The last few weeks have been rather busy in the hospital. This is because of a visit from a Korean urologist. He was able to operate cases that I could not do. During his visit another gynecologist and myself were responsible to see that everything was scheduled and ran smoothly. The patients needed to be selected and then we determined how the operation would be handled. In addition to this we needed to see that we had assistance during the operations. There were certain operations that I wanted to operate with the urologist so that I could see if I could do them later myself.

Several of the operations were with patients unable to control their urine. This problem can occur after a difficult delivery, but more and more we see this after a C-section or removal of the uterus. We also had 3 girls born with this problem. One girl was not allowed to go to school, another girl was able to go to school (only because of persistent asking), but must stand in the back of the classroom because otherwise the seat of her school desk would be soiled. You can imagine how life would change for these girls as well as the women if they could hold their urine.

Also during these 2 weeks my normal patients were also waiting to be helped. This means that it was even busier after the urologist's visit. Plus for the last month I also have been doing a round in gynecology. There are not enough doctors in this area and this helps to alleviate the work pressure. My first two rounds were uneventful but last week's round was dramatic. A young woman, who had given birth to a still born baby in another clinic, came with severe bleeding. Usually such severe bleeding after childbirth means a piece of the placenta stayed in the uterus. The morning I saw this young woman I thought this was the case with her. The uterus was cleaned. The bleeding stopped. In the evening she began again to bleed heavily. I tried several things (I'll spare you the details!), but eventually I had to remove the uterus to stop the bleeding. This operation saved her life but was a drastic step--no matter what country you live in. Here it is even more drastic than in the Netherlands. The position of the woman here depends on the fact that she bears children--especially sons. Because she now cannot have children her husband will divorce her. She must return to her parents and her family will support her. Another option would be that her husband takes another wife and she would be used as cheap labor. With this patient there was a small ray of hope. During her stay in the hospital the family talked about adoption. If she agrees to this then there is hope that she can live a worthwhile life.

Otherwise life here the last few weeks has been demanding and has cost me a lot of energy due to the high temperatures and humidity. In the last 3 weeks the temperature has not been below 30 degrees--even at night--with more than 70% humidity. You need to continually remind yourself to take it easy and do things slowly!

Fortunately it is almost vacation time. Another female teacher form the project and I will go to Thailand for 2 weeks. We'll go to the beach and not do much else. Hopefully my "battery will be recharged" enough to return and continue with new energy and inspiration.

Soon I'll put a short film with a tour of the hospital on the website. But first a few pictures.

Patient's wash drying

The hospital entrance