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Janet Coleman is a nurse/midwife from New Zealand.
Here she talks about her first mission with Médecins Sans
Frontières in South Sudan.
I was called out one evening at about 9pm to see a lady who had
just been carried in by her family from the village. She
was apparently haemorrhaging. After putting on some gumboots
(rainy season), fetching kerosene lamp and dodging frogs and watching
out for snakes I entered the delivery Tukul (mud hut).
Raising the lamp I could see blood forming a pool on the floor
from the bed and my immediate thought was, well, that’s one
litre. "When did she deliver?" I asked Santino, the nurse
on duty. "She has not had her baby yet." He replied.
Heart thumping and a quick antenatal assessment revealed perhaps
a 34 week pregnancy. The fetal heart was regular. Mother's
pulse was barely perceptible and quite rapid. Her husband
said that she had started to bleed 4 days previously.
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© Janet Coleman |
At 'home' this lady would have been in theatre having a caesarean
section! We did not have the luxury of surgery. A
plane came about once a week unless we had an urgent request but
only in daylight hours. As I held her hand I briefly wondered
if, for the first time in my career I would be witness to a mother
bleeding to death.
Santino had already quickly started intravenous fluids. It
was imperative that she bleed no more. I ran back to our
compound to find a 'volunteer blood donor' who turned out to be
our Belgian nurse. We then started a Salbutamol infusion,
my favourite lifesaving drug, in order to stop any contractions
and hopefully further blood loss. This seemed to work and
we were able to obtain a blood pressure for the first time.
A plane was coming, coincidentally, the next day at about 12
midday, on its regular run, weather permitting. So the idea
was to transfuse and pray until then. The brother was the next
volunteer blood donor. The bleeding settled overnight. By
10am she started trickling again. Another volunteer donor
was conjured up while my ears were attuned to the sky for plane
noises.
Finally onto the plane, with the pilot expressing concern about
the state of cleanliness of his floor, quickly assured by myself
that the bleeding had settled and she would be no problem, I breathed
a sigh of immense relief. She was escorted by a doctor completing
his mission and met by the Red Cross in Loki, Kenya and had an
immediate caesarean with a healthy baby and mother. We later
heard that another lady with a placenta praevia from another area
had not been so lucky.
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