MATERNAL HEALTH There are cases where surgery is a choice. In other parts of the world, people might choose a Caesarean section. But in our set up, for those who are really in need, it’s not even a choice.
Dr Rediet Shimeles Anesthesiologist, Ethiopia
“Let’s consider a patient with preeclampsia, with obstructed labour, with life-threatening postpartum hemorrhage. Without safe and timely surgical intervention, she will bleed to death.
“But safe surgery needs equipment, drugs, manpower, and it’s incredibly frustrating when we don’t have them, and you can’t give the care you want to your patient. Things are moving in the right direction, but it’s a challenge.
“I’m a mother of two, and I’m 37 weeks pregnant. I know how it feels. Being an anaesthesiologist, I know the risks of surgery – but I also know that in many cases, it’s the only way to save the mother’s life. And not just one life – you’re salvaging a family.
“Recently I was called to help with a C-section for a mother expecting twins. She was bleeding heavily, on the verge of cardiac arrest, and we were about to lose her. The team worked all night.
“When she was transferred to the ward, I went to see her. I couldn’t find her on the bed and I panicked. But there she was, sitting up and chatting – I had mistaken her for one of her family members. She had no idea what she had gone through, how close she had been to death. That’s what safe surgery’s all about.”
A baby is delivered by emergency Caesarean section at a small district hospital in Rwanda. The mother is monitored with a Lifebox pulse oximeter.
Dr Mary Nabukenya Anesthetist, Uganda Safe anaesthesia advocate
“To understand how safe anaesthesia can improve maternal health, you need to think about how many mothers die giving birth each year – and why.
“Bleeding, sepsis, obstructed labour: these are all major causes of maternal mortality, and if patients don’t get safe and timely surgery, they will die.
“I remember a mother many years ago, referred from outside of the city. She came to the hospital in convulsions, almost unconscious. We worked for hours to stabilise her, get her to the operating room.
“Her baby died just before she had the surgery – and the mother did not survive the night. If she’d had the surgery sooner, if we’d had the resources for better postoperative care, there might have been a chance for both.
“I was quite junior and she was really young, you know – very healthy. She should have gone home. A death that should have been avoided.
“Global attention is shifting. Infectious disease are a big thing, but surgery is huge. Right now I feel like the best thing I can do is to help train as many others as possible, particularly rural anaesthesia providers.
“I’ve had experiences where people are a bit disappointed when they hear you’re an anaesthesia provider. You tell the person – the surgeon needs someone who is going to fight for the patient, for the baby.
“Because I know that if you have any one of these young pregnant women under your care – and almost all of them are young – you do your best, you treat them kindly, and you fight for them.”