Tuesday, September 27, 2011

Storms.


Gusts of grey carried them in, bags in hand. Behind them, black grumbling clouds glowered on the horizon, sending a steady stream of chilly air our way.

As I walked into the clinic, they followed with quick steps --eager to hide from what was coming. Then together we shook the wind from our clothes and smiled conspiratorially at one another.

We were safe.

Heavy drops thumped on the roof above as I asked them why they’d come. He handed me her book in response and sat down. She then crawled quietly on my bed and moaned.

After a few minutes, it became clear that she was in labor... but that she also had malaria. I started her treatment immediately as she looked preterm; I didn’t want her contractions to push her into labor.

But when I looked a bit closer, I realized it was too late. Her contractions were well under way. So I asked to do a vaginal exam to see if I was right; she consented with a slight grunt.

She was already 3 cm dilated.

I wasn’t sure when she’d deliver, but I knew it’d be soon.
“The baby will come tonight,” I informed them, “and since this is your fourth, it might come pretty fast.”
They clicked their tongues in agreement, then looked up at the skies.

I think if the storm hadn’t been raging, they’d have taken her medicines and left. But with night falling early, they resolved to stay.

Once settled in, I counted contractions. They were short but frequent. It was hard to tell how fast she’d progress.

“Abuoc, if your water comes out or you feel the slightest need to push, call for me right away. I won’t be far.”
She nodded but said nothing. So I informed the health worker on duty to watch carefully for any changes, and went to rest a few minutes; it’d been a long day.

A half an hour later the health worker was knocking on my door; her water had come out.

Watch. Pen. Gum boots. Umbrella.
        -- Check.

I ran out into the rain.

The storm was just above.  Howling angrily and pushing things about; it whipped my clothes and bustled my hair as I hurried.

As I stepped into the observation room --mud splattered and wet-- chaos greeted me with a wall of backs and loud voices. As I peeked through the throng, I could see a blue baby covered in goop, barely stirring in his father’s unsteady hands.

She’d delivered without me.

The room was filled with a half-dozen other patients and their families, who stared unapologetically while screaming for her to push even though the baby was obviously out.

When I asked them to step aside so I could help, they ignored me. Perhaps they couldn’t hear in all the commotion.

I also had to physically removed her husband from the bed so I could help. He just knelt there staring at me in horror and disapproval --his hands covered in fluids and blood --his boy not breathing.

The incrimination in his gaze was hard to miss, but I didn’t care. The baby wasn’t breathing!

“Out of my way! Move!” I screamed over their chaotic chatter, “I need to get to the baby!”

My translator was worse than useless. He stood there looking at me with nonchalance and haughty derision. I had to ask him to translate everything three times before he opened his mouth!

“Tell him to put the baby down and move. I need to get to the baby!” I asked, forcing the anger from my voice.

He translated and the father eventually moved. Only then was I able to resuscitate the baby.

Pale blue and coated in sticky vernix, his little frame moved slightly to my touch. I could see he was alive, but hadn’t taken a breath yet. So I rubbed him vigorously and spoke to him.

“Come on, little buddy!” I cooed, “Breathing’s fun.”
As I turned to my translator, I was surprised to find him doing nothing. I told him I needed the birth stuff (towels, gloves, cord clamp, etc.) but mostly the ambu-bag.

“Go get me the Ambu-bag!” I called over my shoulder.
“The what?” he asked.
“The bag used to give the baby air... to resuscitate.”
I was screaming by now. Frustrated.

The little guy before me blinked from time to time... but he hadn’t taken a serious breath yet. I continued to stimulate him and pray.
“Go now!” I screamed, “If you don’t know what it is... ask the doctor.”

It felt like ages before he returned, but by then the boy was on the mend; his color had improved and he was making shallow gasps. Every now and again, he’d whimper and whine.

Progress.

My translator returned with the Ambu-bag and I gave some rescue breaths. He responded quickly. Within a few minutes, he was breathing on his own!
    --Hallelujah!

Only then did I lift up my head and look around the room. Her husband was staring at me in horrified bewilderment, holding his hands up in disgust. They were still covered in gunk.

I ignored him and eventually he went to wash them outside with the hose.

The rest of the looky-loos had also quieted down. However one was still instructing Abuoc to push-push-PUSH her placenta out. He didn’t shut up until she did.

By this point, my translator was no where to be found. I waited thinking he must be just running for a few more things... but when 5 minutes turned into 10, I gave up waiting and screamed for him to come.

I had to scream louder than the storm since he was most likely in the main clinic, 10 yards away.
    --Where could he be?

He came running, mumbling something about a convulsing child that the doctor was treating. He looked annoyed that I had the audacity to call for his help. I was ready to beat him and chase him from the clinic with our guard’s AK-47... then I remembered that such things are not nice and I took a deep breath. 
       --Thank you Lord! Thank you that their son is alive despite all this chaos!

Once the dust settled and the room was once again in order, I stepped out into the storm and splashed though the puddles.

He was alive!

Sure... things hadn’t gone as I had hoped, but he was alive! It was time to celebrate.

I splashed away excitedly --my arms lifted high. I couldn't hold it in! What an awesome God we serve! He’d rescued me in the storm.
    --Thank you Jesus!

And as God would have it, their son wasn’t preterm after all. He was just small for gestational age. He and his parents recovered quickly from all the excitement and slept well. I discharged them the next morning... after the storm had passed.