The Scream

Wednesday, 05.09.2018

A scream is an expression of emotions. The cause can be very different, as well as the scream itself.

A scream can be something wonderful, an outburst of pure joy, possibly after a victorious competition.

It can burst out of anger or be a sign of fear, to ask others for help. (Like today when there was a giant spider in my bag)

In my profession, a scream has other meanings as well.

'The first scream' - always a breathtaking moment of happiness for expectant parents and me as a midwife.

And then there is the time before, where women scream from overwhelmed. It is of course an expression of suffering, but for me, these screams reflect true power and strength. And I admire every woman for this strength during childbirth.

But sometimes there are screams that deeply affect you, that you can't forget for a while.

And those are screams caused by pure pain.

Today, I first heard the last of these described screams. I helped my postpartum woman from yesterday with breastfeeding (which unfortunately is not done by the nurses here) and it went through my whole body. I rushed to the labor ward and could hear clearly that this woman is not in labor. Of course, every person is different, but with some experience, you learn to classify screams. Something else terrible must be going on.

I went to her bed, the doctor in front of her, the woman (or probably still a girl, I estimate 16 years old) crying and screaming with pain from the depths of her heart. Blood everywhere. A sister shouting at her. And I recognized...It is an abortion.

In Tanzania, it is strictly forbidden and therefore illegal, without anesthesia or empathy. I had the feeling that the doctor and the sister deliberately act brutally, so that it becomes a 'lesson'.

I couldn't help myself and at least held her hand and said to her 'Pole sana' (I'm very sorry)

Everyone can have a different opinion about abortion itself, everyone can only decide for themselves.

After that, I read a bit about it and the extent of an unwanted pregnancy as an unmarried girl is unimaginable. Tests are sometimes done monthly in schools, where it is mandatory to be tested. If it comes back positive, people are immediately expelled from school and face imprisonment. The hope of learning something and having a good life is naturally gone.

But whether this girl can ever laugh again after this traumatic situation, I seriously doubted at that moment.

The doctor was finished, the girl had to get up (still bleeding) and go home. Because after all, no one should find out about it.

Some money changed hands. Shocking!

Just terrible!

Next to her was a woman in labor. I knew her from yesterday and her screams were simply pure despair. I had the feeling that she was too weak to scream loudly by now.

The woman had the same condition for almost 36 hours now, the birth was still far from sight and the strength of this woman was completely exhausted logically. While in Germany there is the possibility of pain relief through an epidural, here there is simply nothing- nothing at all. She was so strong, constantly changing her position, moving and resting. I tried to motivate her: with looks, touches, and some attention. She did not understand (like most women here) a word of English.

But when after another 7 hours there was no change in sight, she was relieved by a caesarean section at the end of my shift.

In Germany, I often had the feeling that we act too hastily. Sometimes we should give women more time without intervening and in this situation, I believed that the woman had been subjected to these pains for too long.

Isn't there a good compromise?

We didn't find any apparent reason why this woman couldn't give birth spontaneously, but birth is a lot about the mindset. And even though I have no idea what it's like to have these pains myself. I know: in this hospital, with these people, under these conditions, after hearing the brutal screams of other women, I definitely wouldn't be able to let myself go to give birth beautifully.

Where is the empathy of the people working here?

Why do almost every woman leave the labor ward traumatized?

Yes, almost every day here at the clinic, I experience a new situation that leaves me speechless, but also angry and pondering how to improve something here. I have no idea who wants to learn something from whom and take advice from me. Not really willingly.

But I will try to start the next day with renewed confidence.