Blog: Arm Presentation

Nothing ever seems to go as planned here. Not every plan is derailed but most are altered, at least slightly. Sometimes key people don’t show up, other times the day is mixed up, and even other times still babies get in the way. This is s blog about the last so if you’re not a fan of ER or can’t talk about hysterectomies at the dinner table, maybe you should just leave this one out of your reading list.

It started innocently enough. Charis, Naomi, and I were preparing our Lecture Day Three journey to the bush health center in Dalé: 23 km (14.3 miles) of sandy, narrow, bushwhacking trails. For the last two days, we had taken motorcycles (one me, one taxi) but this time we had an additional two visitors who wanted to come. That’s not so easy on motorcycles nor is it cheap with taxis that far into the bush. So we were able to take the truck since no one else has time to even think of leaving the compound.

We hop in, and head off in our nice little AC-ed bubble. We pull up to the mango tree where everything’s been happening and no one is there. Usually there’s at least a few there and then the rest trickle in after 15 minutes or so. We get out and here is someone walking over to us with a concerned look on his face. He greats us all quickly and then continues in a low voice with Naomi. She then says we need to head over to the health center for a complicated birth.

As we pull up, there is a ox cart prepared to head the 23 km to Béré: grass mats and fabric were laid down as the family members were all whimpering and wailing. We quickly asses the situation and see that it is crucial she gets to the hospital. So much for our last day of lecture! Diana, a nurse from Moundou suggests an IV catheter be put in while we have the time to save time later on at the hospital. She assists to get it in and we load her up. As we are moving her into the bed of the truck with her grass mats and fabrics, we all gasp as we see the actual problem: a bloated arm is already out. Its not moving and its blue.

We pile in with her family members and quickly yet carefully head back to Bere. Bumps were taken as smoothly as possible though it was probably less bumpy than that ox cart would have been. We ask her brother about the situation: Not much family, first child, husband isn’t around, lives way out in the bush. Its hard to think that the little Health Center was already big to her.

Now you may wonder why she didn’t come in earlier or call the ambulance? How could they have let this get that far? Well, we are the ambulance now. The district Ambulances are no longer in working order. They tried to call both our hospital and the district hospital on the other side of them but it was to no avail. Either they didn’t pick up or don’t work or there was no cellular service. This village makes Bere look like a huge, happening, city!

We called ahead and our little rag-tag non-clinical ambulance crew got to work as soon as we arrived. Pulled up and got a stretcher. We whisked her and that arm to the OR right away and all that we could do now was pray.

I saw Mason (our anesthesia guy) and Danae (OB/GYN) shortly after the surgery and they just said one word that was visible from their appearance: Blood. It was everywhere. From the windows, to the walls. It covered their scrubs and apparently took quite a bit to clean in comparison to a normal operation. The baby had been dead for hours already. There was no surprise there. The mother however, survived and will still be able to have more children later on.

Talk about being in the right place at the right time! I have true admiration for clinicians who can work under such unpredictable situations. Every day is different here and that’s partially why I love it. And of course all you can do is take it one day at a time anyways! And course, it takes a team to get things done.

Our team is losing one of its members this weekend as Charis, my co-director, heads home. She’s put in a good 1.5 yrs and will continue to voluntarily donate her time (and fast internet) at home. Who really knows though, everyone is hoping she’ll come back in the fall!

Until next time!

Zachary Gately
zchgtly@gmail.com
zgately.com
+235 91122492

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