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Incommunicado

As I palpate the woman’s lower abdomen she winces and gives a soft cry of pain. “How long has she been in this discomfort?” I ask the midwife.

“For an hour, doctor.”

“And she has had a previous Caesarian section?”

“Yes – doctor, 5 years ago. She has been 2cm dilated for the last four hours.”

I am back at Ceza Hospital for a second round. Glutton. Only this week has not been the mellow experience of my last visit. Word has got out – there are doctors at Ceza. Where 2 weeks ago we were seeing just 20 to 30 outpatients a day now there are over 50. Oystein and myself have been working til 7pm. No chance of nipping down the road to the hot springs. And now, just as we were huddling down for an evening of DVD viewing on a 12 inch laptop screen maternity has called.

I scratch my head. The lady is at high risk of needing a Caesarian section – not right away but fairly imminently and possibly as an emergency if she is allowed to continue to fail to progress and ruptures her old Caesarian section scar. There is only one problem. Neither Oystein or myself can do Caesars – we are namby pamby European physicians. Not hard core South African generalists. I have assisted at half a dozen sections. In fact, at the last one Jabu let me do the whole thing under his watchful gaze. I proudly stood back after my first solo sewing up the uterine incision awaiting his approval. He studied the oozing bleeding uterus carefully and then, taking a new needle and suture said, “I’ll just tidy this up a bit” - and then repeated the entire thing. So I guess under pressure I could get the baby out. Just couldn’t put things back to together again.

I pick up the phone and dial switchboard. “Could I have Nongoma hospital please?”

“Ah – doctor. I am sorry – all our lines are down.”

“You mean there are no phones at all?”

“No doctor.”

“What about that radio?”

“Radio?”

“The radio in your room for emergencies.”

“Ah – yes. That has not worked since 1990.”

I check my mobile: “No service.” Telkom and Vodacom share the same malady. I swear under my breath. We are in the middle of Zululand. 30km of dirt road separates us from the highway. It would appear we are completely cut off.

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