Fieldset
Quadruplets

I am leaving the project here in Timergara in two days. It has been a long eight months, and for the majority of time I have spent here I have been in the mother and child health (MCH) centre run by MSF at Timergara district hospital.

I am leaving the project here in Timergara in two days. It has been a long eight months, and for the majority of time I have spent here I have been in the mother and child health (MCH) centre run by MSF at Timergara district hospital. As a paediatrician, my job primarily has been to care for the babies born in this department, and spending so much time here has given me insight into the stories of the women here, both our staff and patients. One thing that will forever stay with me is the strength of these women. They take everything in their stride and when a difficult situation arises, instead of complaining they just simply act. I have been privileged during my time here to bear witness to some of the stories of these women, some of them heartbreakingly tragic, some uplifting and hopeful. There are too many to recount. However on Saturday morning something happened in the MCH that was nothing short of miraculous and really made me so proud to have been part of the team even for a short period of time.

There were four staff on duty for deliveries - Gulnaz, Rabia, Lubna and Asma. A woman came in at 4am, in active labour, fully dilated and ready to deliver. She had one five year old boy at home and had previously had twins die in the first few hours of life after caesarean section. She told the staff that she was 33 weeks pregnant with quadruplets!

I can only imagine the panic and drama that would have ensued had this occurred in a hospital at home in Ireland. Multiple births, particularly premature babies, are incredibly high risk for both mother and babies. If possible the babies are delivered during the day via a planned caesarean section with midwives, paediatricians, obstetricians, and paediatric nurses all present. Usually there are at least two medical staff per baby in the delivery room.

Here, with this not available or possible, the MCH staff did what they always do: they took it in their stride. All four babies were delivered safe and well within twenty minutes. Two babies delivered head first and two were delivered breech (feet first), another technically difficult achievement. The nurse working in the neonatal ward was called down and all four babies were soon cosily ensconced together in the neonatal unit. Meanwhile, the mother went to the operating theatre as she had experienced some bleeding after delivery, which is to be expected after such a dramatic delivery. The total weight of the babies amounting to 8.2 kilos!

I came to the hospital the next morning to find these four beautiful babies waiting for us. Seeing the look on the mother’s face when we informed her that all the babies were healthy and stable will be a memory I carry with me forever. It will remind me of why the MCH is so important here in Timergara. It gives these women a chance to have their babies safely, in an environment where mother and child will be given a high standard of care. It also leaves me in awe of what the MCH staff achieves, in a place with limited resources and where the enormous volume of complicated deliveries could easily overwhelm and panic even the most experienced people. Instead they unfailingly continue to take care of their mothers, sisters, aunts and daughters, and prove that moments like these four babies are possible anywhere with the right amount of knowledge, passion and skill.