Village hospital saves both mother and baby

NAIROBI: An experience at my rural home was both scary and reassuring. It was 1am when my farmhand came calling that his wife was in labour.

I knew the nearest hospital was a two-hour drive away. I realised we had to get to the nearest health centre, which was ten minutes away.

We quickly reached the refurbished facility, which is now a hospital. As I was explaining the basic facts about the patient, we all heard a loud scream at which I asked the midwife to check and confirm all was okay.

The midwife, shouted for help saying the placenta and cord were preceding the baby and there was heavy bleeding.

I donned a gown and gloves and joined the team. I noted the cord was pulsating, showing the baby was still alive. As I made the life-saving maneouvre to prevent the compression of the cord, I realised the baby was almost out. I encouraged the mother to bear down as hard as possible. Within two minutes the baby-girl was out screaming. I knew that was only half the task accomplished.

Though the whole placenta was out, there was brisk bleeding. My experience in advanced, obstetric life support kicked in knowing that every minute counted.

We quickly established intravenous access. We commenced resuscitative measures and put in place all interventions to stop bleeding. At this point I knew we needed blood replacement. From my recollection, this was a facility without blood transfusion services. Nevertheless, I still asked if there was blood in the facility.

I was pleasantly surprised to be told that the facility was able to do blood transfusion and carry out all emergency comprehensive obstetric and neonatal services. By this time the resident medical officer, who happens to have been my student, had just arrived.

We managed to get two pints of blood and start the transfusion. We had also stopped the bleeding through uterine massage and use of drugs that promote contraction of the uterus.

This was a near-miss maternal and neonatal mortality averted due to availability of necessary equipment, supplies and personnel, largely attributed to devolution of health services.