A Swazi Birth

This will be about baby birthing very shortly, but first, I must say: books. Thank you to everyone who has been sending books! On a strictly personal and selfish level, I have been enjoying the heck out of what you have been sending (it’s quality control, you see. I have to test drive the books before they can be admitted to the library). Between those, the books already at school, and the Peace Corps library the volunteers have been creating in the office for the past ten years, I have begun absolutely devouring books. No, not devouring them, inhaling them, swallowing them whole. I have always been a terrible reader (long story I can tell you sometime when we go out to coffee next year, but really not worth blogging) and thus have always limited my reading efforts. But here - oh man, I am unstoppable! Today on the khumbi to Mbabane, I had 7 books in my bag. I finished the last 1/4 of Bill Bryson (the one where he drives all over the USA) and am 1/3 of the way into Ishmael by Daniel Quinn which I found in the office at a primary school yesterday (not my school, a different one). A book where, in such a fundamentally, vehemently Christian culture, the school would undoubtedly be closed if anyone knew what was written inside the deceivingly religious-friendly cover sitting on the office shelf. It’s not pornographic or anything, but it sure as heck doesn’t quote the bible. (Side note: That visit at the primary school not only earned me an interesting book  to read, but also two hours a week of teaching grade 5... Teaching what? I guess I’ll have to come up with something before Monday.)

Now. Babies. Well, baby - singular. My sisi with whom I lived in eKudseni during training (June-August) had her baby on Thursday. She came down to Mankayane (a town only about an hour from me) to the government hospital to have her baby. It is supposed to be the best hospital in the country (besides the Mbabane clinic, but that is for rich people). Before leaving home, I asked Ntombenhle what she would like me to bring while she was still in labor. “Toilet paper and something to drink,” was her response. Knowing full well one must never question a woman in labor, I brought the requested items along with some fruit to the hospital. I got there and walked down a mostly-enclosed hallway to the maternal ward and was directed to a room where Ntombenhle lay on a metal bed with a thin foam mat strait out of a 1930’s war movie. Three other women lay on identically rusting beds moaning and wailing, all partitioned by sliding curtains. Before I went to her, I asked a nurse if there was somewhere I could wash my hands. He looked at confusion and pulled another nurse to him. Sure we were having an issue with language, I asked again to the both of them if I could wash my hands before going to my sisi. “Kukeza tandla,” I said rubbing my hands together. 

“You want to wash?” came the response in clear English. 

“Uh... yes. I just came in from outside. I was riding a khumbi....” 

Blank stares. 

“I don’t want to give her any bad germs when she is about to have a baby.” 

They mumbled together and pulled in a third nurse who asked me the same question, “You want to wash?” 

“Yes please.” 

Shrugging, “Ok, this way.” 

I was taken to a far corner and directed to a dripping sink. I reached for the soap dispenser which was broken beyond repair and covered in a thick crust. There was no soap. Anywhere. I saw a jug of iodine scrub leaking a brown goo onto the  floor and guessed that was my best bet at sanitation. I poured some over my hands and washed while a gathering of nurses whispered and watched my outlandish behavior. I actively fought off thoughts of the nurses’ sanitation while working with the laboring mothers and new-born babies for the next two days.

I went to Ntombenhle who was texting her boyfriend and laying on her side. She looked beautiful... and a bit miserable (let’s be honest). I asked her if they were taking good care of her and she told me yes. They brought the women three meals a day (sour  corn porridge for breakfast, cornmeal and chicken for lunch, two slices of white bread for tea, and “something” for dinner), there was a shower they could use (she motioned to the bathroom - not fully enclosed, but it had 3 walls) and a toilet. But they did not provide toilet paper. And the closest place one could obtain toilet paper, should one desire it or have the funds for it, was a 35 minute walk down the hill and a 35 minute walk back up the hill. But once admitted to the hospital, you can’t leave until you pay. So, basically unless you have a friend come visit or you travel with toilet paper wherever you go (as I do), you get to go through days of labor, birth, and recovery with a... well, I won’t get graphic, but you get the point. 

