An obstetrician in CAR: Coming to the end

Back in April, Rennie left Scotland behind to join the MSF team in Bangui, the capital of the Central African Republic. Almost three months later, he blogs about what he’s learned, what he misses, and how he feels to be going home…

Hi, that's me approaching the end of my mission. Will head home at the end of next week. It's been tough, especially at the start, but has got easier as I get used to the people, the work, the language, the living conditions, and as my support mechanisms – friends, colleagues, etc have strengthened. (Don't forget the local Mocaf beer.)

I have learned loads and seem lots of interesting things – including an abdominal pregnancy where the baby grows to term outside the mother’s uterus in the abdomen. It's rare as hen’s teeth. I had never managed a case or even seen one - and neither had any of my Scottish colleagues who I keep in touch with through the miracle of WhatsApp. That's getting on for 200 years of combined O and G experience. We delivered the baby through the mother’s abdomen, but sadly the wee boy (3kg) died shortly after birth as his lungs hadn't formed properly. The placenta had attached itself to the liver - so you leave well alone (to try and remove it would cause unstoppable bleeding). Close up, give antibiotics and hope that the placenta gets reabsorbed naturally. It's now five days and all going well. Time will tell.

A young mother holds her baby in the MSF maternity hospital in Bangui, Central African Republic

A young mother holds her baby at the maternity hospital. Photo: Borja Ruiz Rodriguez

I hope I have managed to pass on some good practice to the staff I have been working with. It must be difficult for them to have to put up with international staff who come for short postings and want to turn everything upside down. I have used the nudge-nudge technique. In particular I have tried to demonstrate good bedside manner. I suppose you could say this is a nicety compared with the lifesaving procedures that are carried out here several times every day. But as standards of healthcare improve and patients become more educated with higher expectations – communication skills and the quality of the doctor-patient relationship will rise: the "soft" side of medicine.

So, I say "Bonjour", have bit of a chat and coo over the baby, I try to explain to the patient what I am doing and what the plan is. They (both patients and staff) think I am a bit eccentric – but hopefully some of it will rub off. 

I think I might have been of more value to the mission if my French had been better. I thought it was quite good before I arrived. It has improved. I had a great compliment this week. Someone said to me Quand tu es arrive tu parlais terriblement. Maintainent tu parles mal. (When you arrived here your French was terrible. Now it's bad.)

So. It's been a positive experience for me and hopefully a positive useful collaboration with the maternity hospital (I haven't had my evaluation yet!). 

I am looking forward to going home. I miss my wife, my family, my friends. I miss sliced bread toasted, British weather, a proper sausage, the Scottish News at 6, fresh milk, being able to walk down the shops and of course, the golf.

I also have to add that it hasn't been easy for those left at home. When we first discussed my doing a three-month assignment with MSF it didn't seem a long time. Time flies doesn't it? But Mrs Urquhart and I have never been apart for more than a few days over the 35+ years of our married life. She has had to take over my roles on the home front which she has not been used to doing. So we have both had to make adjustments. I think we will appreciate each other more on my return. She says she misses me and doesn't want me to go away without her again. 

-  Give it a month and she will be asking me when am I going on my next assignment!

Most first postings for MSF are 9-12 months. However obstetricians, surgeons and anaesthetists are eligible for shorter, three-month postings, due to the intensity of the work. If you’re interested in finding out more about working with MSF, click here.