Fieldset
“Her life is going to be totally different from what she must have hoped for”

Heidi Wikström is a Finnish surgeon currently on assignment with Médecins Sans Frontières / Doctors Without Borders (MSF) in the Abyei Special Administrative Area – a disputed region between Sudan and South Sudan – where MSF operates the area’s only secondary healthcare facility. In this heartbreaking blog, she shares the story of a young mother’s life-changing surgery.

The empty operating theatre in Agok

Every second Sunday one of us two surgeons has the day off.

Today, it wasn’t me...

We had two small surgeries in the operating theatre and some patients in the minor surgery unit, where nurses do the dressings and can consult the surgeon if needed.

The day was quite peaceful and we had some time to talk about non-work-related issues.

A nurse asked me about my life back home and was quite astonished to hear that I only have two children and also to learn my age, which is 51. Here, life-expectancy for women is about 56 years according to UNDP, and it is not uncommon for women my age to have carried an average of 10 babies.

Children are the most valuable asset a person or a family can possess. Here, even more literally than in my home country, they are the promise of a future."

We also talked about my children’s occupations and their studies. This issue also required an explanation, since my daughter is a dancer and my son doesn’t have an occupation yet. It seems being a dancer is not considered a serious job in this part of the world.

Having also told the nurse, who was a young man in his twenties, that marrying someone is free of charge in my home country, I saw he was amazed. He said: “your country is very funny. You don’t even have to pay for getting married!” He told me that marriage here may cost as much as 200 cows, which really is a fortune.

A difficult surgery

Considering all this, it’s no wonder that the mother of a patient from two days ago had cried so desperately outside the recovery room.

Her daughter, aged just 23, had already gone through two previous pregnancies – both of which had ended in the loss of the baby – and was just out of the operating theatre after a difficult surgery.

That day, she had again lost her baby, again. But that was not all.

She had suffered an abrupted placenta, meaning the placenta had become detached and she was losing a dangerous amount of blood.

We had tried hard to save her uterus by using the bakri-balloon method. This meant placing a condom-like balloon that’s filled with water inside her womb to put pressure on the wall and stop the bleeding.

I had managed to position the balloon correctly, but still, the bleeding had continued.

The young woman’s blood pressure was 60/20 (extremely low) at its worst. We got it up with blood transfusions from five of her relatives, but finally, we had to perform an emergency hysterectomy – a surgical removal of her uterus.

A different future

Her life was saved, and, this morning, she was quite well.

However, I wonder how her life is going to continue with no chance of being pregnant again? I have heard that a woman’s worth in the Abyei Special Administrative Area is often measured by her ability to produce offspring and that many men have multiple wives.

It's easy to judge from afar, but after seeing how fragile life is here, things like this become understandable.

Children are the most valuable asset a person or a family can possess. Here, even more literally than in my home country, they are the promise of a future.

I don’t know how it will turn out for my young patient, but I was almost comforted by the sight of the relatives at her bedside.

Her husband sat there and softly touched her hand. A very tall, grave-looking older man was probably her father. And her mother, crying so much when people here are generally polite and calm and never show their feelings in the public. She certainly cares for her daughter.

I hope the young woman will find a purpose and happiness for her life. It is going to be totally different from what she must have hoped for only a two days ago.