I went back out and got her a newspaper (she was terribly board of staring at the wall as she’d already been there a day and a half) and some biscuits. I asked if she would mind terribly if I had one of the biscuits as I was starving. I was just taking my second bite when I heard a horrible, guttural, screaming noise coming from the curtain behind me. Ntombenhle sat up with a look of sheer pain, “We need to get out. They will be angry if we are in here.” I grabbed my bag and looked back to see the head of a baby, along with large amount of blood and birthing fluids being ejected by a screaming woman as nurses crowded around. We walked into the hall and found a bench where I finished munching my biscuit. Ntombenhle sat, laboring painfully on the wooden bench for twenty minutes while I tried to make light conversation and silently lamented about the package of biscuits I left on the table next to the presently birthing woman. A nurse walked by with pilled, frayed blankets soaked in birth-stuff. He stood and chatted with other nurses for a while - his bundle quite uncomfortable close to my face in the narrow hallway. Finally Ntombenhle was allowed back into the birthing room, and I told her I would come back later. Luckily, I have a friend who lives right near the hospital where I could stay the night. I went over there to say hello, and she gave me some American magazines to give Ntombenhle to read. When I got back to the hospital, my sisi had been moved to the post-birth room because she was not progressing fast enough to be in the hard-labor room. I asked how far she was dilated and she didn’t know what I meant. I asked if she had any tests done lately and she said that yes, they took her blood pressure and checked to see that the baby’s heart was beating. I asked if they checked her “down-there” and she said that they hadn’t done that since earlier in the morning. It was now 6:30 in the evening. We had a bit of a chat, then I had a chat with the nurses, and then Ntombenhle got examined. While she was gone I got a chance to meet all of the new mothers and babies in the post-birth room. The women were on the same rotting-foam mattresses they were on before, but now eight to a room and no partitions, still all sharing a toilet-paper-less bathroom. Many were hooked up to saline IV’s which were hung on hooks on the wall too high for most to reach, so when someone needed the toilet, I would take down the bags and hang them upon the women’s return. Nurses only made visits a few times a day to deliver food and check everyone’s temperature. The babies all shared the tiny beds with their mothers. Eight brand new babies. Eight brand new mothers. Eight thin metal beds. Not a lot of sleep for anyone in the night. The hospital did give the women a bottle of antiseptic to share, however. Every now and then, a sore mother would unwrap her baby from the blankets she brought from home, remove the cloth she used as a diaper, and blotted antiseptic all around the baby’s clamped, purple umbilical chord. 

When Ntombenhlel returned, I asked her why she came all the way to this hospital. She told me that it was the best in the country. She could have gone to one much closer to home, but it was more expensive, and was very very dirty. I looked at the trail of ants crawling along the edge of the room and up her bed leg into a bag containing a banana peel that lie on the corner of the mattress. She continued to tell me about how wonderfully she was being cared for here as opposed to the rumors neglect at the other hospitals. I told her I was glad she was in such a good place then went to my friend’s for dinner and drinks and helped tutor a kid she mentors.

I woke in the morning to a text from Ntombenhle. She had given birth to a baby girl! I grabbed a banana and made her a peanut butter sandwich and ran out the door. Her baby was beautiful. Sihleliwe (...I think... I had a hard time pronouncing it and honestly don’t quite remember it now). And, the most important, most interesting thing I learned, which came as quite a shock to me, is this: All babies are born white. The African ones just turn brown later, I guess. I went to hold Sihleliwe, and there, was a beautiful, little white baby girl. Her skin was more pale than mine! Anyway, I spent some time with them in the morning and then again in the afternoon, bringing snacks and toilet paper as needed. I was pleased too that Ntombenhle’s mother came in the afternoon - it was great to see her again. I saw three ladies today on their way back home (the baby was light brown), and I will go visit the whole family later this weekend. So much excitement. And such a different birthing experience than anything I have ever imagined. I kept thinking the whole time about my sisters and what the hell they would have done if they delivered their children in a Swazi government hospital as opposed to the Des Moines Mercy Clinic.