Let me start by saying, South Sudanese women are strong! I have attended 13 sets of twins since my arrival and 3 sets in the last week! The last 2 sets were quite something. I may start buying lottery tickets! The first mother was a grand multip, 35 years old, G8 and she was term. She walked in to the birth room and started pushing. Out came a beautiful baby perfectly encased in the caul. It was a little girl. Not 2 minutes later, her sister decided to join us. First a big balloon of water came out and then she slipped her head out right into the bubble and then the rest of her was born. Both ..read more

I have been home from South Sudan for nearly 6 weeks. It has taken me all this time to write about my end of mission (EOM) primarily because it has taken all this time just to process those last hours. I was already suffering from pretty severe burnout and vicarious trauma but the last hours really upped it to a whole different level. I really wanted a simple EOM day. I would wake up in the morning, have my coffee and then just spend the morning bidding farewell to staff, get in the truck around noon and go to the airstrip. I was still on call (by choice, never wanting to miss a thing!) and as ..read more

Compassion fatigue is real. Often referred to as, the cost of caring, compassion fatigue and it’s often accompanying companion, vicarious trauma, can take their toll even on some of the most seasoned first responders, healthcare providers and humanitarians. No one is immune. From a personal standpoint, I have suffered the effects of compassion fatigue more times than I care to think about. It happens less frequently now because I have learned how to care for myself better while out in the field and I have learned how to use the resources and tools at my disposal. Still, most of us in the field ..read more

I have 2 more weeks before I am home and I feel like a long distance runner nearing the end of the race and getting that final burst of energy to make it across the finish line. In these last few weeks, aside from all of my tasks here, I managed to get in a podcast interview with Blyss Young, midwife and Stuart Fischbein, OB. They have a podcast called Birthing Instincts. Amazingly, the internet cooperated and only went out once the whole time! I had a lot of fun chatting with them even though there was a slight delay and a few people have messaged me asking if I was ignoring Stuart’s question ..read more

Early in my midwifery career, during my apprenticeship in fact, I learned about gestational trophoblastic disease firsthand. It fascinated me from the start. Here in South Sudan, I have seen several molar pregnancies per month, every month. Each case is unique and some of them are more complicated than others. This post will be a little more clinical/technical than others and may not interest those who are not midwives but I did my best to write in terms most people can understand. For readers unfamiliar with molar pregnancies, I will give a brief overview. Gestational trophoblastic disease (G ..read more

Hepatitis what? E? “I’ve never even heard of that!” I heard this statement over and over again when speaking to friends and colleagues back home. It isn’t surprising, Hep E is not at all common in the developed world. For future reference, and to dazzle your friends at any cocktail party over the holidays, there is hepatitis A,B,C,D & E (so far). Hepatitis D requires a hepatitis B virus for its replication – go figure! According to the World Health Organization (WHO), there are 20 million cases of HEV worldwide and of those, about 3.3 million are symptomatic. “HEV infection is found worldw ..read more

I arrived in maternity at 2:12. I left by 2:47. Middle of the night breech, my favorite and this one was particularly beautiful. First time mom, 18 years old, came in complete and the staff called me. When I arrived, I had to bypass a big puddle of amniotic fluid and fresh meconium – the telltale sign of a breech about to be born. The mother was already on the table. I prefer upright physiological breech but the staff is so accustomed to putting everyone on the table to examine them, they don’t think twice. I could see the baby had already descended and the mother looked like she really didn’t ..read more