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My heart bleeds for mothers, babies robbed of life by the health crisis


In maternity units, there is no room for second-guessing or delays. A normal delivery can turn into a slippery slope towards death in a matter of minutes

Monday October 16 2017

A few years ago, during a fairly quiet night shift in a busy maternity hospital, we received a desperate patient.

She had developed complications at 34 weeks of pregnancy when her placenta started to separate from the wall of the uterus prematurely, causing her to bleed and compromising oxygen supply to the unborn baby.

Not understanding the gravity of the situation, she wasted time getting to us and by the time she was being wheeled into our operating room, she had one foot in the grave. Our intervention helped save her life, but she lost her baby.

Being a calm night, it took five minutes from the time she walked in to get her on the operating table. The entire team put everything else aside to keep this woman alive. Five hours later, the patient spat out her ventilation tube and loudly complained that she was feeling cold. The entire operating room went up in applause. She had survived!

A few years later, a young woman at the national referral hospital ended up in the maternity operating room.

We had had a slow morning and the team was happy to be doing something.

The young mum had developed sudden-onset high blood pressure just when her baby was due. She had presented to a smaller facility and had convulsed while there. She was quickly referred to us for specialised care and arrived in good time.

CARDIAC ARREST

She was put under anaesthesia and just as we began to open her abdomen, she went into cardiac arrest. As the anaesthesia team called for reinforcement and commenced resuscitation, my scrub nurse and I were in a race against time to save the baby.

The little three kilogramme baby girl came out flat. She was not breathing and her heartbeat was barely there. The nurse in charge of theatre took over the baby’s resuscitation. That is the day I found out she was a trained expert in newborn resuscitation.

The rest of the team was still at it, sweating out of tension and exasperation. Mummy was not doing well. Seven minutes after the baby was born, a cry pierced the tense atmosphere.

CHEERED LIKE CRAZY FANS

We cheered like crazy football fans! The baby was going to live and this gave us renewed hope that mummy would live too, if only for her daughter’s sake. It took us two hours to accept that we had lost the war. I went home and cried.

Today my heart is even heavier. Our public hospitals have remained closed for over 130 days. These hospitals deliver over 60 per cent of our mothers. Both times above, my patients walked into a hospital environment that was ready for them but we still lost a life. The current  situation is so dire that mothers die in the hospital waiting for care.

The few institutions giving a semblance of service are overwhelmed beyond measure.

Mothers are bleeding to death while waiting to get onto the operating table at Kenyatta National Hospital because there are five other dire emergencies ahead of them.

Babies have been robbed of a normal life as we continue to create an epidemic of the cerebral palsy generation.

Others have died of infections directly resulting from overcrowding in newborn units.

AT BREAKING POINT

Faith-based hospitals are at breaking point. Most of them are fairly small, with limited resources, especially on the human resource front. Having to cater for more than triple their usual numbers is impossible. They are having terrible outcomes through no fault of their own. Most do not even have the capacity to handle babies in need of specialised care yet these babies are pouring in in droves from home deliveries and from small private clinics.

In maternity units, there is no room for second guessing or delays. A normal delivery can turn into a slippery slope towards the precipice of death in a matter of minutes and the mother dies in a flash.

 When this mother is on a mattress on the floor in the corner of the ward with no one to respond to her feeble attempt to call for help, the nurse will eventually find a cold pale body that exsanguinated long ago.

Someday when politicians are done turning the country upside down and their staunch followers have been felled by hate, tribalism and bigotry, we shall find that we have nothing left to rebuild the health system with.

All our young, hardworking productive women will have died, while all the surviving children will be full-time dependents on wheelchairs, robbed of a chance to contribute to building the economy.

While all other ministries in this country are maintaining a semblance of productivity, the deafening silence from Afya House regarding the state of healthcare in this country is deeply disturbing.

 Are we sure this country has enough ground for the thousands of little graves being dug every day in our public cemeteries and in our villages? Do we have a fund big enough to support cerebral palsy orphans? I rest my case.