Emergency C-Section

08/15/12

Beginning section

Power outage. Waiting for generator.

The mom had been stalled in labor for probably many days before coming to the hospital. The doctors suspected infection due to the foul smell coming from between her legs. One incision cuts through the abdominal wall. The second incision cuts through the uterus. Upon incision the uterus erupted with stinking brown liquid - pus and meconium and blood. My dad quickly thrust his hand into the uterus trying to find the baby, whose head was trapped low in the pelvis. With great effort he pulled the limp body from the womb and cut the umbilical cord. Sarah rushed the baby to the adjacent operating room where she and another doctor frantically suctioned brown pus from his nose and mouth and bagged oxygen, squeezing air into his lungs. Intubation took three failed attempts. They rubbed his chest. They gave him CPR. The suction from the bagged oxygen sounded like a cry and I thought he’d woken up, but no. They went back and forth over whether or not he had a heartbeat, desperately straining to detect one with their shared stethoscope. He didn’t. He never opened his eyes. His lips stayed blue. His tiny fingers and toes stayed white. Sarah carried him through the hallways past dozens of people to weigh him on the one baby scale they have. He was 9lbs. She wrapped him up in bright cloth and set him by a sink with another woman, who would take care of him.

The woman had tearing and bleeding in her cervix. The doctors, including my dad, sewed up the tear and closed her up, but she continued to bleed. She had a second surgery later in the day to stop the bleeding, which turned into a complete removal of her utuerus - a hysterectomy. 

Malaria in Galmi

This 16-month-old has malaria. He needs a blood transfusion, but he has O-negative, a rare blood type that is in short supply at the hospital. The blood bank here survives by asking for a blood donation, usually by a relative, when a patient receives a blood donation. But any number of blood payments will not help this little boy because we have no O-neg to give him.

Blood is so precious here that transfusions cannot be approved unless the patient has a hematocrit of 18% or below. (Hematocrits are a measure of the percentage of red blood cells in the blood. Normal levels are 35-50.) Even a patient hovering around 19-20, which is less than half the normal amount already, cannot receive a transfusion. This little boy has a hematocrit of 10.

His exhaustion, which is obvious from this photo, is a symptom of his low RBC count and oxygen, and malnutrition. Niger has a heavy load of malaria cases. It is the leading cause of death in this country, and a major contributor to the fact that nearly 2 in 5 children will die before the age of five.

EDIT: A donor was found for this boy!