30th Sept.

We normally start school at 7 a.m. but have been starting a bit early as I've been heading to clinic at 8:30 rather than shortly after 9. Didn't do much school with the kids yesterday but I hear that they did OK.

Our first patient was a thin, sickly looking lady who hadn't gained any weight since her last OB visit in June. As the last visit wasn't well documented I don't know if the baby was growing well or not. We sent her and others to lab and were done by 10:30! Yeah....but did I hear a slight grown from the delivery room.

Yes I did and the grown in my head wasn't slight!! Maybe I had a slight chance that she was an experienced mom and this would be easy and fast. WRONG. This was a short, thin, 24 year old with her first baby. She was quite anemic, hadn't had her pre-natal tetanus vaccinations and was almost complete. SIGH we'd be hanging out for this delivery.

So we did. Went back to my exam room and talked medical for about an hour. Then went to check. Time to push but she didn't feel like pushing. As we had some signs that the baby may be in distress I had her push with the contractions. She did well but the contractions were spaced out more than 5 minutes. So push.......wait.......push.......wait. She begged for a drink, for food, for a bath.

Now it was after 1 and the labs were finished. So between contractions, Chris, my great secretary would hold up the labs for me and then write out the scrips. We sent about 3 patients home. At this time the laboring lady had decided to lay on her side and take a nap. No contractions for 20 minuets or so and I had asked the nurses to get ready an IV. Now this would of been risky because we don't have the micro-slow IV that we really would of needed for Pitocin to give her contractions but I was getting desperate.

But wait..she suddenly turned onto her back and gave a mighty push! YES. Baby girl arrived and cried instantly flooding my heart with happiness. She was only 5 3/4 pounds but much bigger and she would of had major trouble arriving. Waited another 15 minutes or so for the placenta. Only small tears-so we were good.

Back to clinic-unfortunately to tell our expecting mom that she has HIV. We wrote for Iron for her anemia and for the food program. Gave her a Moringa tree, Moringa powder and Artemesia powder along with a referral letter for an HIV treatment program in the town next to us. And we prayed.

Walked back up for lunch about 2 p.m. but before we had the table even cleaned up. The call came that we were needed in clinic for a motorcycle accident, three patients.

1-Maybe fractured facial bones- Ibuprofen and referral.

2. Three small lacerations: Left temple, right ear lobe with a tear that went though and looked like an Y, and a linear laceration behind that ear. And epigastric pain likely from the stress.

3. Young 15 month old found under the bike. A tiny superficial non-bleeding scrape on his chin. [The Lord had protected him.]

Back up home shortly after 4. Shower. Scrubbed my shoes. Read E-mails. Supper. Read a bit more. Bed at 7:30. Keep Praying!!!!!