A strange event...

On one of the last days, we thought it would be a great way to thank the primary health center's (PHC) staffers by getting them a cake and to surprise them at the end. One of my fellow colleagues, Sarah and I were free so when we heard that there was a delivery continuing to occur since 11 am, we decided to go and watch at 2:15pm. 

The mother had been pushing since 11:30 but the crowning had just happened when we had walked in. The mother and some other family members had been in the room asking the nurses, the health worker, and peon if they should take the mother to a private hospital. However, the mother was not able to push effectively so the nurses tried to slap and pinch the mother in the face and on the thighs to cause pain and lead to pushing. The nurse would yell at the woman to push. She looked really annoyed at the mother. These practices are common we later heard from another American intern who had been working in the delivery center. Another intern who had been present during the entire delivery said that earlier on the nurse and midwife had been slapping her face and pinching her vagina and had given her an episiotomy without anaesthesia.

My mentor, Nadja, was not present until much later on. Later on on discussing the case with her, she said that at this point as there was prolonged labour and exhausted mother, a C-section should have been conducted but PHC is not allowed/ equipped to do a C-section. It was poor decision making on the nurses' part to let the delivery continue so long. The baby finally came out at 2:57. Initially the baby wriggled, but when the umbilical cord was cut, it turned the normal blue- but it failed to cry. The nurse hypothesized because of the prolonged labor, the baby had probably swallowed meconium, the poop, and could not breathe. They tried to use the suction but at that point the power and UPS packed up. The baby started to turn really blue and looked lifeless. The nurses tried to rub the baby’s back roughly and slap his feet to induce sensation in the baby. But, nothing was really happening to the baby. In the meantime, the nurse removed the mother’s placenta and stitched her up. The mother and grandmother of the baby came into the room and assisted with the mother. The doctor was also called into the room after 10 minutes and he tried to ventilate the baby with an ambu-bag while the nurses continued to rub the baby’s back and hit the feet. He kept hearing a heart beat, so he kept trying. After 30 minutes had passed, Nadja came into the room. She recognized that it would be best to call the ambulance. Nadja felt uncomfortable about intervening in doctor’s decisions which is why she tool 5 minutes before saying anything. After Nadja suggested that the ambulance could take the baby to take to the recently built pregnancy center, the doctor agreed. 

He called the ambulance . It took time to ask about the seriousness of the case and the location. The ambulance arrived at 3:45. When the ambulance arrived, Sarah asked the nurse why they didn’t call earlier, they said that it was their first priority to try everything at their PHC first, otherwise they will be scolded. We were shocked by this as it seemed to us like they were more interested in not appearing  incompetent yet at the cost of a life. Nadja when handed the stethoscope to check for the heart beat heard 2 faint beats in 40 seconds to a minute, whereas Sharath previously seems to have heard 40 beets a minute. Before the ambulance could leave, many of the mother’s family members climbed into the ambulance. The ambulance was not even completely ready to move the baby. They were still getting things in order. One of the members had left their chappelles behind and asked for it, wasting time. Then a young girl went to get it and put it on and tried to shuffle on over to the ambulance- a completely absurd end to the incident. Finally both the mother and baby were taken to the hospital

On one of last days, we see how the clinic is not ready to handle emergency situations for one of its primary health concerns- day to day events have become a routine but the mindset and system's priorities are so warped that the baby suffered.

Then, we cut the cake and took pictures. Everyone from the PHC seemed to have a great time and did not seem too perturbed by the prior events. It was a strange atmosphere for us, as we were quite emotionally shaken by the prior events.