The maternity center

I went to the Mbita maternity center yesterday and was able to talk to the manager of the department, as well as one of the nurses. It was great – they actually had a lot to say and gave me some good information. When I was talking to the manager and asked her why she thought women chose to stay at home, she says, “Do you want to hear what I think? Or the reasons the women give me?” and she went on to say that for many women, yes, it’s true that transport is difficult to get and they don’t have money to pay. But, she says, there is also a lot of fear of HIV testing, which is what happens at the first prenatal visit and so, often, women will only come once, find out they’re positive, then stay away for fear of what that means. Another big issue is the issue of planning – for many, it is a bad omen to plan and so even though they talk about the “Individual Birth Plan” at the prenatal visits, many women will still not plan for fear that it might harm the baby or complicate the delivery. So, interesting information.

The nurse I spoke to was great – she gave me a tour of the whole place, talked a lot about the women who come, reasons why women might not come and issues they were having at the center. When I asked her about what components might be missing to better support maternal health in the area, she started talking about the staff attitude. She says, “For us, the issue is the staff attitude. We have some nurses who are very harsh and so the women don’t want to come. I have my problems and the women coming have theirs, we don’t need to add to them by being harsh.” And really, watching her with the women, she was so tender to them – if all the nurses were like her, there would be such an improvement. One big problem, aside from the staff attitude, is that they have an operating theater, fully equipped, with no one to run it. She told me the anesthesiologist and the doctor have “problems between each other” and so only three surgeries have actually been performed there since the center opened a year ago. Right now, every time there is a complication or a woman needs a c-section, they send her to Homa Bay. “So”, she says, “women don’t want to come for fear they will have to have a c-section and be sent away. We need better management to make those people work together – it is too bad that we can’t use the operating room.” Anyway, there are obviously a lot of issues going on there – they seem to be doing their best, aside from having some bad staff. The facility itself is REALLY nice and clean, but, as usual, there is little to no management of it and so there are problems, like not having any supplies.

After my meetings, I headed to the clinic to stop in and say hi – when I got there, there was a woman being carried into the observation room. I could hear her throwing up, so I’m guessing she was really dehydrated. And I saw the clinic’s new nurse (yes, one was hired! It is really good.) bringing in an IV and some fluids, so I’m guessing that that was the problem. Anyway, I will find out today how she did. The rest of the day was spent transcribing, reading, cooking (I made fried potatoes – yum. Totally indulged myself). Today, Kelsey and Morgan are coming for the girls’ football tournament that is happening tomorrow. That will be fun! Then I’m going to go back to Kisumu with them to work and then to tag along with them to Nairobi. Now that I’m finished with my interviews, I have a lot of computer work to do and that is more easily done in Kisumu with faster internet connections, etc… And I’ve never gotten to spend any time in Nairobi, so I figure this is a great chance to see more of it!

I have to return the internet stick to the clinic today, so I’ll update you more on Saturday when I get to Kisumu.