A Birth in the ETU
Before we started rounding, someone called out from the ETU to say that pregnant Watta just aborted. When we got into the ETU, Watta was up in her room, no baby in sight. We found the baby on the ground next to the fence, cord coiled loosely around its neck, placenta attached. The baby was crying and breathing well after such a rude entry into the world. We found a shoe string to tie the cord. By then a midwife donned and came wearing heavy duty gloves which decreased her dexterity, to tie knots on the shoe string before she finally cut the cord. The baby’s left face was covered with small pieces of gravels. It was a baby boy. My sense was he had an Apgar score of 8 to 9, surprisngly he was perfectly pink. The mid-wife estimated the age to be about 24 weeks. He was covered up and brought to mom who was eating breakfast.
The baby was just about the lengths of three of my palms and was as light as a feather. He had such perfect little toes and fingers. It is quite likely that the premature birth was caused by the Ebola infection. We used kangaroo care to warm up the baby. Even though we were all aware that the baby’s chances of survival were slim, we all felt blessed to see such a miracle of birth in the ETU.
Watta tried to put the baby to her nipple and he attempted to suck. Pitocin drip was started to slow mom’s bleeding, her uterus hardened and she passed some clots. I wanted to give him dextrose but I was told otherwise so the baby took about three mls. of formula. I was worried about indigestion in a premie.
We sent parts of the cord and placenta to the lab but not willing to do a heel stick on the baby. By late afternoon, the baby was reported to be gasping. The nurse who went in to see her reported that Watta requested to have the baby taken away from her. Perhaps it was a mother’s instinct to realize that her child would not survive. This was her fifth baby. But this fighter could be saved in a NICU. Later my roommate who is also a midwife, came on duty for the night said we could take the blood through the cord. None of us had the desire to hurt the baby, preferring to get the blood after he slipped away.
Ironically, while Watta brought a life into the world, albeit briefly, across from her room was Magbla, a very tall and big woman who had been weakened significantly by the infection, her life was snuffed out like a candle. She was found in her bed, quite stiff and cold, seemingly asleep. Her husband and child left the Suspected Ward a few days ago having tested negative for Ebola.
This morning Mai had Cheyne-Stokes respiration, I held her arm and said a silent prayer for her. She breathed her last when I checked on her before I left the ETU. Her husband Togbah is right across the hallway from her. He has been quiet since admission, wears three layers in the heat and has been weakened by diarrhea. Mai joined Pai and Alfred K, all of whom were admitted to the ETU on the same day not too long ago. Carr who was left in the Suspected Ward hanged on till this morning. She too lost her battle to Ebola.
Tehwa and Majama left the ETU Ebola-free. Tehwa was the elderly woman with a distended belly and difficulty breathing for almost a week, responded to prednisolone which we found in the pharmacy. She raised her arm in the air rejoicing and praising Jehovah that she beat Ebola.
In the afternoon both our and Phebe ambulances brought in a total of thirteen patients, we stayed way past our shift to admit them.
Andrew, George and Munyah were the happiest persons in the world. Their Ebola tests are negative. Andrew requested his morning tea from me most mornings which I made and put in a bottle and threw it over the orange netted fence. Munyah was so ill for so many days with bleeding from the mouth, his young life was hanging in the balance for a while and yet tomorrow he will walk out of the ETU alive.
Still I remember the little baby that started our long day-- a miracle in the ETU.