Pregnancy complications are more common in Pakistan because, among other reasons, there is little antenatal care. Problems such as high blood pressure are not detected or diagnosed until severe symptoms develop, by which time the life of the mother or baby may be in jeopardy.
One such case arrived at the Women’s Hospital yesterday. Shaheen (not her real name) had been admitted to the Hangu Tehsil Headquarter Hospital (which MSF supports), in labour and with eclampsia (a pregnancy complication where there is very high blood pressure and seizures). The treatment is to give medication to stop the seizures, control the blood pressure and then deliver the baby as soon as possible. This was done, the baby being delivered by Caesarean, but it was unfortunately stillborn. Shaheen was still very unwell and needed high doses of drugs to control her condition. She was transferred to MSF’s Peshawar Hospital for more specialised treatment.
On arrival, after a two hour journey in the ambulance, Shaheen was barely conscious, and needed intensive treatment and nursing care. The next few days were stormy. The blood pressure settled and it was safe to gradually withdraw the anti-epileptic medication, but she developed a high temperature and her condition deteriorated again. The cause was an infection of the genital tract. High doses of powerful antibiotics were needed to bring the infection under control. After a further three days, the antibiotics had done their job and Shaheen was for the first time sitting up in bed and looking well. She was ready to be discharged back to Hangu.
At her bedside the entire week of her stay was Shaheen’s mother-in-law, constantly and anxiously watching over her. As we did our daily ward round, we assessed Shaheen’s case and told her she was fit to go home. The mother-in-law became very agitated, crying and gesticulating alternately at Shaheen and then at us, the group of doctors and nurses at her bedside.
She seemed very upset, so I asked the nurse standing next to me “What is she saying?”
The nurse replied: “She is saying that when Shaheen came here a week ago, she was nearly dead, and now she is her normal self again. She is overjoyed, and is thanking us over and over.”