Hospital in David

               On Thursday, June 7, we went to the hospital in David to work alongside the Unachi nursing students (the hospital's full name is "Hospital Materno Infantil Jose Domingo de Obaldia in David."

Nursing students :)

I was assigned to the labor/delivery unit, which we will be rotating through next semester, and found that it was not like anything I had experienced yet as a student.  First we were brought into a waiting room where all of the women in labor were awaiting transfer to the delivery room.  After observing several measurements, one was finally ready to go and we were allowed to follow her.  This was her third child, so apparently things moved relatively quickly, but the entire procedure was performed by a nursing student!  We don't get the opportunity to do that as students in the US, so that was really cool to see.  There were a number of differences between US and Panamanian deliveries:  first, the mother showed no emotion during the entire thing, including when they handed her child to her and the nurse had to place the mother's hands on her child because she kept them by her side.  Second, they do not use epidurals - not just in Panama, but largely anywhere outside of North America (apparently we are just wimpy in the States).  Third, the doctor poked his head in once to make sure everything was running smoothly, but was more or less absent otherwise.  Evidently they are only called in if surgery is required (i.e. c-section), but any minor sutures are, again, done by the nursing student.  Lastly, there were four USF students and an instructor, five Unachi students and an instructor, plus on-duty nurses in the room with the poor woman, and they were all standing around educating us on various aspects of the delivery process, taking pictures, laughing, but not really paying much attention to mother and baby.  It was great for us, but I felt rather bad for her.

It's a girl!

               I suppose that the nursing students here are required to have this type of experience because it occurs more frequently here, especially among the indigenous people.  In the United States, most families have between one and three children and the parents are getting older with each generation.  Here, however, more than half of the population is under 19 years old (at least in Chami, our community), and many of the women have their first children before the age of 20.  I realize that part of it is cultural, but after seeing so  many women struggling to feed themselves I'm wondering if there ought to be a better effort to promote education on birth control.  In our clinics, Dr. Barry and his staff were very good about making it a point to mention the various implements and injections available, but most of the women I observed were reluctant to discuss it.  

A family in Hato Chami