This week we went to Lukonzolwa to supervise activities in our health centre. A few minutes after we arrived we found a woman who had been in labour for a long time and who needed an urgent c-section because her pelvis was too small and the baby could not pass through it.
Option 1: Luanza (very bad option)
This is the closest hospital to Lukonzolwa but it is not an MSF supported hospital. This means that it is not a free hospital and the quality of care is questionable, to say the least. Luanza is actually only 12km, but that is two hours on the back of a bike on a dirt road in the Congolese bush while you are in labour. The cost of a C-section in Luanza is $25,000 Congolese Francs. Don't be alarmed by the amount; it is roughly equal to $52.63 in Canadian Dollars. Unfortunately, that is an astronomical sum of money for
this woman and her family. Without the money the hospital will not perform the surgery and they will let the woman and her baby die. Paying for the C-section is not an option because we have no idea if the people in the hospital are even qualified to perform the surgery.
Option 2: Kilwa (slightly better option)
Kilwa is over 80km, which is at least two and a half-hours in our boat, plus the half-hour hike down the mountain to get to the boat. An hour may not seem like a lot but to a baby in fetal distress it is the difference between
being born dead or alive. Also we do not have enough room in the boat for the garde-malade. I am not sure if I have explained this concept before, but here every sick person has a garde-malade. This is the person that cooks for
you and feeds you and bathes you, etc. while you are in the hospital because the nurse to patient ratio here is somewhat alarming.
We go with the slightly better option and decide to transfer the woman to Kilwa. Her family somehow makes a stretcher out of a reclining chair and an IV pole out of a tree branch and four people carry this woman down the mountain and into the boat. I have never been in labour, but I can tell you that I never want to be in labour and carried down a mountain or spend two-and-a-half hours in a speedboat. I can't imagine how scared this woman must have been. She is young.it is her first baby.she speaks only Zela and she is alone in a speed boat in agony with a muzungu woman who is taking her to the hospital where they will cut open her belly.
It seemed like an eternity to get to Kilwa. We waited for a long time in the maternity for them to bring the baby but he didn't come. He was alive for a little while, but for some reason he just couldn't breathe on his own. We
don't have any machines here to help babies breathe or enough electricity to run machines. Before we left Lukonzolwa we took the address of some family members that could come and take care of this girl and her baby. Now they
will come and help her to grieve. It is so important here, funerals and grieving. It is a big part of life in the Congo. It is so sad that this woman will wake up to find that her baby didn't live. But it is comforting to know that she will wake up.