Not for the weak of heart...or stomach

So this week I thought I was going to get to see a baby be born. There was a young girl in labor and Miriam asked me if I wanted to come in and see. I said of course. This is what I’ve been waiting for…it’s what I’m here for. I walked into the delivery room, which is a cement walled and floored room with a delivery “table” in it, a sink and a couple of little tools (which my Leatherman is probably better equipped for the job than this set of tools was) to cut and tuck stuff after the delivery. When I walked in there was a young girl, maybe 16, laying on the table with only her shirt on. Legs up, just bent, there are no stirrups on the delivery table, thrashing her head back and forth with each contraction. Crying is not something that Malians do and making any noise during delivery would also not be acceptable. Miriam went over and talked to her for a minute and then slapped her stomach around a few times. Now I’m not a doctor or someone with a 6th grade education that went to class for 9 months to learn to deliver babies but I can’t imagine that she was taught to do this. I’ve had a couple of babies of my own and have many, many friends that have had babies and none of us have had our stomachs smacked around during labor.

Miriam then came over and kind of shuffled me out of the room. I went across the hall and sat in the “recovery” room with the girl’s mother. When she heard noise coming from her daughter she went in the delivery room to be with her. Miriam came out and told me to go home. I asked her if she was sure. I wanted to stay and it was what I was here for. She said, no, to go home. I saw Miriam up at the butiki about 4 hours later and the girl had just delivered a little boy. I say the mom and the grandmother outside by the nyegen washing off the delivery table padding with a bucket of water. No soap, just a bucket of water. I don’t even want to know what they do with the after birthing mess. Bury it, throw it down the nyegen. I don’t really have the language skills to inquire if I did want to know. So finally a baby born and I still haven’t gotten to see a birth.

The next day the regional director for my area came by to check on me. I told him that things were going OK. That I am a bit lonely and finding it hard to cope with being at site by myself and not having the language skills to communicate well with my community. He asked if I was helping out at the clinic with Miriam. I told him of yesterday’s events. He said he would talk to the matron and let her know that it would be OK for me to sit in when she has a patient, when a baby is born, when she does pre-natal consultations, etc. Miriam agreed that this would be fine.

Now even though the clinic is a “maternity” facility it’s the only medical like place in our village. So Miriam, a matron/midwife with a 6th grade education and 9 months training to deliver babies, will see sick babies, sick women, sick men, anyone with basic injuries that need cleaning and bandaging. Everyone else she would have to send to Zantiebougou, the next village 7k away that has a “clinic” and a “doctor” so to speak. So the very next day after the regional director talked to Miriam about me sitting in when she had a patient we got our first patient since the baby was delivered. It was a young man, about 25, limping over with 4 other men, two on each side of him. She told me to come along with her to see him. I suggested that he had hurt his foot perhaps? She said, no, and pointed to her crotch. I wasn’t sure what that meant. This young man was already in a room and there was a male doctor from the next village in there with him already working on him. When I walked in this young man was on the “delivery table” stark ass naked with his knees bent up much like the young girl in labor was on the very same table just two days earlier. Since the table end is facing the door I walked in and was eyeball to ball with his…well balls. He had what appeared to be an infection. An infection that was so bad that his testicles and penis where covered with sores and puss and oozing slime the likes of nothing I have ever seen before in my life (I told you not for the weak of stomach). I was sure his balls and penis would either need to be removed or eventually would fall off on their own. The smell was overwhelming. In my head I was imaging the smell to be of the iodine this doctor was using to clean his crotchal area with. Apparently this man had this infection for some time and was in for a dressing change. Old gauze was being removed, hair was being cut away from the area, the sores were being cleaned and treated and then dressing was going to be replaced.

There poor man/kid appeared to be in excruciating pain. Thrashing his head back and forth without making a sound, again much like the girl delivering her baby on the same table just days before. I felt so bad for him, not only because of the infection and not only because there was a female Malian woman in there watching but now here’s this tubob (white ghost) woman also in there watching. Although I was not watching. The glimpse and the smell I caught on the way into the room is something the likes of which I will remember and see at night when I close my eyes many times over in between now and the end of my days. I quickly moved over into the corner by the sink trying not to make eye contact with him or his balls. Not only for his sake but for mine. The room was about 110 degrees and I was sweating profusely…as was the doctor only my sweat was not dripping on to some man’s infected testicles. I felt faint and I wasn’t sure exactly why. The heat or the site and smells of the “delivery” room. By the time the doctor was finished with the dressing change his balls were neatly wrapped like a present with a strip of gauze wrapped around his waist to be used as a sling to hold his “package” up relieving them of the pain of their own weight. The doctor gave him a couple of shots of something (they love giving shots to everyone no matter you are in there for) and told him he could get dressed. This poor guy had so much trouble just trying to sit up he was in so much pain. I didn’t know if I should go over and offer to help him up, pick up his robe off the floor or just stand there looking like an idiot in the corner not making eye contact. So that’s what I did. Stood in the corner. He got up, put on his robe and limped out to his friends waiting in the front room. The doctor rolled all the old gauze, blood, hair and guts into the plastic sheet that was under this guys legs into a ball and proceeded to wash the tools in the sink with a little laundry detergent and put them back into his medical bag and was off. This was clearly one of the most hideous experiences of my life. Again, I will see this man’s balls at night when I close my eyes. It will be a site I will not forget anytime soon.