Maternal Mortality: A Fatal Error...one too many
She was shivering and sweating profusely as her hubby stood by wiping the beads of sweat off her fevered brow.
Her brave clear eyes sparkled with unshed tears as she struggled to keep faith in line with the many verbal admonitions. As she had been doing for 5+ painfully long weeks.
Bravely enduring the pain wracking her entire being with all the tubes passed into her, the thirst and hunger...muttering to herself at intervals...praying the pain would go away...praying she would walk out of that room to be with her baby...praying the administered drugs would work the required miracle...keeping faith...
Then the dreadful nerve-wracking cough that always shook her to the core threatening to snuff the life out of her approached even as I silently prayed it would go away immediately while patting her fevered back.
The cough heeded not my pleas as it tauntingly came, cruelly mocking our efforts and prayers.
But it came with a strange visitor this time around....the visitor whose presence was announced by the pungent smell which filled the room as she spat into the small clear bowl held out to her. It appeared that the 'pus' 'originally' draining through a pipe inserted into her, by the side...somehow maneuvered its way to her esophagus...
I knew there was trouble even as I desperately maintained a cool exterior, trying to calm down inwardly as I cling to hope....maybe this is nothing afterall...maybe she would be treated only for malaria and everything would be fine.
...only a few days back, hope was burning brighter than a million megawatts bulb as she began to take little steps round the surgical ward and down the corridor, aided by her husband...and the doctors deliberated on when to introduce oral (fluid) sips to her parched throat...after 6 long weeks.
The prognosis was great, the level / rate of progress / response was astounding for someone brought in half-dead with little chance of recovery.
She turned to look at me, showing me what came forth from deep within her as she held out the small clear receptacle....I motioned to 'Mi', her hubby to get the nurse(s).
The nurse dutifully came but could only encourage her to hold on for the doctors as she was powerless to prescribe or administer any drug without the doctors authorization.
I stared helplessly at her as cold compresses were being applied to bring the fever under control.
Noon was approaching but the retinue of doctors are yet to come around for the morning ward round because the same set of doctors are handling an important surgery. They have been handling surgeries, back to back, so we were told.
Same set of doctors...covering the entire surgical wards -male and female.
I tried not to panic as I stole a glance at her again. Maybe 'he' could help as I whipped out my phone to place a call through.
But 'he' is also busy at the hospital where he practices and would not be able to come straight away. Probably because the same scenario is playing out over there, albeit on a smaller scale. Many patients...few doctors available.
Wait for the doctors, he said. They are the only ones who could properly access and prescribe or advise what to do...he could not bring in 'anything' from 'outside' even if he wanted...they wouldn't allow it and he couldn't teach them what to do as it was no longer a gynecological/obstetric case but surgical...technically they know better...I understand...perfectly...
I kept hoping against hope.
I looked at her again, a shadow of her radiant self. She still wore the hair she must have painstakingly made over one month ago in her cosy and colorful salon where she practices what she loves (rather than what she studied at the uni). She loved hair, make ups, accessorizing, head-gear manipulation and tying -beauty generally.
She was passionate about her chosen path and was set to go places...an industrious lady, she was.
Her tired eyes, clear, still full of life but no longer twinkling...her mouth, the usual smile playing at the corners had long taken flight as it could not understand why it wasn't needed as often as before anymore.
Her body, battered...ravaged...with all the tubes and 'hydra' needles passing through at different points to drain fluid as well as replenish, replace and nourish in order to 'keep keeping' the raging infection ravaging her system under control.
Her swollen legs which are unbelievably nearly thrice their usual size, garbed in the brown medical control stockings drawn up to her knees, gingerly rested on the foot rest.
To think that just 5 weeks ago, things were completely different...she had just given birth to the little bundle of joy whom we all awaited with so much joy and love. The much awaited little angel whom I was yet to see as we battled to save the mother.
The doctors, about 6 of them eventually came around, joined by more nurses...some minutes to 1pm...for the morning ward round that ideally would have been done with hours back!
They are specialists -led by the chief consultant...good at what they do but encumbered by the system they operate in.
Too much to do by so few...with so little.
Tests were prescribed even as they laughed away the amateurish postulation that 'pus' came out from her throat. They are two different tracts...they believed...it is not possible, medically.
But tests would establish what the problem was and they scribbled away.
And the infection ferociously and resolutely raged on unbeknown to all.
No drug could be given until tests are done.
Approval for tests sought....granted. Blood samples taken and handed over to take to the laboratory.
Too late for tests...Laboratory closed for the day!
Even if the tests were done elsewhere, the results would have to be evaluated the following morning, by the same set of doctors who may not be able to come around till late morning or noon, again.
Effectively, nothing more could be done till the following morning. Nothing more except to wait, hope and pray.
