necessary equipment just isn’t there. There is no suction. No suture kits. No sterile gauze. And I don’t think it’s that the midwives don’t care, but there is some sort of passive acceptance of the situation, so in an emergency it feels like everybody just walks away. Attempts to save babies or hemorrhaging women are half hearted and then the blame is placed on poverty and a lack of supplies. In truth, some of the supplies could be here. Sterile cotton wool and suture kits are in the hospital, there is just no consistent method of getting them from the supply room into the maternity ward. The suction device simply needs a new plastic tube in order to work…but nobody is advocating to get it fixed, even though a baby dies here once a month for lack of it working. I feel stuck in an impossible situation. Acceptance of poor conditions means nothing will change and my outsider perspective is received as hope for a handout. I can buy some cotton wool for the hospital, but it will be gone in a week. Sustainability comes with accountability. Where is the anger? I wonder. Perhaps to anger is also a privilege.
Sister Rosemary's sister was describing to me a bridge she has to cross occasionally. It has no railings and she feels close to death every time she crosses it. She is upset about it. She feels the government should put up rails to fix it. Her daughter jumped into the conversation and said yes but mommy, they cross it every day so for them it is normal. You are an outsider so the conditions anger you, but for them, it is just the way things are. Is this what is happening in the hospital? Acceptance of sub par conditions because it is just ‘the way things are’? Is this what keeps a slave a slave? A victim a victim?
The women I have engaged with in the labor ward remain stoic with their emotions. Almost apathetic. The midwives work quietly and without showing a trace of feeling, except for anger. If a woman is not pushing effectively, the midwives will begin to yell and slap her into pushing. After the birth, she will return to her normal static state. Almost like New Yorkers in a traffic jam. The anger bubbles to the surface but then disappears after the incident.
Pregnant women walk quietly, kneel down on the floor as a sign of respect for the midwives when they enter the labor ward, and then often remain stoic throughout early labor. If asked how they are they will without exception answer ‘fine’. Some look a bit sad or scared, but of course this is my interpretation and may have no reflection of the actual truth. The hall is full of women who remain calm and collected, almost detached, until they are in second stage of labor and are allowed entry into the maternity ward. The moment a woman places her plastic sheet on the metal bed, it is as if permission is given to set the apathy aside. Many women instantly and almost inevitably begin to scream and wail and fling their limbs about wildly. They roll on the bed and ask for Jesus to save them. Eyes glaze over and women pee and shit all over themselves without seeming to notice or care. It is a dramatic performance of extremes and is staged by almost every woman I have witnessed give birth at Gulu Hospital. The moment the baby is born, the melodrama ends. Women become stoic again, show no interest in seeing their babies and at most may flash a smile or a quiet thank you to the midwives. The moment of possession is over. The scene of childbirth offers permission to emote, but it is a package deal when it is over, it is over.
I want to explore apathy. It doesn’t seem like an authentic human emotion. Children aren’t born apathetic. It is learned. Is learned the right word? Perhaps it comes into existence through traumatic experience and suppression of emotion. Maybe it is passed down and transmitted from mother to child, brother to sister. What purpose does it serve?
How can childbirth be a vehicle for processing emotion and raising voices?
I do not have answers. Only more questions. Which I love. I am grateful for the opportunity to see and to emote freely and to question, question question. What a gift.
Wednesday, June 13, 2007
I have been at a loss for words. The days pass by like months and then with a spark they are over. Last year this hospital was refuge for the girls who were night commuters; they sought safety in the sweat soaked walls from the terrorists from whom they escaped. Now these girls come back to this place to deliver their babies. They return with mothers, aunties, sisters, or alone. They bring with them a piece of plastic, which they lay on the seventy year old metal gurney to birth on, and a blanket to wrap the baby in. If they have a little more money, they may bring two blankets. There are five metal birthing beds. Soon after one woman delivers, the plastic is removed and another woman comes to take her place.
