Lake Atitlan from the San Pedro Volcano

Lake Atitlan from the San Pedro Volcano
Lake Atitlan from the San Pedro Volcano

06 February 2012

The Nursery

“See that you do not despise one of these little ones. For I tell you that in heaven their angels always see the face of my Father who is in heaven." Matthew 18:10

After spending my first two weeks on the children’s ward at Patan Hospital, I transitioned to the nursery this week and have now spent two days with the babies.  Each morning I attend a teaching session, yesterday it was about the previous day’s admissions and today it was on chronic kidney disease, after which the residents disperse to their respective teams to pre-round and round. There are two intermediate nurseries and also a NICU. I have spent the first part of the week in nursery A and will spend the last couple of days this week in nursery B.  Thus far the babies have ranged in gestational age from 27 weeks to full-term and have varied in birth weight from less than 1 kg to over 3 kg. There are a couple of incubators in the intermediate nurseries, but any baby that requires intubation is transferred to the NICU. 

"Nursery A"

After morning rounds at the bedside of these babies, the team scatter to various duties. One resident will go the post-partum ward to exam the healthy babies “rooming-in” with their mothers. Another will cover the OT (Operating Theater) for c-sections and the Delivery room for vaginal deliveries. I’ve been waiting for my opportunity to attend the deliveries. Today I was granted that chance!

After trading my tennis shoes for “slippers” (plastic shower sandals) upon entering the OT area and donning scrubs atop by street clothes, a blue hair cap, and green facemask, I was dressed to observe my first c-section delivery.

The resident showed me how he prepped the bed with a warming lamp, set up the facemask, bag, and O2 if necessary, and prepared the suction. After watching him receive and care for one new baby, it was my chance to “catch” the next one. 

Ready for the hand-off!

“Catching babies” is a role medical students can fill for healthy babies and one that I have filled multiple times back at home. However, little did I know until today that there is a big difference here related to how the baby is later presented to its mother. In the U.S. we make sure the child is stable with an exam and necessary support, swaddle them tightly in a blanket, and bring them to the parents’ sides. Here in Nepal, the naked baby is carried to the mother’s side. When it was my turn to show the baby off for the first time, I supported the baby with one hand under its rump and the other hand under its head. Well, when I brought it to the mother’s side, I quickly learned why the baby had to be naked. It seemed the most important part of this encounter was to be able to visualize the baby’s private parts, as words alone were not enough. With that first baby, I quickly learned how to present the baby properly to its mother. Despite the emphasis on visualized the sex of the child, all the mothers today appeared equally thankful to have a boy or a girl.

He's a squirmy fellow:)

As I reflect on today, I just keep thinking how words really cannot describe the miracle that each life is. I love being there for the transition from a baby swimming in a sea of amniotic fluid to one breathing air and crying for the very first time. When their little eyes open up to the world around them, I am moved to my soul. I sense such ultimate innocence and dependence, yet such wonder and awe. Of course a healthy baby is such a blessing, as there unfortunately are many complications with the grueling birthing process. Today the babies were wonderfully pink.  

"Like newborn infants, long for the pure spiritual milk, that by it you may grow up to salvation– if indeed you have tasted that the Lord is good" 1 Peter 2:2-3

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