Saving a precious Bosavi baby | By Dr. Kevin Pondikou

Reblogged from:  http://asopa.typepad.com/asopa_people/2017/08/flight-into-the-night-saving-a-precious-bosavi-baby.html 

“I RECEIVED the call from Keith Kedekai in Tari at 2.30pm. A woman was in labour at Mt Bosavi. The people there wanted a doctor’s opinion about whether she should be referred.  My day had begun with an operation for an infected abscess on a woman’s finger then a regular ward round and other work in the wards that ended at two when I went for a break.

Receiving the call from Tari, I said I couldn’t make a decision without more details. This type of case would need a medivac which means that an MAF plane would have to be located.

It turned out the Rumginae MAF planes were in Kiunga but the pilots had reached their maximum flying hours and were temporarily grounded.

Then the community health worker at Bosavi called me. She’d had to walk a long distance to get to an area with phone reception.

She said the woman had been in latent labour for nearly a week.

She was 4cm dilated and her waters had broken. This was her fifth baby and all four previous babies had been stillborn. The community health worker thought the presenting part was transverse with arm or knee presentation with other complications.

This mother definitely needed an emergency evacuation to the nearest hospital by MAF.

I let Dr Brandon know and she agreed the woman was for medivac to whatever hospital was convenient for MAF.

It turned out MAF’s Mt Hagen based plane was in Kiunga and was able to fly to Bosavi to pick up the patient.

Rumginae pilot Marcus arranged the flight which would cost k7,200 – a 50% discount because Rumginae is a church-run organisation.

Keith Kedekai agreed to pay the money, saying that’s the price to save a life.

I gave the community health worker at Bosavi the go ahead and she asked the sub-health centre people know to prepare the mother for travel.

That done, I reviewed a critically ill patient in the ward – poor prognosis – and then went for my run.

Our staff were notified that the mother mom was flying from Bosavi and would arrive at Rughaz by 6.30.

It was now was five.

I went for a 6km run and I arrived back to hear the drone of the MAF plane in its red, blue and white lifesaving colours.

I couldn’t believe the plane had picked up the woman because it was so late in the day.

MAF can only fly during daylight hours. It turned out that there was just one minute of daylight left as they landed, which left the pilot stranded in Rumginae for the night.

After reviewing this woman and who was well overdue and with all previous children stillborn, it was decided to undertake a caesarean section.

I did the caesarean assisted by our resident, Dr Sakias. And so a bouncing 3.2kg baby girl was born at 9.15pm.

There was major bleeding and Dr Brandon stepped in to locate the source and managed to arrest it. Then the power went off as it was 10pm and time for the hospital generator to shut down.

For a while we were in total darkness fixing the bleeder but thankfully the solar power kicked in and the lights came back on.

Locating the marker stich would have saved a hassle but thankfully everything was under control and I took over to do a bilateral tubal ligation and close up the abdomen.

Thanks to all the staff members, students, Dr Brandon and Dr Sakias for helping to save this woman and her child. And not forgetting MAF for going out of their way to fly 

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