Super Tuesday

It is Super Tuesday here
and Sue and I have been glued to the SatTV. since early morning
At 1pm almost on the dot, there is a knock on the door.
It is Evelyn. She is the lady that looks after the house, cleans, dusts and does all the washing except our underwear, culture forbids.
Evelyn is a really nice young woman. She is 23 years old and has two girls, both at school, aged 6 and 7 years.
Her husband is a nice chap too. He has no formal education, no land, no skills and has recently finished DOTS for TB. So she looks after him too
Evelyn is the sole wage earner and is great at her job so gets spoilt. She now has a bike and a mobile telephone and new clothes, Sue dotes on her.
When I arrived back from the COMFORT mission, I found out that Evelyn was pregnant again. She had been on "the Injection for seven years and had been told to stop for a while".
Back to the knock on the door. Evelyn, looking exceeding uncomfortable, announces she "having pains". She is 7 months pregnant by her calculations.
I ask her a few questions, yes she is 'spotting'. Yes the pains are regular etc.
her kids are at school and her husband miles away.
I put her into my truck and we crawl down to the town's Referral Hospital.
i am feeling a bit like a Grandad to be.
When we arrive we are met by pandemonium
The entire hospital staff are out on strike. Not a medic of any shade to be found in the hospital. Chaos, crying wailing, its like something out of Dante, only hotter.
Inside the 'maternity unit' the scene is like the set of a Angelina Jollie movie. The dads, grandads grandmas and mums come at me like a wave, 'Muzungu help us!"
By now I am used to African theater so I shout back and smile.
As it calms down, Evelyn is getting distressed and I am thinking what next. I hear a scream and then groans.
I walk into the delivery room[s] and there on one bed is a kid of about 15, she is naked, sweating and in agony, her mum is holding her down.
i find an English speaker, a brand new dad, nothing to do with the girl in agony, he looks 18.
He translates, the girl has been in labor since the previous evening ( the nurses walked out at 10am today)
I gird my lions and examine her, she is about 6/7cm dilated baby's moving a little and i can hear a heartbeat.
I know i cannot do anything here. I am not credentialed for Uganda, the nurses are on strike, its an MOH hospital. I could end up in a law court
So think. I find out there is a private medical clinic some 5 miles away. The nearest city, Kampala is 200 miles away.
So i load preganant child with mum and grandma into my truck. Evelyn, now really uncomfortable is in the front.
As we were trying to leave, i am suddenly surrounded by people who need help.
At first I say no I must go and point at the girl, but they and I know i am lying, i am simply overwhelmed.
The young guy who speaks English and translated for me asks me to look at his wife. I push through the crowd to her bed.
She is so young, sweating and out of it. I think she is a problem about to happen, lift her sheet to find she had had a Caesarian within the last 24hrs. He points at an empty IV attached to the window frame and pulls out from under the bed a box with 9 remaining 500ml units of Normal Saline." Fix for me please mzee!" At this point I see a bundle of rags under the bed, "whats that?" "My son Mzee! A strong new son!"
I pick up this tiny newborn from the filth and flies on the floor and put him next to mum. She smiles. I say, "ask if she has had a drink, is she thirsty?" "I am so thirsty and hungry too".
I tell the dad no more IVI ( I risk getting in deep trouble even changing an IV) "plenty by mouth" . I leave both smiling
Outside a woman and a man meet me with a baby, it is no more than 6 months, a twin they tell me. "But this one will not suckle"
I take one look at the baby, feel its little head and chest watch its eyes roll and back arch and know why. "How long has your baby had malaria?'
"Oh three days mzee." i pinch his paper dry skin he doesnt flicker, I open an unseeing eye and search for a thready heartbeat that is almost exhausted. His back has lost its arch and he is flaccid, deeply unconscious.
I get back in the car and say I cannot help, I know the baby is doomed. I have to get the two pregnant women to a private clinic quickly
We set off. A word to the wise. Africans do not travel often in closed vehicles, they throw up. God bless mum, she opened up her handbag, a fake crocodile-skin, and her daughter threw up in it.
When we arrive, the chaos is similar but less intense
Dr Pamela examines them both.
The young girl is 7cm but making heavy weather of it, she is 16 and a PG, small in pelvis and been at it 10 hours, odds on for a Caeser'.
Evelyn, acting in sympathy gets a spurt on and starts to do it for real. The nurse tells me she is 5/6cm and moving along nicely.
At that point I tell the young woman who came with us, the child mother's mother, she is about to be a Grandma, she must be 30.
I ask what next and the hospital staff say come back in the morning and pay the bill please.
I drive home slowly thinking about the dozens I had done nothing for still waiting for the nurses to come back to the hospital, knowing that it will not be tonight
Wondering if the the baby is still alive
Trying to convince myself there was nothing i could for it
(done this a few times with babies with fulminating cerebral malaria)
We have phoned Evelyn's family, given them money for their telephones
and food and water for Evelyn
Food and water for the kids' family, I don't even know their names
And now i am going to have a beer and watch CNN
And try and forget about my Super Tuesday