A week of mayhem

We are writing a week later about last week as we have been so busy we haven’t had a chance to get to the computer. We’ve been on the maternity ward, and seen half the babies die. The nurses are good, and work hard, but it is a controversy that in the country with the highest maternal mortality in the world, in a referral hospital there is only 1 obstetrician. He works hard, trying to prioritise patients but when Charlotte and I came across a 19 year old woman with an obstructed labour, where the head was stuck in the pelvis, the doctor was resting and didn’t answer his phone for several hours. Without a c-section this young mother would have died. Luckily the doctor came and performed a c-section, but this was complicated by bleeding after the operation. She was v. close to dying on the operating table, she was in haemorragic shock and was dying. The doctor opened her up again and managed to do a B-Lynch procedure which basically works by pulling the womb tight like a drawstring bag to stop the bleeding. This second procedure was done with no anaesthetic, but luckily she was in such severe shock, she didn’t seem to be in pain. After 6 hours in surgery, we left at 10.30pm to go home, and were pleased that she was alive and well in the morning with her baby. However, a few days later her baby died. This is just one example of what happens everyday on the maternity ward. Sorry about all the doom and gloom, Charlotte and I delivered twins!! They were girls and the midwives called them Charlotte and Alix!! We were more excited than the mother, who wept that she couldn’t afford to have 2 girls. Oops sorry, was trying to end on a good note. It’s hard to find happy endings here.

Baby Resus Sierra Leone Style

1. Swing the baby upside down
2. Shake it upside down until it probably gets a brain haemorrhage.
3. If unsuccessful, hold upside down by the ankles and tap the feet. This is called the ‘pepper pot technique.’
4. Suction.
5. Suction.
6. Suction.
7. Repeat steps 1-6.
8. Repeat steps 1-6.
9. Wrap up and hand over to relatives for 50% chance of survival.

There is no oxygen, there is no incubator, there is no way to secure the airway and nurses don’t listen to their heartbeat or lungs as they don’t have a stethoscope, the mothers who have c-sections cannot feed their babies for several hours because they are off their face on ketamine from the surgery.

By Alix