16.04.2020 Emergency and Premature

Thursday mornings is our weekly trip to the supermarket to get supplies. Its strange seeing all the military presence around and knowing normal routine has really come to a standstill here in the afternoons. Back at the house I’m staying at I soon get a phone call that has be running to the ward. A patient IIIG IIP with two spontaneous births has just come in with an unknown date of delivery and contractions. Scan suggests somewhere between 34 and 35 weeks and in transverse position! We decide to try to do an external maneuver in hopes to get the baby in a position for natural birth. This we decide to do in the operating room ready for C-section in case we run into any complications. The maneuver is successful. Dr. Joselitto and I have just finished scrubbing in and are ready when a prompt rupture of membranes takes place with umbilical cord prolapse. Midwife Tanja is prepared and pushes the head up until we can operate. We immediately have anesthesia put the patient to sleep and begin the emergency c-section. The case was a special one, details which I will be happy to share if you ask but too much for here. Mother and baby are well. The little one received a feeding tube and is doing surprisingly well for the circumstances and premature age.

Case #20 Premature baby Fanambinana 2086g and mother Harivola

One week later

Fanambinana has nicely gained weight and is adapting to the surroundings

The pictures below are pretty typical of weekly shopping routine and the stretch we walk to get there.

Strolling through Ambohidratrimo market, the orange shirt with a picture of the president worn by the man is quite common here.

Peanuts shells from one of the market ladies while she sells now only till midday as opposed to all day pre-Corona times. The scales are the standard for shopping and things are purchased either in half kilogram or kilogram quantities or little piles like the ones of the three cucumbers or in cups like the white beans

Here we usually purchase things like flour, sugar and lentils.

There are giant sacks behind the shop with these products.

Covered large market in Talatamaty. This place has the most options and the ladies working the stands know us Vazahas (white people) from MHM so we no longer need to negotiate so much we just get a fair price.

So many veggies to choose from!

Delivery of goods via Zebu Cart

These guys don't have a Zebu so they are doing it manually, uphill does seem a bit strenuous but I guess its saves having to do any fitness activity after work!