We arrived at Pasua this morning with the hope of being present at a birth. As we walked into the 'birth suite' we were pleased that two women were well advanced in their labours.
I spent almost three hours supporting a lady, she was prima gravida (first baby) she was in a lot of pain and I can only pray that our presence went some way toward making the time a little less difficult for her. There was no pain relief as she laid on a wet kanga which was soaked in amniotic fluid. The lady in the next bed ended up being sent to KCMC, the largest hospital facility in the area as they believed she had placenta previa which was dangerous. There are no stretchers, so she walked to the waiting 'ambulance'.
Not long after a new lady was lying on her bed and it wasn't long before her baby presented himself. It took us a little while to identify the protruding part as a scrotum, so this delivery was going to be a difficult one. The stint had no money for fluids or a cannula, so Sandy paid for it.
It seemed that the baby took forever to deliver. He was tiny and it took her so long to deliver the shoulders and head. The RN Heuston was in control, the birth suite was so full of staff us and their students. Finally the baby was born and to our stunned amazement another baby popped out. In the shock and lack of preparation, the babe fell on the floor.
It took a second to pick him up and see that he'd died at some stage. I held the little one and cried. I held him for quite a while. Meanwhile, however Sandy and the Doctor had started to resuscitate. The babe was not breathing and there was no pulse. I then spent the following hour and a half with Sandy, the Doctor and then Heuston to resuscitate the babe. Ally went outside and found hot rocks which we wrapped in a kanga but the baby was getting cooler by the minute. Thanks to Sandy we had an oximeter so we were able to monitor him while he was suctioned and his breathing was supported. There was no access to hot water so Rachel emptied tea into her water bottle. We placed this in the blankets to maintain the its warmth.
The heart rate and oxygen saturation went up and down and it took an hour and a half for the baby to be able to breathe on his own.
The Mama got up and walked to the ambulance, as they both needed support. We'd given her the dead baby to hold, hoping that it would help with closure. Rachel believes that as infant deaths are much more common than at home.
The doctor was incredibly grateful to us. It was an experience and a half. I walked away from there happy that I'd been able to help and shocked at what is seen.
The mothers have to supply all their own things. From sterile gloves to a huge roll of cotton wool, many kangas for themselves to lie on and then for the newborn. They bring their own food. They have a bucket into which the placenta is placed and they also have all their dirty washing, which they wash themselves soon after delivery. They have no nappies, again the kanga comes into force. They bath their babies in cold water.
I'll never look at a length of fabric, or bucket at the same way again. Not ever.
The lady I supported today, who went to KCMC.
Sandy and the Doctor. The resus team!!!
The mother and babe we supported yesterday.
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Location:Pasua Hospital, Moshi, Tanzania.