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Our second week in the maternity ward did not pass unnoticed.
happy mother holding her newborn baby in her armsBeside a number of deliveries that ended well, with a happy mother able to hold her baby in her arms, we had to cope with a few painful situations in which we felt powerless, mainly because of the local mentality: cause and remedy of problems are often sought outside the hospital.
Only when things have gone completely wrong the women are brought to the hospital; in most cases we can only try to save the mother’s life while all help comes too late for the baby.
The hospital’s staff is used to these kinds of situations and is often relieved not having to go through the cumbersome registration and audit in case of maternal death.

Our first patient of the day had previously had a cesarean section and was convinced she could avoid a second one by going to the very popular "prayer room" (chambres de prière); the "pastor" had promised her a natural birth, so she stayed at home until she had to stumble to our delivery room. The first examination showed a full cervical dilatation with uterine rupture and no heart sound for the baby. Fortunately, the uterine rupture was well encapsulated, so the woman’s condition was still relatively good. She carried on refusing any intervention, still holding on to the pastor’s promise.

Two days later, another woman with a history of 3 previous caesarean sections was brought into the ward; she too had a uterine rupture, which occurred while working in the fields. In her 7th month of pregnancy, she had not started prenatal consultations and help came too late for the baby.

On that same day, another pregnant woman in a very alarming condition was brought to us; she obviously suffered from placental abruption and the baby’s life could not been saved.
We were nevertheless able to round off our first week with a happy end.
On arrival in the maternity ward we met a patient with a history of one caesarean section and one natural birth.
Her medical record did not show any problems: full cervical dilatation, regular contractions but no progress while pushing.
In order not to overburden the uterus, I intended to start vacuum extraction; at the same time an ideal opportunity to practice this procedure with the medical staff.
While probing I found blood streaked urine and this immediately rang a bell.
No vacuum extraction possible. After some hesitation, the doctor decided on a caesarean section.
An encapsulated uterine rupture was, once more, causing the problem.
Luckily, this time we were able to give the mother a healthy baby. She was over the moon with happiness!
It was not surprising that the medical staff had not seen the problem since the only symptom was the blood-streaked urine.
In this case a vacuum extraction might have been fatal and I must admit that I was very relieved when it all finished well!
In a remote place such as Mubumbano, in a poorly equipped hospital, with extremely poor patients coming from the far away hills, one has to be very focused and never loose concentration.
I have the greatest admiration for the doctors and the nursing staff who, against all odds, try their utmost to help people.
The extra
training provided by Medics Without Vacation gives a boost to the staff in their attempt to always do more with the little they have.
Resignation tends to make them careless but as the "Bond Zonder Naam” puts it: "A compliment every now and then makes you grow wings!"
Our support helps them to fly higher and higher.

Construction work Intensive Care UnitThe highly professional attitude of chief doctor Jean-Paul, who never gives up trying to improve the hospital’s image made it possible to acquire new pieces of equipment, to have the operating theatre’s light fixed, and to refurbish the Intensive Care Unit.

 Intensive Care Unit three months later
The next objective is to take care of all the equipment and to use it in a professional way.

Rita Van Theemsche

March 2015