Evacuations

No, there’s no security risks, we’re not being evacuated from South Sudan, I’m rather referring to the medical term used here to describe a procedure following an aborted pregnancy (whether elective or spontaneous) to “clean out” the woman’s uterus if she has persistent abdominal pain following the abortion, or is having trouble conceiving when she has been successful in the past.  We call them D&C’s in the USA.

I’ve seen 4 of them in the last 2 days that I’ve gone to the health center.  One for a woman having difficulty conceiving and 3 for women who have lost 2nd trimester babies days/weeks before, and 3 of them back to back yesterday.  It’s been a smack of reality for several reasons.

1) It’s out of my usual pediatric/wound care nursing realm - my only OB/GYN experience was while studying abroad in Israel 13 years ago.  I think getting experience from different angles of medicine is really eye opening.  Usually I get to take care of children who are sick, but survived childbirth at least.  This is caring for women whose bodies could not, or chose not to, sustain life for one reason or another.  Seems like it should be similar but felt very different - and very outside my skill set.

Whether it’s true or not, there’s at least enough prevalence of syphilis here in Mundri
to cause Zebra, the Theatre Assistant/Nurse who does the D&C’s, to blame the 2nd trimester spontaneous abortions on the presence of the disease even though their medical histories including nothing of it...Again, I’m used to treating children, some of whom have STD’s but not as many as I’ve seen in adults young and old here.  The promiscuity evidenced in the prevalence of syphilis is disheartening/maddening depending on the day.

3) The way that women’s usually private anatomy is treated during the procedure like a car being worked on by a mechanic makes every muscle in my body tense up (similarly to Scott’s while we watched Zebra do a couple circumcisions a few weeks ago).  Metal rods and forceps and clamps and such (no idea what the instruments are actually called) being shoved and scraped around inside there is not what our bodies were made for - I’m pretty sure of it after watching that as a woman.  NOT OK.  But that’s just it, death occurring inside of us isn’t what our bodies were made for either.  One in certain instances requires the other.  For some reason the car mechanic approach is easier for me to handle when there’s a scalpel and cutting involved...shoving and scraping things inside natural orifices is just disturbing - kinda like dentistry...


Death is just a hard reality, whether the woman has chosen it for her body/offspring or not.  The 3 in a row thing yesterday made the reality of the loss of life here even more in my face.  And this is after being greeted in the morning by a friend who when I asked what the news was, she told me “akubar mafi, kulu mutu bes” - “there is no news only that everyone’s dying.”  We talked about how it seemed like there were funerals daily (and yesterday I knew of 3) for people young and old, important people and lowly people, everyone here is susceptible, no one can escape this reality.  She went off to bury her cousin-sister’s 9 mo baby who died that morning at the hospital 45 minutes away, and I went off to the maternity ward where Zebra was waiting with an apron, mask and sterile gloves for me to help her face a similar reality, just a different form and  just a few steps removed.

And the reasons go on.  But I rushed home to cook dinner for the team and be a part of a house chores discussion and Bible/book study re. our calling and why we are here in South Sudan and what that and we should look/live like here.  Not even a re-run of the Cosby show could quite shake these realities from my mind...if Bill can’t do it, you know it’s serious :)  But that’s why I’m here, to offer help and hope in the face of such realities,    I pray that’s what I did.