Fieldset
Yemen: The girl we could not save

Hella Hultin is a surgeon from Sweden. She is currently on assignment with Médecins Sans Frontières/Doctors Without Borders (MSF) in Khameer, Yemen. Here she blogs about a tragic family incident.

Today I have seen something I want to forget. A small child died because her parents didn't know about the risks of infection.

It was in the morning that the night watch told me about the two-day-old girl who had come into the emergency room.

She had a fever and an infected umbilical stump.

When I did rounds, I saw her.

That image will never be erased from my memory: Small, burning with fever, and with gasping breaths she lay stretched out on her back, eyes closed.

That image will never be erased from my memory: Small, burning with fever, and with gasping breaths she lay stretched out on her back, eyes closed.

Her abdominal skin was dark red and hard, from her chest down to her thighs. Her umbilical stump was cut off close to the skin, swollen and greenish, the size of a two pence coin.

Had we found ourselves somewhere with more resources, we might have had a chance to save her. But I can't be certain. She needed advanced intensive care with respiratory support and high-tech monitoring of vital functions.

And most importantly, surgery that removes any infected tissue. This we could not offer.

Just to sedate her would kill her, and without surgery she would die as well.

An impossible choice.

"These kinds of events can only be prevented with knowledge and training." Photo: Hella Hultin/MSF 

With heavy heart my anaesthetist colleague and I agreed to give her the best pain relief and care we could, while we waited.

We informed the father, who then told me that the birth took place at home.

It turns out the umbilical cord was cut with the traditional dagger that all men carry in northern Yemen, known as a jambian. He had done this with their two older children, which had gone well.

This time, the newborn got a serious infection, which quickly led to blood poisoning and a desperate situation.

Had we found ourselves somewhere with more resources, we might have had a chance to save her

These kinds of events can only be prevented with knowledge and training.

We have a hospital  that provides free care. It is simple but clean, and hundreds of children are born here every year. If a woman's labour gets complicated in any way, there is a doctor, such as myself, who can do a caesarean section.

But if people don’t reach out to us because they don't understand the advantages, it doesn't matter how great the resources we have are.

She died at two o'clock.