“I hope, someday, she can hold a newborn baby against her heart”

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. 

Heidi at work in the operating theatre

Last year, somewhere between February and May, I finally made myself complete the online application form for MSF.

Then, some weeks later, I received an invitation for an interview in Stockholm. After some serious form-filling and several vaccinations – as well as warnings from friends and colleagues – here I am in Agok, a town within the Abyei Special Administrative Area.

Actually, I have been here for almost three weeks already.

A steep learning curve

I’m a gastroenterological surgeon with not much experience either in burns, gunshot wounds or orthopaedics, but thankfully I’m not left to my own devices here and have a more MSF-experienced colleague to back me up.

He has been a long-suffering listener to my myriad of questions. I’m not lying if I say I’ve never learned as much in a fortnight as I have during this last one.

I have debrided burns, opened abscesses, drilled pins into a patient’s tibia and cleaned-up gunshot wounds.

I have also discovered that the three days I spent last autumn, in Finland, learning to perform caesarean sections have apparently been time well spent… So far, I have already performed two here.

Emergency operations

Caesarean sections, as it can be imagined, are quite rare here in Agok.

They are never planned. They are only performed by a surgeon at the request of one of our experienced midwives when it is an emergency situation – where there is a serious threat to the life of the mother, the child or both.

In one of the two operations I undertook, both the mother and child came out of theatre perfectly fine.

In the other, sadly, only the mother survived.

Hopefully, someday, she can once more hold a newborn baby against her heart – as the other young mother just to her left was doing."

The placenta had become separated from the her uterus and she was suffering from substantial blood loss. Without the operation, the mother would not have survived either.

Hopes for the future

In the following days, I saw the two mothers several times in the maternity ward. They were actually being cared for in neighbouring beds.

The woman who had lost her perfectly developed baby boy, because of a problem that had only developed during the last hours of her pregnancy, had a grave face. As did her husband sat beside her.

The small consolation was that she already had one child.

Hopefully, someday, she can once more hold a newborn baby against her heart – as the other young mother just to her left was doing.

I’ll be here in Agok for another seven weeks or so. In my next blog posts, I’ll share some of the experiences that, from a medical point of view, have been of special interest to me as a surgeon learning to work in an environment with limited resources. Although, resources that are still good enough to help us really save lives and reduce suffering.

I will also write about those patients or events outside of the operating theatre that have touched my heart in some way or another.