Option 1: For a casual crowd. A little hair showing. Probably not appropriate for too much out-on-the-town stuff.
Option 2: The favorite of the expats and coolest and most practical. How I've been doing it mostly due to above reasons.
Option 3: The most traditional, and closer to the way you see the Somali women wear it. But it is hot this way, and tends to slide down. The quickest way, though.
Headscarves are part of the uniforms here: the student midwives wear light blue ones, the staff midwives and nurses royal blue ones, the cleaning women navy blue ones. When the student midwives aren't working, they wear their regular scarves to class.
I mentioned yesterday that I had assisted with a neonatal resuscitation class, and today I ended up teaching a group of student midwives myself. As I also mentioned previously, 1 out of every 8 babies born in Somaliland dies before he/she is 28 days old, many of these immediately at birth. About 10% of babies born (everywhere, not just Somaliland) need some assistance at birth to establish respirations, with about 1% of babies needing significant assistance. Without this assistance (infant CPR and/or positive pressure ventilation with an mask and ambu-bag), these babies quickly die. Until very recently, apparently, it was common to see a baby born not breathing and have no assistance given to that baby, though these were in general healthy babies who just needed a little help getting things started. The prevailing attitude was, "Inshallah"--God wills it. Somehow these midwifery students had made it their final year of school--they will graduate as qualified midwives next month--without receiving any training in resuscitation, even though clearly it is a critical skill. Another volunteer midwife, Lauren, identified this as an area of concern, and integrated it into the curriculum.
But actually teaching these student midwives to do it has been a huge issue. Problems continue to pop up where you wouldn't even think. Some of the girls can't tell time, so timing 30 seconds of CPR or 6 seconds of listening to the heart rate is impossible. Almost none have watches (though apparently they can be bought at the market here for about US50 cents), so even if they can tell time they have nothing to do it with (this raises some other questions, like what have they been using to time contractions and vital signs all these months, too!). Many girls have struggled with the concept of listening to the heart rate for 6 seconds (all the time you have in an emergency situation) and multiplying by 10 to get the beats per minute. Headscarves get tangled up with stethoscopes and waste precious seconds. Recognizing when to do CPR (if the HR is <60>60 but <100 bpm) has been a source of eternal confusion.
After several intensive practicum sessions where they had a chance to practice hands-on with baby dummies over and over and over again, most have been able to develop some level of competence. But there's still a long way to go before most are going to be able to resuscitate with any confidence, and there are concerns that without repeatedly reviewing these skills and lots of prompting the actual skills won't be taken into the delivery room. Lauren and I will keep working at it with them though, and hopefully they'll continue to improve.
Also today: teaching about treating newborn jaundice to the two student midwives on the postpartum unit (very yellow baby, needed sunlight, people here [as in many other countries in Africa I have been to] are very concerned about keeping babies warm, sometimes to the point of overheating, and the mother was very reluctant to keep the baby unwrapped and in sunlight for more than when someone was watching her) and a stalled labor (hey, Pitocin!)
Wandered up to the roof of the hospital a few minutes after sunset and took this video of Hargeisa from the roof, with the call to prayer in the background if you turn your volume on.
No comments:
Post a Comment