It Takes a Village

We had lectures today for a couple of hours. The students are asking GREAT questions, and are really understanding the value of ultrasound, when to refer and why we're teaching them all these things. I think they were weary of my questions on placental location and amniotic fluid volume (they were focusing on measurements and sex), but now have a better appreciation of why these things are important - indicators of risk. Then... they started telling us some great stories:

Allaye had a small patient (45kg) at term with twins. He was concerned of complications at delivery due to her small size and wanted to refer her to the hospital in Segou (closest hospital). The husband wouldn't agree due to the cost (in this culture, men make all the decisions - see earlier blogs from last year for more). So... all the women of the village conspired and said to the patient 'start screaming when you go into labor'. btw... any outbursts/emotions are normally frowned upon here (women are silent during labor & delivery). With the signal (screaming) ALL the women went to the husband and put pressure on him so that he would take her to the hospital. It quickly all came together and she was taken to the hospital and delivered (by C-sesction) 2 healthy babies.

Abel had a patient who was at high risk for complications at delivery and who could not afford to go to the hospital in Sikasso. The fetus was in transverse lie at 8mos and also at 9mos. With the hospital 40km away, she couldn't afford to go. Fortunately, Abel had funds from the clinic that he redirected towards getting her to the hospital and picked her up himself and took her. She also had a successful delivery.

At Pierre's clinic in N'Torosso, he saw a woman with twins at 29 weeks who was already dilated 2cm. He refused to take her in the clinic due to the high risk associated with this early stage. The women was forced to another hospital/clinic for delivery and fortunately, had a good outcome. Pierre, with the help of ultrasound was able to make a sound decision (no pun intended) to help save these babies and mom.

Isn't this fascinating! Ultrasound has become more than a diagnostic tool for them. The 'proof' from the scans are forcing social change within the villages and best of all savings these precious lives! The diagnoses and referals that the nurses are making are garnering respect for the clinics. Patients are noticing and as I said earlier word travels quickly here. These clinics even have Drs from other clinics refering patients to their clinic! Wonderful! Bravo!