Cultural Observations

This week I will write about the many cultural differences I've encountered while working here, especially in a medical and nursing capacity. But first, I would like to mention the exciting news the little Marisol is out of the hospital, and recovering with a caregiver at a home in Quito, where the altitude is a bit more manageable. We don't have a date as to when the surgery will be, as she still needs to regain a bit more strength since her recent intubation in the Pediatric ICU, but it is in the works.

One of my favorite parts of working here, is getting to be present for the births. I find it such an amazing experience, every time. I get to be the first one to catch the baby, after the obstetrician pulls him or her out of the mother. I rub the baby down with a sterile towel, to stimulate them to give their first cry, and sometimes use a bulb syringe to suction out their nose and mouth. After the cord is clamped, I carry the baby to the adjoining neonatal room, and put them under a warmer, as I do their first newborn assessment, checking their lungs and heart beat, that they have 10 fingers and 10 toes, height, weight, and head circumference.

Then comes the funniest part to me, is dressing the baby. In the US, to my knowledge, the baby just gets wrapped in a blanket and handed to the mother, but here, oh no, you have to fully dress the baby before handing them off. For me, this is often the most technically difficult, to get undershirt, long sleeve shirt, jumper, booties, mittens, and hat on, a newly born, squirmy, sticky baby. But so it goes. And since no one here ever knows the gender ahead of time, it's anyone's best guess, and I'm usually dressing baby boys in bright pink, and girls in blue. So we start early breaking gender stereotypes.

The mothers and babies usually stay about 48 hours if all goes as planned, before going to their homes. From there, it's customary that the mothers stay in bed, all bundled up, for 40 days. I'm a little foggy on who takes over the housework and childcare during this time, whether it's the father, or the mother's extended female relatives. We have had several newborns who have had to be re-admitted to the hospital for various reasons such a newborn jaundice, fevers, or low oxygen saturations. Often the mothers are very upset that their 40 days in bed have been interrupted, and strongly dislike being here. We try to be culturally accommodating and provide the mom a bed that she can sleep in at night at least, where as all the other mothers of older children are sleeping beside their child's bed in an upright or reclining chair.

Care of the umbilical cord is also an interesting topic. Many parents wrap a long piece of cloth around their babies waist, to "keep their belly button inside." Others might put a silver dollar coin over the umbilicus, intending to prevent an umbilical hernia. None of this is backed by any evidence, but it is a cultural norm here. When the babies come into clinic, they are often so bundled up in multiple layers of blankets, pants, shirts, with a dress on top, that it takes a good several minutes to get down to some skin to do an adequate physical exam.

View of the mountains from sitting at my desk in my makeshift consult room, that I moved to during the surgery brigade that is here for 2 weeks and using the room I am normally in.