Hospital

(From top down) 1. The procedure room in labor and delivery - where all of the D&C's take place.

2. Beds in labor and delivery - deliveries performed here.

3. More beds in L&D

4. ? A fetoscope - Nurses use this to record/monitor fetal heart tones! **

5. Ultrasound machine in labor and delivery - a newer, nicer machine is located in the theatre.

6. Main outdoor corridor through the hospital - usually filled with patients and families

7. Benches outside of the theatre. By mid afternoon filled with patients referred with surgical issues.

8. Conference room - morning conference takes place here

9. Physiotherapy department

10. Pharmacy sign

** One of the biggest "challenges"/frustrations of working in the maternity department here is this instrument. Fetal heart tones are monitored once per hour in laboring patients and once daily in antepartum patients! Standard of care in western countries is "continuous monitoring" of all laboring patients and much more frequently in antepartum patients.

I was on call Monday night. Soon after my shift started our triplets ruptured membranes. I delivered the triplets (33+ weeks) by c-section and the three babies did well. All delivered breech (2.6kg, 2.0kg, and 1.6 kg). Mother and babies doing well. I asked the mother if I could take a picture of her and the babies but she declined. Sorry no evidence!

I am looking forward to my "annual volunteer conference (AVC)" coming up next month. All of the volunteers in Tanzania (about 65) are meeting in Dar Es Salaam for meetings and to share experiences. I'll be in Dar Es Salaam from December 17-20th for the conference.

I'm spending one day in Dar to look around at medical suppliers, hoping to buy some dopplers for the maternity department!!

After AVC, I requested a little holiday because most of the volunteers have time off during christmas. So I'm going to go to Zanzibar over this holiday period. I'll be in Zanzibar December 21-26th.