When the sisters start to sing, it is time to go to the hospital. It’s not much longer than a five-minute walk from the staff quarters (a few single-storey buildings surrounding a badminton field) to the hospital. The short uphill walk takes us past two swamp-like ponds that shimmer in the morning light. At first sight it feels like the hospital is situated in some kind of damp tropical forest, with birds, squirrels, frogs that keep me awake at night with their mating sounds, and enormous spiders (yes... that also). But after becoming more familiar with the surroundings, the hospital is more like a single green island among barren rice fields.
It is not just a green island, but also a Christian island, within an area predominantly Islamic or Hindu and with only a minority of Christians. An island filled with dedicated, very hard working nurses and a few doctors, driven by their desire to serve the poor and God above all. I admire their desires, their dedication without complaint. I make 6 or 7-day working weeks, with every third day a 24-hour shift without compensation, but I am here for ‘just’ 6 months. The couple that runs the hospital is committed for a lifetime, the few other doctors that are in their team are also here long term. They are often the only specialists, and on call 24/7. This hospital was built up from almost nothing, to a well functioning pro-poor hospital with an always busy maternity (obstetric) ward, a female, male, paediatric ward and even an intensive care unit were critically ill patients are treated with limited resources.
It is hospital life in survival modus. Within two weeks the whole ‘Obstetrics Emergencies’ book was covered. From doing a vacuum delivery in between seizures of a severely eclamptic patient not responding to the medication (NL: zwangerschapsvergiftiging), to running to the operation theatre to do a ceasarean for foetal distress. But also things you can’t even imagine in the Netherlands like a woman who came with 2 meters of her intestines stuck in her uterus due to a perforation of her uterus after a curettage by an unskilled person. Contraceptives are not always accepted and abortions are illegal, with the consequence that unskilled people perform them in secret, non-sterile and in ways unimaginable.
Besides the caesareans, and the difficult and severe cases, many women deliver healthy babies without complications, about a dozen per day. The experienced nurses hop from ‘bed’ to ‘bed’, and check if there are any hairs visible yet in the ‘bacha rasta’ (‘the way of the baby’). The labour ward has 4 metal flat tables, one wooden low table and two stretchers, usually all filled with women in the last part of their labour. All flat on their back, spaced less than a meter apart, they endure the labour pains together. Men are not allowed in this domain of sisters (‘didi’ in Bangla), but have to wait outside until the baby is shown to them.
While shouting the name of the mother, the little bundle is brought to meet the relatives. The father and grandmother eagerly unwrap the part that covers the sex of the baby. It is not who the baby resembles that will spark their joy, but only male genitals can count on thrilled exclamations. Both the mother and the relatives don’t even try to hide their disappointment when the child is female. Fortunately this image of disappointment is partly erased during evening rounds, by the sight of the new mothers lovingly sleeping together with their beautiful black haired babies and their own mothers in one bed.
It is strange to realise that how alien everything might have been to me the first time I came to a low resource setting (over 10 years ago, also to India), this time in many ways it feels so normal to be and work here. This is what I trained for and I am curious what my time in this hospital will bring.