(Based on true events and dedicated to our local staff)
Her name was Binita. I only knew her for a few moments - a moment of joy and a burden of sorrow.
It was midnight. We had just finished life-saving surgery on a pregnant mother who’s uterus had ruptured during labour assisted by a traditional birth attendant. She attended the hospital just hours before I met little Binita.
This was her second pregnancy and I cannot imagine the turmoil she must have suffered having already lost her first child. Her first child had died in her own womb and now she is in the hospital with a myriad of faces rushing around her, some speaking a language she doesn’t understand at all, others speaking an unfamiliar dialect. All the time her waves of excruciating pain from her abdomen wash over her. Needles are poked into her veins; a few drops of blood are taken by another person; someone inserts a urinary catheter into her bladder; simultaneously someone seems to be pushing some liquid into the needle in her arm; yet another person asks her strange questions about when she last ate and whether she had had any previous operations. Focus on, or care for the apparent commotion around her is mitigated by the agonizing pain she has endlessly felt since morning and had worsened beyond her imagination in the preceding few hours. Suddenly she is taken to another room where she is made to curl up into a ball around her spasming abdomen and she feels a sharp pain. Then relief sets in. After what felt like an eternity of suffering, she feels no pain, just warmth and tingling in her legs. Thankful for the relief she withdraws into herself and sleeps.
The team works proficiently together; each supporting one another’s roles. Within just a few minutes a young lady with a ruptured uterus is in the operating theatre. Sadly the baby is already dead, but every person in that room recognized the continued threat to this woman’s life. They act safely, fast and focus their attention on enabling the surgeon to begin. Instructions are followed well and promptly. Some have never seen a major procedure such as this before; others have been to the classes and even done some role plays; some have greater experience. These are all shared. Everyone recognizes the most important person in this room - this young mother. Everyone recognizes that their own role is important. After an hour the surgery is complete, the mother is stable and the staff are relieved. This is the second cesarean section which has been performed in this hospital so far.
She is transferred to another bed. Relieved to be out of the unfamiliar surroundings of the previous room she is comforted by her mother-in-law. She hears that her father-in-law has given a pint of blood for her. People mill around her once more, organising, reassuring, giving more medicines and taking her blood pressure amongst other things. The people around her seem more relaxed. There is a new lightness in the tone of their voices which comforts her and they are not moving around so much, but enjoying talking with one another. The news that her baby had already died has not yet sunk in. She is able to rest.
It was a few minutes after this that I met first Binita. Binita is two years old and weighs nine kilograms. She had been sick for a long time. Her mother told me she was ill for six months already with chronic diarrhea. They had given her medicines but never came to the hospital until now. As I look on the bed for her little form I see a pile of blankets, I hear the oxygen concentrator whirring and women around the bed space fighting back tears and sobs. There is darkness on the ward so we work with torches to review the child. I fold back the blankets and see a tiny child with prominent ribs, arms and legs thin as bones and muscles desperately lacking. Her breathing pattern is not normal. When I examine her she does not respond at all. I have to look so closely, placing a hand on her chest to convince myself she is actually still breathing. “She looks like she is dying”, I whisper to my colleague. We rack our brains for any little thing we can do to reverse this terrible condition we see her in. In the depths of my heart I know everything we are doing is probably futile. I look to one of our nurses and see the same realization in her eyes. We long for hope for improvement and search for options. Only once did she open her deep brown eyes. A single moment I will treasure. Her family already know what the outcome will be. They have watched her demise as they tenderly support her fragile frame. They have seen her sink into unconsciousness as she no longer calls for her Aamma (mother). Their stifled grief stricken sobs have already started.
Something changes. Her breathing shallows. Her heart rate drops. We give medicines to increase it but it is futile. Her tiny body is worn out from her long illness. She has no more strength to fight. She breathed her last. Familiar echoes of the chants and wails of grief flood the silent night air.
Cry my sisters, cry. Cry for your lost daughter. Cry my sister, for the loss of your unborn child. My tears fall with yours. “If only’s” are fruitless for these children, all we can do is grieve the loss, and treasure just a moment of joy.
We yearn for alternative outcomes for other women, for less suffering and pain. We strive for safer management of labour, for earlier recognition of severe childhood illness, for the provision of high quality medical care in remote hospitals. We commend the team for their excellent work in saving a mother’s life - share your motivation, your skill, your service and, we pray for no more losses of lives which could have been saved.
(Photo by Jane Ungoco)
Add new comment