Case of 'Baby Aisha' - Where do you stand?

After a hot shower and a change into clean sweats, we were just sitting down for a cup of tea and a card game of Shanghai when he came knocking at the door, “Baby is coming! Baby is coming!”  We left our steaming mugs, threw on a pair of flip flops, grabbed a flashlight and went running across the dirt walking path (“across the street”) to the grass and mud hut of Aisha and Tapisa.  We had been anxiously waiting for this moment; the opportunity to see an Ethiopian baby being born in its hut.

They welcomed us inside their tiny hut about the size of an average sized American living room.  Pitch black, the only light came from the smoldering fire hole dug about 8 inches down into the dirt floor.  We’d been here many times before, but this time was surreal, crowded among the other family members that were here for the big event, the room so dark and smoky you couldn’t even see the face of the person you were greeting with the traditional three-shoulder-tap morphed into a hug and a handshake to follow.

We finally made our way to mama – Aisha, lying on a bed of banana leaves in the far corner of the room, a threadbare wool blanket covering her otherwise naked body.  The baby had already come.  She, traditionally named after her mother (Aisha) was swaddled in the red-dirt stained t-shirt of her father and a ratty vibrant red women’s neck scarf, the afterbirth still on her head.  She was lying next to her mom, who though exhausted, was smiling and gorgeous. 

After about 5 minutes of taking turns adoring the baby, the pains had returned - it was as if Aisha was still in labor.  A lot started happening all at once.  We decided to call a local American missionary who specializes in child-birth.  

She walked us through several things to check like how much blood was coming, what was the texture of her stomach above the belly button, below the belly button, the cervix and on and on.  She sent us on a search in the hut for the placenta, which we successfully located under a chunk of banana tree bark.  To top it off, in the chaos of it all, we turned to see the mother-in-law handing Aisha a 3 foot piece of wood, one end of which had been resting in the fire and was burning-red-hot, and Aisha in turn taking the stick and going towards her stomach to burn herself with it.  We learned that in traditional medicine here, this method is believed to relieve pain.  We doubt it…

The decision was made to rush her to the hospital.  We called a local bajaj (motorcycle cart) driver to come pick us up.  We got Aisha dressed and helped her into the bajaj, in next went me, someone handed me the baby and then Aisha (the husband/dad) piled in on the other side of me.  Sidney jumped in the front and off we went.  The bumpy ride down the dirt road was torture with every bounce, Aisha draped over me, moaning in pain.  In what seemed like forever, we finally made it to the paved road that takes us into town and subsequently to the hospital.

Upon arrival, we helped Aisha onto a hospital bed next to the wall in the waiting room.  After finally locating the doctor, we wheeled her into the room.  By now the baby’s dressings, along with myself, were totally soaked with urine and that brand-new baby poop tar stuff.  Since the hospital has no running water, let alone rags, Sidney and I walked the baby across to the corner of campus where the American missionary doctor and his wife live.

We washed the baby in the sink, clamped the umbilical cord and got her dressed into some new baby clothes (which were again, thoroughly soiled by the time we made it back to Aisha’s room since diapers are completely non-existent here).  I then, brought the baby to a room back at the hospital where we cut the umbilical cord with a crude razor blade and wiped her down with whatever we could find in the pitifully un-stocked room – a dirty pillow case and a piece of gauze.  At this point it’s questionable as to whether or not any patient actually has a chance to leave the hospital in better condition than they entered.

After re-uniting with Aisha, Sidney and the rest of the group that had slowly grown over the course of this hospital debacle, we received a positive diagnosis and were discharged with a prescription of Tylenol.  Really?  All that for 20 tabs of Tylenol?

In hindsight, here are the things we learned: a) I guess sometimes the pains of having a child are actually worse after the birth than they are during – obviously Josh nor I knew that, and Sidney, being many years past childbearing didn’t remember that part, b) in this culture, if the new mom and family think something is “wrong” for one reason or another (i.e. the afterbirth pains), they will 1) burn themselves and 2) refuse to nurse the baby allowing it to die within a few days.  We learned that Aisha had yet to nurse the baby, so we practically had to force her to.  For these reasons we were applauded for bringing her to the hospital so someone could explain to her in her own language that she was ok and to please stop burning yourself and to please start feeding the baby.

After checking on Aisha a few times and administering her meds, she is doing well and baby is happily nursing.  As cultural tradition requires, we won’t see her emerge from her hut for at least 6 weeks, where she and baby will be kept in the darkest part of the hut (we’re not totally sure what to make of this one) on a banana leaf bed.

This experience and health of the baby is extra sweet because just about a year ago, Aisha’s last baby girl died at 6-months old.  It has been precious to get to go through this with her over the past month or so – babies are a sweet blessing from above!

WHAT IS/ARE THE ISSUE(S)? (Define the issue(s) and identify where you stand on this given scenario)

GET THE FACTS? (What are the relevant facts of the case)

IDENTIFY ALTERNATIVE COURSES OF ACTION (Resist inclination of viewing alternatives in dichotomous terms)

MAKE A DECISION AND TEST IT (Make a decision and test - as if you had a global audience listening to your decision)

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