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“I was about to return to the clinic when it hit”

14 Mar 2016

While heading up the neonatal unit at Médecins Sans Frontières’ women’s hospital in Peshawar, Pakistan, Dr Tim Pont saved a mother’s thirteenth baby, led a team of 25 and experienced a magnitude 7.5 earthquake.

 Was your first mission with Médecins Sans Frontières what you expected?

Yes, although it took me a little while to adjust to the level of responsibility I was given. In Australia I was used to doing my job and being a part of a system – I would finish work and go home and try not to think about it too much more. In Peshawar, I was responsible for managing the neonatal unit. This included safeguarding the welfare and morale of our 25 staff.

 

 Why is Médecins Sans Frontières in Peshawar and what did your role as a paediatrician involve?

Pakistan has one of the highest rates of maternal and infant mortality in South Asia. For instance, the maternal mortality rate in Pakistan is around 178 out of 100,000 live births, compared to six out of 100,000 in Australia. Médecins Sans Frontières’ Women’s Hospital in Peshawar has 30 beds for mothers and 18 beds for babies. A typical day for me involved caring for infants, managing admissions, making ward rounds, attending complicated deliveries and various non-clinical work. 

 

“It’s upsetting to know that those 10 lives might have been saved with fairly basic treatment.”

 Can you share a particularly memorable patient story?

An ill baby girl born in our hospital stands out in my mind. We found out her mother had two older children (aged 13 and 15) but had since given birth to 10 other babies who had all died at about one week old. The family was terribly worried that this baby girl was going to experience the same fate. We diagnosed the baby as suffering from jaundice as a result of a mismatch between her blood group and that of her mother. We began treatment immediately and she recovered well. We cannot be sure but it’s likely the 10 other babies may have had the same condition. Although this was a very satisfying case for us, it’s upsetting to know that those 10 lives might have been saved with fairly basic treatment.

 

 What does it take to go into the field in a place like Pakistan?

You need to be resourceful; you need to deal with what you’ve got. I’m not just talking about facilities, equipment and tests, but drawing on your innate skills and knowledge to manage people and situations that are worlds away from your formal training. Patience is very important too. When conversing with patients and their families you have to bridge a number of cultural, knowledge and language gaps. Through a translator, these exchanges take time and you may have several of them a day. Each time though it was important to me that everyone felt heard and understood. I’d often run communications training and scenarios with my colleagues, with this in mind.

 In October 2015, a magnitude 7.5 earthquake shook the Hindu Kush, killing at least 398 people, mostly in Pakistan. Was the Médecins Sans Frontières hospital affected?

I was in my room just about to return to the clinic when it hit – my door slammed open and my fan swung from the ceiling. Everyone in the hospital ran outside into the yard. As a maternity clinic we didn’t receive casualties but more than 100 people were admitted to other hospitals in Peshawar. There were cracks in our walls and ceilings, and a frenetic exercise to shift babies around so that we didn’t have oxygen mixing with electricity outlets that had started to spark.  Pakistan lies in the most active quake zone in the world. The last major earthquake of a similar magnitude was a decade ago and killed more than 87,000 people. We were lucky that this one was much deeper – 212km compared to 15km – reducing its effects at the surface.

 

 Has your experience made you a better doctor?

It will take time to fully understand, but yes. The experience of leadership and supervision was new to me and was invaluable training towards becoming a more senior doctor or consultant. I can say, “I’ve led a big team; I’ve made big decisions”.  I was also relying more on my clinical skills – observing and examining patients rather than running a lot of tests. I’m more resourceful, resilient and confident than before. I know I can go into a challenging or unfamiliar situation and work my way through it.

 

 What’s next for you?

I’m moving to the other end of the paediatric spectrum to work in adolescent medicine at Westmead Hospital in Sydney. I’m going to concentrate on my training for a while but I very much hope there will be another Médecins Sans Frontières role for me in the future.

 

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