Grace Chew’s Blog

18/3/2009: Day 35, Kikori Hospital

Two women were the focus of attention today. One,
probably younger than us, had been having
shortness of breath for the last few days –
pneumonia ? TB, with perhaps an element of
anaemia. She was transfused (with type O blood
from a very generous member of staff, whose blood
was siphoned off right next to her) with a unit
of blood and seemed to improve, but developed
jaundice and increasing shortness of breath
today, with a lot of pain. We did our best to
make her comfortable, but Ruth said to me, “I
think she’s near death”. We didn’t expect her to
pass away this afternoon though, and receiving
the news when we were at the airstrip sending
Uncle John off was a bit of a shock. As we walked
around the hospital compound, we could her mother
and some relatives bemoaning her demise, a
sobering reminder of her life cut short and our
remaining questions about what really ailed her.

Meanwhile, we were also wondering about a
pregnant lady who had come in with slight pains.
At first the CHW had diagnosed a UTI, but as the
story unfolded bit by bit we found that she had
ruptured her membranes on Friday, 5 days before,
and the pains she was feeling were akin to labour
pains, though less severe and less often. Because
she had lost most of the amniotic fluid we had
trouble figuring out what that medium-sized hard
lump in her abdomen was at first, then because a
pregnancy test was strongly positive and fetal
heartbeat was strong, the trouble became figuring
out what happened, the lie and presentation of
the baby, and what to do next. What made it more
difficult was that there probably was an element
of IUGR (she was very thin), and she was a grand
multipara with a history of 2 neonatal deaths
before this one. 5 pairs of hands tried to
ascertain the baby’s position, and with much
prodding and palpating we decided it was probably
a transverse lie (we were all certain that the
head was not in the pelvis!) and despite the
contraindications, external cephalic version was
tried and failed. She and baby were stable
though, so our plan was to keep her that way
until there was transport to transfer her to a better-equipped hospital.

One life gone, one more at the brink and could go
either way. The fight for life and against death goes on.