I Can Feel Your Heartbeat



Nursing intern Tanui explaining the difficulties of using a pinard

For the past couple days, we have been observing clinical care at Bondo District Hospital and Thika Level 5 Hospital.  BDH is a local hospital that sees patients who get referred from health centers and TL5 is a referral hospital, mostly for people who went to a local hospital and got referred to Thika for a more complicated condition.  At BDH, I was finally able to watch someone listen to a fetal heart! The most commonly used tool is a pinard horn, typically also called a fetoscope by the nurses here.  Health care providers must palpate a pregnant mother to figure out where the head and back are, then listen closely with this device and count the beats.  Pankti and Michael were both taught how to find the fetal heart by an experienced nurse, and they both agreed that it is quite difficult to hear. 

Yesterday, Pankti and I were able to conduct a workshop as a part of Continuing Medical Education.  Michael and Aaron graciously volunteered to be our pregnant patients for demo purposes, and also took lots of photos of our demonstration! We got to show our fetal heart rate prototypes to 30 different midwives, nurses, medical and nursing students, and a couple doctors.  We think the feedback we got was very helpful and they seem to think we are on the right track for solution that will actually be easier to use and save them time. It took us a total of 6 hours to finish the workshop and we were all very tired at the end of it. We are really grateful to Jhpiego for organizing the opportunity for us!

Pankti demonstrating how to use our fetal heart
 monitor to listen to the beats on patient Michael

A nurse practicing using the prototype

In addition to the study, we also spent some time observing labor and delivery and MCH (maternal child health clinic).  Aaron and I got to see two births with healthy babies and healthy mothers! I am very impressed by the women who give birth and immediately get up and walk around and give their bed to the next patient.  In MCH, Pankti and Michael got to listen to a health talk given to all the patients waiting for their clinic visits.  Lots of topics were covered from preparing an individual health plan to nutrition and health warning signs.  Aaron and Michael also got an opportunity to meet with a person from the office of District Disease Surveillance team.  They got to learn how certain diseases are monitored closely so that the district can try to intervene based on trends from previous years and potential disease outbreaks. 

Today we return to the Jhpiego Nairobi office for a debrief on our trip and later we are meeting with people from the Ministry of Health to get their perspectives on implementing new health technologies.