lunedì 1 dicembre 2014

Emergency call

It is 5.15 am when the telephone rings. Immediately we recognize the number of Kaongo Health Centre and Maternity: “We have a client with hypertonic contractions and possible breech presentation. She is not cooperating and we fear to have her here”.
“We are coming now, wait for us!”
There is no electricity and it is a bit tricky for Bro Giancarlo to organize the necessary in the ambulance. He is also a bit nervous because it has been a rainy night and the road will be probably very slippery.
In spite of all the odds, he manages to go and come back in 45 minutes.
We receive the patient in hospital immediately: she looks in great pain; she is extremely restless and sweats profusely.
The first thing to do is an emergency ultrasound to find out exactly about the presentation and to ascertain if the fetus is still alive.
Being on solar panels only, for the running of the ultrasound machine we use the u.p.s. unit which allows us about 20 minutes of power: the presentation is breech and the fetal heart is irregular and slow.
“We must be quick and prepare for caesarean section”
While the night staff of the maternity department prepares the patient, the membranes rupture and we notice thick meconium.

“It is a very severe fetal distress. Hurry up with the preparation. The excessive contractions and the extensive sweating make me fear even a possible rupture of the uterus!”
We set the new theater which has a backup generator already running.
I am the only anesthetist, because it is still very early in the morning.
The spinal is very difficult because the patient is restless and moves continuously while she gets strong contractions. Fortunately I manage to enter in the intervertebral space with my needle quite quickly and I inject the anesthetic drug.
In a moment the mother becomes relatively calm and the contractions stop.
We can start the operation: the disinfection of the skin and the draping of the patient are done at very high speed and we are able to extract the newborn baby in less than 3 minutes.
The operation itself has no much problem: there is no excessive bleeding and the woman is stable from the anesthesiological point of view.
But I am not at peace.
I keep checking at the neonatal coach where the nurse is struggling with ambu bag and oxygen. I continue stitching and completing my operation, but my heart is heavy because I don’t hear any cry from the child.
It is only when I have already stitched the skin that I realize the truth: in spite of all our efforts, we have been late!
Yes, the mother is safe, but the child did not make it.
I take a stethoscope and I listen to the chest: no heart bits and no breathing sounds.
I feel really depressed: we have rushed to Kaongo immediately; we have not delayed the operation… but the child is not with us.
Now in front of us there is the terrible duty of informing the mother of her loss: it is too heavy for me, and I ask Susan to do it on my behalf.
Medicine is like that: even when you have done whatever you could and honestly you believe that you have done nothing wrong, sometimes the outcome is very different than what you expect.
May God accept that little angel in his eternal peace, and may He give consolation to the parents.

Bro Beppe Gaido

3 commenti:

Anonimo ha detto...

Ciao Beppe , bellissimo il post sull'ultimo cesareo . Conosco quell'angoscia perché e' capitato anche quando c'ero io di non sentire il pianto del bambino e ricordo perfettamente il peso che avevo nel cuore.....
Mi dispiace molto per il bimbo e anche per la mamma e anche per tutti voi che dopo tutti gli sforzi avete vinto solo a metà .
Questo ancora di più rende ragione della vostra presenza costante e attenta tra quella povera gente e di quanto sia importante sostenervi in ogni modo .....
Siete un faro nell'oscurità per quelle persone e per quella terra.
Un abbraccio e buona giornata Laura

Anonimo ha detto...

"This is sad. May the little child rest in eternal peace. Sorry about the pain and loss." Jacinta

Anonimo ha detto...

"may the almighty God bless you.the state of the roads at chaaria only God knows why?once again thanks." Dominic

Chaaria è un sogno da realizzare giorno per giorno.

Un luogo in cui vorrei che tutti i poveri e gli ammalati venissero accolti e curati.

Vorrei poter fare di più per questa gente, che non ha nulla e soffre per malattie facilmente curabili, se solo ci fossero i mezzi.

Vorrei smetterla di dire “vai altrove, perché non possiamo curarti”.

Anche perché andare altrove, qui, vuol dire aggiungere altra fatica, altro sudore, altro dolore, per uomini, donne e bambini che hanno già camminato per giorni interi.

E poi, andare dove?

Gli ospedali pubblici hanno poche medicine, quelli privati sono troppo costosi.

Ecco perché penso, ostinatamente, che il nostro ospedale sia un segno di speranza per questa gente. Non ci sarà tutto, ma facciamo il possibile. Anzi, l’impossibile.

Quello che mi muove, che ci muove, è la carità verso l’altro, verso tutti. Nessuno escluso.

Gesù ci ha detto di essere presenti nel più piccolo e nel più diseredato.

Questo è quello che facciamo, ogni giorno.

Fratel Beppe Gaido

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