What Sierra Leone was lacking…

Skrevet av Emmanuel Sahr Musa Tamba, CHO

If anybody ever asked me why I chose a medical profession, and to enter Capacare´s surgical training program, I will answer simply “to save lives”. Working and training at Masanga hospital, I was recently reminded of what this means, and why I was motivated to choose surgery. I was treating a pregnant woman in her late twenties, who like thousands of others in Sierra Leone, had a very sad obstetric history. She had experienced five previous deliveries, all resulting in IUFD(intra uterine fetal death). Predominantly due to obstructive labor. In her pregnancies the fetus would survive up to week 38-42 and she would go into labor, but subsequently deliver a stillborn.

This time around the patient was advised to deliver in hospital before week 38. She arrived at Masanga hospital contemplating the outcome of her sixth pregnancy. Willingly, but with certain degree of doubt she accepted admission and to be monitored until labor set in. She prayed for us to deliver by caesarian section before she lost the baby and it was a great relief for her when the medical superintendent informed her that a date was set for her operation. However the procedure was postponed due to the work burden in our operation theater. In distress she told me that “maybe God does not want me to have a child?” I advised her to be patient and that her time would come. The next morning she was scheduled to preform the procedure and the patient had barely slept. She even left for the theater before she was asked to and sat outside, because in her words she “would not wait until it was to late”.

At ten o´clock in the morning she was draped and prepared for surgery. Her vital signs were good and the fetal signs strongly positive. She lead the team in prayer and ended with a big amen before being given the anesthetic. I made the first incision. It was a footling breech and the 3.26 kg baby was delivered safely and the closing procedure was conducted without complications. The patient was transferred to the maternity ward and at 12 o´clock she woke up from the ketamine influence and was informed that she had delivered a healthy baby girl. This mother was one of the most grateful patients I have ever encountered and the smile on her face reminded me of how many mothers we could have saved if this capacity was in place, enabling us to operate on patients with a poor obstetric history before it is to late. I think this is what Sierra Leone was lacking!