Often there is only one midwife on the floor. Or maybe just the woman who does the cleaning. She has become a lay midwife by virtue of spending time in that space. Women labor in the halls and come onto the beds to be examined and when they are close to pushing. The first baby of the day is strong and comes out with a cry. As we deliver the placenta a woman who has delivered at home comes in because she is hemorrhaging. She has a displaced uterus and is HIV positive. I triple glove, push it back up inside of her and massage it into place. She must lay on the floor because all of the labor beds are in use. I send her auntie to make her tea. Another woman pushes for three hours while two more deliver. We have one set of clamps and a pair of dull scissors. If the power is out they cannot be sterilized so we use string and a razor blade to clamp and cut the cord. Even if the power is on, there is not enough time between each birth to sterilize. The child mothers seem to take the longest because they are young and they are scared. One girl refuses to push for two hours while her baby waits just below the pubic bone with a very low heart rate. She is scared she will poop on the bed and no amount of coaxing will convince her that this is an ok thing to do. Another woman lays in fetal position and cries out for Jesus to save her. She has been in labor for two days. We have packed a small lunch of sim sim paste and mango marmalade on stale white bread. We take five minutes and while we are gone another woman has been admitted. Late in the day a woman comes in from the Congo. She has a group of seven Congolese women with her. They wear charcoal on their eyes and bright red blush. They stand around her and rub her and speak to her softly, holding her hands and feet as she labors. As she pushes they begin to wail, flailing their arms around, beating their chest and then they begin to slap her and strangle her (there is no way to contextualize this properly, but from what I can gather this practice is used to stop a woman from blowing out her nose when she pushes) this baby has the cord around his neck very tightly. The sisters are still wailing and strangling this mother and I have to scream at them to stop. They stare at me strangely, but pull their hands away from the birthing mother. The clamp and scissors are in use so I hold the head while Aimee uses the string and razor to cut him free. When he comes out he is lifeless and blue. I flash to the first baby of the day and feel the tears well up in my chest. I push them down. This time the bulb syringe is clean so I am able to suction him and massage him into breathing. While I am working on him his mother gets off the metal bed, cleans up the fluid (they all clean up after themselves) from her birth and walks out. One of the seven women comes to take the baby and I explain that she must keep him very close to her body for warmth. His skin is still blue, clammy and cold, but he is breathing and his heart rate is good. With each mother I make a connection and then forget her name. When one returns because she is bleeding too much I cannot remember if she has delivered today even though she is the one who spent three hours pushing. The placenta bucket is overflowing and one of the orphans who lives in the hospital brings it out to empty it in the placenta pit. There is a moment of silence and while one young mother pushes (it will be a while) and another tries to sleep I step outside to see the sun setting.
We leave the hospital at 6:30. Two hours after we were supposed to leave, but this is when the night shift midwife shows up. I feel I have no personality left. The nuns invite us to tea and it is all I can do to sit for ten minutes as the milky warm liquid swishes in my mug. When I return home I step into the cold shower, immerse myself and cry. The water beads up and trickles slowly into the drain. The cold feels shocking and real. The dinner bell rings but I cannot imagine eating. My head is swimming with images of placentas and tears, spurting blood, amniotic fluid and feces. This was today. I cannot remember the ten women whose babies I caught yesterday.
I feel numb but also terribly alive. The aches in my back and feet, the pulse in my chest, the chapped skin on my hands from all of the gloves, the washing, the purell, converge together as both witness and testimony to my day.
Aimee and I stay up late talking. She re-enacts parts of the Congolese drama that I missed because I was so focused on the baby and the cord, I laugh hard for the first time today. We question ourselves. What are we doing here? What can we do that will really impact this situation?The medical information being used is dated. There is no one here to update it. One of the midwives was talking about how the TBA’s are contributing to maternal death rates because they only refer women to the hospital when labor is obstructed. I wonder though, if there is anything in that hospital that could help an obstructed labor. All we have are razor blades and string. Perhaps the herbs and gentle coaxing of a TBA would better move a labor along. Of course it sounds ‘better’, it sounds like progress from a western governmental perspective to send women to a hospital, but when the circumstances are dire, I am not convinced.
The individual stories are pieces of one larger story. We will hold our first story circle on Saturday, and then a mini ‘conference’ for the hospital midwives where we will exchange best practices. Ideas flow in and then out. At the end of the day I fall into a deep sleep and I dream of working in a clinic where legs are falling off and women carry double headed babies on their backs. This is a lot to process. I have been at a loss for words.
Often there is only one midwife on the floor. Or maybe just the woman who does the cleaning. She has become a lay midwife by virtue of spending time in that space. Women labor in the halls and come onto the beds to be examined and when they are close to pushing. The first baby of the day is strong and comes out with a cry. As we deliver the placenta a woman who has delivered at home comes in because she is hemorrhaging. She has a displaced uterus and is HIV positive. I triple glove, push it back up inside of her and massage it into place. She must lay on the floor because all of the labor beds are in use. I send her auntie to make her tea. Another woman pushes for three hours while two more deliver. We have one set of clamps and a pair of dull scissors. If the power is out they cannot be sterilized so we use string and a razor blade to clamp and cut the cord. Even if the power is on, there is not enough time between each birth to sterilize. The child mothers seem to take the longest because they are young and they are scared. One girl refuses to push for two hours while her baby waits just below the pubic bone with a very low heart rate. She is scared she will poop on the bed and no amount of coaxing will convince her that this is an ok thing to do. Another woman lays in fetal position and cries out for Jesus to save her. She has been in labor for two days. We have packed a small lunch of sim sim paste and mango marmalade on stale white bread. We take five minutes and while we are gone another woman has been admitted. Late in the day a woman comes in from the Congo. She has a group of seven Congolese women with her. They wear charcoal on their eyes and bright red blush. They stand around her and rub her and speak to her softly, holding her hands and feet as she labors. As she pushes they begin to wail, flailing their arms around, beating their chest and then they begin to slap her and strangle her (there is no way to contextualize this properly, but from what I can gather this practice is used to stop a woman from blowing out her nose when she pushes) this baby has the cord around his neck very tightly. The sisters are still wailing and strangling this mother and I have to scream at them to stop. They stare at me strangely, but pull their hands away from the birthing mother. The clamp and scissors are in use so I hold the head while Aimee uses the string and razor to cut him free. When he comes out he is lifeless and blue. I flash to the first baby of the day and feel the tears well up in my chest. I push them down. This time the bulb syringe is clean so I am able to suction him and massage him into breathing. While I am working on him his mother gets off the metal bed, cleans up the fluid (they all clean up after themselves) from her birth and walks out. One of the seven women comes to take the baby and I explain that she must keep him very close to her body for warmth. His skin is still blue, clammy and cold, but he is breathing and his heart rate is good. With each mother I make a connection and then forget her name. When one returns because she is bleeding too much I cannot remember if she has delivered today even though she is the one who spent three hours pushing. The placenta bucket is overflowing and one of the orphans who lives in the hospital brings it out to empty it in the placenta pit. There is a moment of silence and while one young mother pushes (it will be a while) and another tries to sleep I step outside to see the sun setting.
