It was a night like no other. So many emergencies, and I put my head on the table to try and catch a little bit of sleep. After just a few minutes Hilda, my midwife, woke me up with a tap and said “the President’s wife is here to deliver.” What a joke. Today wasn’t April fool’s day, and Hilda doesn’t do drugs. She looked at me and repeated “the president’s wife is here to deliver.” How? Why? Where? I was confused. Even for a common cold the president’s wife flies to the UK. So why is she here to deliver…in a district hospital of all places? I got up to check and truly, there lay the president’s wife on our delivery bed!
Goose bumps covered me. I got the story from her mum. She had been booked to deliver at Mayo in the US, but at 6 months of the pregnancy had made a quick trip to visit her mum who lives in a village in my district. Probably the trauma from that ‘organ shifting road’ had caused her to go into labor prematurely. So, despite all the Mayo plans with a neonatologist and fetologist and all the high falutin equipment and whatever, she was now here with me and my ten fingers and a preterm delivery. How will I keep this baby alive?
I saw that the nurses had brought out one of the staff bedsheets and had attempted to make the first lady comfortable. Calls kept coming through from the senior obstetricians and pediatricians, asking if I had prewarmed the radiant warmer. Radiant warmer my foot! I use light bulbs to keep the babies warm. Another person was telling me about ventilator settings for the preterm. Seriously? In my district hospital? I felt like laughing but I didn’t want to be called by the regional director for having been rude to the bosses. So, I just stopped answering the calls.
The first lady pushed out a tiny baby and as soon as I saw the baby, I knew there was no way he would survive in my facility. I cringed as I thought of the newspaper headlines: “President’s baby dies in district hospital” and there would be a picture of me. Hmmm. I helped the baby as best as I could under our improvised warmer, ventilating him with the bag and mask. Then Hilda called me. “She’s bleeding” she said. Oh no. I had neither fluids nor drugs nor blood in our blood bank. Insurance hadn’t been paid in months and our hospital was more like a hotel except that there were no bedsheets. Pharmacy shops were closed at this time of the night, so I called one of the pharmacists to open his shop. I could just picture the breaking news: “Presidents wife and baby die in district hospital.”
I called for an ambulance but it would take about an hour for the nearest one to come. Would they last that long? Our ambulance had broken down over six months ago and hadn’t been repaired. I felt weary as I tried to help mum and baby. Too many unnecessary deaths. Nothing had been done. And now the president’s wife was joining the list. I felt like giving up. My head began to ache as I tried to save their lives. And Hilda tapped me again. I didn’t even want to listen to her as I woke with a start and looked at her. She looked very unamused as she said “doctor, please don’t be sleeping so deeply when you are on duty.”
It had been a dream. I felt so relieved till she said “there’s a patient here to deliver.” Déjà vu. I hesitantly asked who it was. “It’s some village woman. An unkempt village woman” she said as she left. I heaved another sigh of relief. The president’s wife delivering here had been not just a dream…it was a nightmare. I thanked God that it was just a dream. Just a village woman coming to deliver a village baby. It doesn’t matter that I don’t have oxygen or equipment or drugs to keep them alive ‘cause after all, they are just villagers. So, it doesn’t matter, does it?
Written by Dr. Adoma Dwomo-Fokuo, colleague of Dr. Jean and Bob Young.