Sierra Leone: "Christopher you are wanted"

Chris is a nurse currently working in Sierra Leone. He blogs about a tiny patient...

Mariana our cleaner is standing outside the health centre. She shouts over to me whilst I'm outside looking for our lab technician. I spot him in the designated smoker’s area; a tree 50 away with roots large enough to sit on.

"Is it important?" I ask Mariana. She has already turned away.

I head in to the maternity room to find her. When I enter there is a mother lying on the bed; she is exhausted. She has just given birth.

I realise something is wrong as there are no cries coming from the bundle of bright fabric on the trolley.

In the corner there are two midwives and an assistant around the trolley new babies are placed on. I realise something is wrong as there are no cries coming from the bundle of bright fabric on the trolley.

"Could you come and see this please?" asks Debbie our midwife from New Zealand. Her team has helped to deliver the baby, andshe speaks in the calm yet inquisitive tone that you would use to show someone a strange rash, or a new mole you've found on your skin.

On the trolley is a little boy. Debbie is listening to his chest and tells me he has a strong heart rate. The midwife assistant holds a special type of resuscitation bag and mask over the baby’s face, pushing air into the child every few seconds.

"It's strange" Debbie says, thinking aloud. "He has a strong heart beat but he isn't breathing". I take over from the midwife assistant as using the equipment can be tiring. The midwife team have been working hard to help the baby breathe. As she removes the bag to hand it to me, he lets out a small gasp. We wait for another gasp that doesn't come, so I grip the mask and baby's head with my left hand, and start lightly squeezing the banana yellow bag with my right. I notice that he takes a breath once every minute.

His gasping has increased to three times a minute.

We discuss what else we can do. We give glucose in case his energy reserves are low, and have wrapped him in a survival blanket in an attempt to raise his temperature. We suction fluid from his nose in case anything entered his lungs during birth. His gasping has increased to three times a minute.

I look at the clock and ask myself when we should stop. As I’m thinking this over, his gasping becomes more frequent and I’m surprised to find that when I remove the bag, he is breathing on his own.

We move him onto his mother. He is now breathing normally. Over the next two hours he will open his eyes and start making noises. 

I'm not sure if he'll make it through the night. I visit him the next morning and find him lying on his mother; he has started crying and is now feeding. He is monitored by the midwives and treated with antibiotics. In the afternoon he receives his immunization and is ready for discharge. Before he leaves Debbie wants to show me something.

"Come and see this" she tells me, and I follow her in to the midwifery consultation room.

She opens a yellow ledger. As she flicks through pages I realise that it's the birth certificate book. She points to a page of a baby boy that was born yesterday morning. Above her finger, beside the word ‘name’ is written is the word 'Christopher'.