We leave the hospital at 6:30. Two hours after we were supposed to leave, but this is when the night shift midwife shows up. I feel I have no personality left. The nuns invite us to tea and it is all I can do to sit for ten minutes as the milky warm liquid swishes in my mug. When I return home I step into the cold shower, immerse myself and cry. The water beads up and trickles slowly into the drain. The cold feels shocking and real. The dinner bell rings but I cannot imagine eating. My head is swimming with images of placentas and tears, spurting blood, amniotic fluid and feces. This was today. I cannot remember the ten women whose babies I caught yesterday.
I feel numb but also terribly alive. The aches in my back and feet, the pulse in my chest, the chapped skin on my hands from all of the gloves, the washing, the purell, converge together as both witness and testimony to my day.
Aimee and I stay up late talking. She re-enacts parts of the Congolese drama that I missed because I was so focused on the baby and the cord, I laugh hard for the first time today. We question ourselves. What are we doing here? What can we do that will really impact this situation?The medical information being used is dated. There is no one here to update it. One of the midwives was talking about how the TBA’s are contributing to maternal death rates because they only refer women to the hospital when labor is obstructed. I wonder though, if there is anything in that hospital that could help an obstructed labor. All we have are razor blades and string. Perhaps the herbs and gentle coaxing of a TBA would better move a labor along. Of course it sounds ‘better’, it sounds like progress from a western governmental perspective to send women to a hospital, but when the circumstances are dire, I am not convinced.
The individual stories are pieces of one larger story. We will hold our first story circle on Saturday, and then a mini ‘conference’ for the hospital midwives where we will exchange best practices. Ideas flow in and then out. At the end of the day I fall into a deep sleep and I dream of working in a clinic where legs are falling off and women carry double headed babies on their backs. This is a lot to process. I have been at a loss for words.
Sunday, June 10, 2007
The last three days have been rich.
So rich I am not sure where to start. How does one tell a story and bring it to life?
Of course, any point that I start will never be the beginning, so I will just start with this moment.
I am sitting in an internet cafe called 'Long Tick'it is across the street from the side of the market where they sell flipflops and second hand clothing. Up the road from me is the hospital and in the other direction is St. Monica's, where I am staying.
This is an interesting time to be entering into the birth dialogue.
Aimee and I were invited by one of the nurse midwives, Sister Florence, to attend a workshop she was leading for Traditional Birth Attendants. These are women who have not been formally trained, but attend to most of the births happening in villages. The purpose of the workshop, she explained to us, was to train them in recognizing the signs of early labor so that they can refer women to hospitals. Because of HIV/AIDS the Ugandan government has now made it illegal for TBA's to conduct a delivery unless it is 'by accident'.
Aimee and I attended the workshop and we filmed.
Thanks to IMovie we were able to edit together 3 minutes of our footage last night which I will try to be internet savvy enough to post. (the quality will be shitty since I have reduced the pixel size for the blog, but you will get a sense).
The hope is that we can continue filming in the villages and the hospital to really get to the heart of how women hope they will birth, talk about birth and actually birth.
So rich I am not sure where to start. How does one tell a story and bring it to life?
Of course, any point that I start will never be the beginning, so I will just start with this moment.
I am sitting in an internet cafe called 'Long Tick'it is across the street from the side of the market where they sell flipflops and second hand clothing. Up the road from me is the hospital and in the other direction is St. Monica's, where I am staying.
This is an interesting time to be entering into the birth dialogue.
Aimee and I were invited by one of the nurse midwives, Sister Florence, to attend a workshop she was leading for Traditional Birth Attendants. These are women who have not been formally trained, but attend to most of the births happening in villages. The purpose of the workshop, she explained to us, was to train them in recognizing the signs of early labor so that they can refer women to hospitals. Because of HIV/AIDS the Ugandan government has now made it illegal for TBA's to conduct a delivery unless it is 'by accident'.
Aimee and I attended the workshop and we filmed.
Thanks to IMovie we were able to edit together 3 minutes of our footage last night which I will try to be internet savvy enough to post. (the quality will be shitty since I have reduced the pixel size for the blog, but you will get a sense).
The hope is that we can continue filming in the villages and the hospital to really get to the heart of how women hope they will birth, talk about birth and actually birth.
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