27 September 2009

‘When Rebecca started improving, I felt so, so happy. For at least 5 or 6 days, I had been very anxious about her. Her mother would always take my hand and thank me every time we came out of the operating theatre (OT), but inside I was afraid that she might die’ Dr Maria Laura Vasilchin, Gynaecologist, Benson Hospital


The photo above shows Rebecca seated between her mother and Maria Laura on 25th September, the day she was finally discharged from Benson.


The photo above shows Rebecca seated between her mother and Maria Laura on 25th September, the day she was finally discharged from Benson.


Dressed simply in a pink t-shirt tucked into a traditional ‘lappa’ tied securely around her waist, Rebecca tells me in a quiet voice that she cannot remember clearly the journey from her home in Kakata (a town approximately 50 km from Monrovia) to Benson Hospital on 18th August. She remembers the car travelling very fast, and she remembers the bumps in the road, which exacerbated her already severe abdominal pain. She was in labour with her fifth child; however the experience was nothing like her other labours, which had been trouble-free and without any medication. She delivered her first two sons, now aged 14 and 10, in the bush during the war; her daughters, aged 8 and 2, were both born at her home in Kakata, with a community midwife in attendance. During her fifth pregnancy, Rebecca had visited her local clinic for antenatal care (ANC), and she also planned to deliver there. When the day came, however, the clinic turned her away saying they could not manage her condition. Some members of her community knew about Benson Hospital for women having difficulty ‘borning’, so her family loaded her into a car belonging to a community member and covered the cost of fuel required for 45 minute trip to Monrovia.

The midwives at Benson attempted to deliver the child in our maternity; however when they realized that the feet were presenting first, Rebecca was rushed to the OT for a Caesarean section. She remembers climbing onto the bed in the OT, and later recovering consciousness in the recovery room while a nurse waved a hand in front of her face and asked her ‘You see me? You see me?’.

Olivia Stewart, a Liberian Nurse at Benson Hospital since 2003, explains that if a newborn baby does not survive, one of the medical staff usually informs a relative, who will then inform the mother. Rebecca didn’t need anyone to tell her, she figured it out for herself. When she was transferred to our Gynaecology ward, she saw other women in the ward breastfeeding their newborns, or sleeping beside small packages wrapped in brightly coloured lappa. Nobody was handing her an infant to suckle, there was no brightly coloured package on her bed. Rebecca’s baby died due to foetal distress, a condition where the baby’s heart rate increases or decreases dramatically due to lack of oxygen. If Rebecca had been in a country with better antenatal services at clinic level, in a country with tarmac roads, with ambulances, with more surgeons, more free hospitals, then maybe, just maybe, her fifth child would be alive today. As the fourth child and third daughter in a family of five children, I feel compelled to ask Rebecca if she knew the gender of her fifth child. ‘De white woman told me na girl child’, she says, ‘she was sooo big’, she adds with a hint of pride.

Unbeknownst to her, Rebecca would stay at Benson a further 5 weeks following the loss of her infant. In the days following her Caesarean section, she developed a high fever, and the site where she was operated on started to leak, indicating an infection. When Maria Laura performed a laparotomy (in plain English an abdominal exploration), she found that Rebecca had developed a huge infection of the uterus; she had no choice but to carry out a hysterectomy. When her fever still persisted, Maria Laura opened her up one last time and cleaned her abdominal cavity. Rebecca says she cried each time she was told she couldn’t eat after midnight, knowing that the next day she would be wheeled through the dreaded swing doors of the OT.

Rebecca speaks candidly, she understands that her uterus is ‘spoiled’, but she thanks God first, and Benson second, for her life. Her smile and composure on the day of her departure from Benson belie the physical and emotional pain the she has endured here, however she vows to return. She wants to see Maria Laura again before she ends her mission and returns to Argentina, and she wants to thank everyone at Benson again for restoring her health. But right now, all she wants to do is go home to her husband and family.