Skip to main content

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.

Comments

Post a Comment

Popular posts from this blog

Abscess

The phone rings. I am lying on the sofa in the dark squinting at the laptop screen: someone has lent me series 1 of Spooks. I struggle up and bump across the room to the phone. “Hello?” “Moran!?” “Yebo.” “How are you?” “I am fine.” “I am fine too.” And then those four dreaded words. “Please hold for maternity.” The line goes dead for a second and then a midwife comes on the line. “Moran?” “Yes.” “How are you?” “I am fine. “I am fine too. I have a 22 year old primip. She is in labour but I cannot do a PV. She has a Bartholin’s abscess.” I ask a few intelligent questions and then, pausing only check what exactly a Bartholin’s abscess is (an abscess of the Bartholin’s gland apparently) I head for maternity. On arriving I am taken to the woman concerned and, yes, sure enough there is a large abscess in the position that I imagine a Bartholin’s gland might sit if I knew exactly what it was. “I cannot do a PV to check the cervix because it is too painful.” The abscess blocks the way. “Right.
1 comment
Read more

10 years on

The door flies open. Lele peers in. "You must come out here and see. They are doing a play!" I finish up my case file annotation and come to the doorway. The waiting area is in chaos. A gang of school children are manhandling a couple of marimba's to the space in front of the consulting rooms, a team of nurses and counsellors are creating a stage area. Patients look on mutely. Some with interest, others - presumably feeling proportionately less well - without. "What is going on?" I ask. "It is 10 years since the clinic started. 10 years since MSF first started the HIV treatment programme and proved that it could be done in Africa. So the staff are celebrating. They are doing a show or something." The sister in charge of the clinic has moved to the front of the crowd of patients. She calls for silence and then gives a short introduction. Lele translates for me. "She is saying that this is a very important day. 10 years ago people were dying. And 10
3 comments
Read more

Ceza Hospital

I am woken with a jolt. The 4-wheel drive has left the tarmac and we are on dirt road. I look ahead into the hills – the road wends its way high up into the distance. “How far?” I ask Amos, our driver. “About 40km.” I settle back and watch as the settlements become less and less pseudo-bungalows and more and more mud rondavels. The road to Ceza It was about a month ago that our medical manager first mentioned that we had been asked to help out at Ceza Hospital – a remote rural hospital about 2 hours away. Its medical staff (only 8 at the best of times) had been steadily departing and only one remained. He was leaving at the end of May and they were desperate. Desperate enough to accept help from us. As I said – a month ago – but it was only last Thursday that I found myself agreeing to go. Two of the others had been that week. I phoned them to ask what it was like. “There are no words to describe it,” said Nomfundo, “speak to Dr Kekana.” Dr Kekana comes on the line and after humming an
3 comments
Read more