Feb…wait…March. the first of March.

Feb…wait…March. the first of March.

We are so fragile when we are new. Something in our physiology or our spirit isn’t convinced that the outside, so cold and bright, is worth the breathing.  After the first seven days, most of us find something to like and our breathing gets easier.  But those first seven days. We sit on the fence and a breeze can knock us down.

So much more true in places like Sudan.We die commonly, from infection, or because we are too early, or because the mother is as far from a hospital as you and I from mars. If one cares to look at infant mortality rates, you can see that western Europe, North America, Australia and, somehow, Cuba fight for the lowest at around 5 per thousand. Poorer countries like Mali, or Mozambique, suffer with the highest. The latest data I have with me shows an infant mortality rate of 181 for every 1000 babies born in Sierra Leone. Nearly one in five babies doesn’t make it.

This afternoon, as I was gathering some motivation to take a young boy to our operating theatre (it sounds more grand than it is) and remove some of his burned skin, I was pulled aside. The nurse pointed at a woman sitting on the ground. So what. People sit on the ground here all the time. Most of the time I don’t know who they are, and assume they are one of eleven necessary relatives that accompany most of our patients.

“She was seen at the outpatient department. I think it is her baby. It is two days old and not breastfeeding. She was told to go home, and to come back another day if it didn’t improve. But she says she is too tired.”

I walked over. The woman was very tall, her forehead marked with sloping scars. I asked her, through my translator, what the problem was.  She handed me an outpatient card. It read: “Breastfeeding Problem”. Beside it was a temperature: 37.8. It was unclear if it was the mother’s, or her child’s.

“how many children has she had?”

“this is her fifth.”

That is the most important question you can ask a mother who comes to

you with child problems. New mothers are, well, new. Everything is a cause for concern. A woman with four babies does not walk for hours to find simple answers.

I asked to see the baby. Pale. Sleeping.

“Has it been sleeping like this all day”.

It had. I listened to his heart. It was beating too fast. About 190 times per minute.  His breathing was too fast. And every now and again it would stop. One one thousand. Two one thousand. Three. Four. Five. Six. Sev… He was swaying on the fence, trying to decide.

I went into the nursing station and asked the mother to follow. I asked for the nurses to start an intravenous, and prepared to put a cannula in his shinbone if it failed. They succeeded. I took saline and glucose in a syringe and pushed it in slowslowslowly. While I was doing it, for the first time, he opened his eyes. He looked into my face as best he could with new retinas, and slowly closed them again. The odds, in my estimation, fell.

Oh. Must go. Radio. Hospital. Writing time over. Over.

Fragile when we are new. I was called to a complicated delivery. The baby was presenting with her hand over her face, in a premature swoon, an “oh great, what have I gotten myself into this time” pose. She delivered before I arrived. But she has a brother or sister not far behind. Twins. He/she is coming out foot first. If they live, I wonder if they will get along. Already they seem so different.

I think they are too new. This first one was small enough you could fit her comfortably in a lunchbox. She has the most tiny, perfect fingernails. Her heart, no bigger than a cherry, tapped in her thin chest. You could feel it.

Time will tell for her. And for her twin, who will be making his first appearance in the delivery theatre.

Next week, on delivery theatre, the triplets of abyeiville.

I will let you know how all three do. For me, though I would like to write more, I am going to bed. It is my day off tomorrow, which means I start work an hour later. Sweet. Night. Lights. Out.