She was a bit relieved as the fever relented a bit and already recovering what was left of her gait by the time I got ready to go back to work. A close friend of hers came in to check on her. She is also a nurse at a different hospital.
They cracked jokes, she laughed. Her spirit was lifted once again as the fever further subsided. She said she couldn't wait to walk out of that hospital as she was tired.
They urged me to go back to work and I reluctantly left after some time promising to come back the following day, a Saturday.
Baby Ire would be brought to see her..to hold and to cheer...and I would see them both. I would get to hold my little niece for whom I bought some more pretty things from my travels earlier in the month.
But she never made it till Saturday morning. She indeed left the ward, but not on her feet.
September 5, 2015...shortly before dawn, she passed on. She was 30 years.
She never got to suckle / breastfeed the much awaited bundle of joy. She never got to dress little Iretomiwa in the pretty little things she lovingly bought in anticipation of the motherhood journey.
She never lived to celebrate the 1 year anniversary of her marriage which was October 10.
She never lived to go back to work or to actualize any of her many dreams.
I only got to see her lifeless body as they lifted her onto the cold gurney for the heartbreaking journey to the morgue...nothing changed between Friday afternoon when I saw her and Saturday morning except that she did not get up when I called...could not hear or talk to me...Hours later, I walked- sobbing behind her as they wheeled her out of the ward hoping she would defy all odds and flip the cold, metallic cover up...and rise...
She succumbed five weeks after she was delivered of her baby. The infections succeeded despite all the care, efforts, resources...she just never made it. She now forms part of the sad maternal mortality statistics, in Nigeria for 2015.
She was my younger sister...in law and love.
It is truly heartbreaking. So heartbreaking I wanted to crawl up the hospital wall and perch there hoping to catch sight of her fleeing soul and coerce it back into the lifeless form on the bed...
The only time I felt this way was when I lost my mother 12 years ago.
The world came crashing down again.
I was shattered into a million tiny fragments. I howled like a deranged animal. Voices raised in anguish but she did not come back. Could not.
Cause of death: Infection!
Caused by human error!
A fatal error...one too many.
All the more painful...human error...in this day and age of technological and medical advancement, in Nigeria - a developing economy...in Lagos State - the acclaimed commercial center of the nation.
You see, she was 'registered' at a private hospital with beautifully great 'structures' but less than great and qualified personnel as events would show so much that they could only deliver 'promises'...of death. The hospital name belies the result they churned out...to us.
She was managed at the hospital all through the 'ante-natal' period through to delivery. And then they got it wrong where it mattered most. They failed woefully and massively. It was a very costly failure.
The Ceaserian Section was bungled and 'they' senselessly cut her up, leading to acute infection. Fecal matter (faeces) oozing from the sutured site, post-operation.
She never recovered even though she was a fighter with a brave spirit...after two major surgeries, several transfusions, antibiotics...but in the end, we could only spend..and spend..and spend...hoping and praying she beats it but...
But in all, death is not victorious...neither did the grave conquer.
She is resting, albeit painful to everyone left behind.
The body is gone but the soul lives on...resting up there and watching over her little one.
So many maybes, whys and what ifs.
Maybe she would still be here with us if my family did not go on summer vacation and hubby was on ground...maybe the CS should not have been authorized...maybe the second surgery wasn't necessary...maybe they should have registered and delivered at the State Specialist hospital instead of the private hospital where they messed up everything...maybe....maybe...maybe...maybe
There are so many pertinent issues surrounding this case...from the 'Private' hospital to the renowned 'State Specialist' hospital. Those issues are as intricate as they are weighty.
Litigation or petitions would not bring her back to us...baby Ire...husband...parents...siblings but if this could serve as a deterrent and prevent some other families suffering this way, then it might just be worth the effort.
But how many more preventable deaths need to occur before the government declares a state of emergency in the healthcare sector in Nigeria?
Nobody is truly secure. Nobody. Not the privileged who can afford to hop on the next available flight or charter flights to the developed countries for proper medical attention. Not the less-privileged or the 'middle-class' / 'in-betweeners'
Anybody could be a victim of these inadequacies and systemic failures.
What is the cost of the life of the average Nigerian?
What does it take to do the right thing, at the right time and with the right tools?
How long would this continue?
Having ill-equipped hospitals is as good as not having any in the first place. Of what use is a specialist hospital that does not have blood in its blood bank to cater to emergencies? Of what use is an hospital with inadequate oxygen tanks?
Inadequate infrastructure stares us in the face at every turn.
I would never forget in a hurry few of the events that rubbed some of these inadequacies in...from sourcing for blood several times which is mostly unavailable at the hospital's blood bank and which the patients / families have to struggle to source for by themselves at exorbitant cost....to sourcing for medications / drugs...to sourcing for supplies such as latex gloves, methylated spirits, etc...to the Tap in the room / ward that never brought out water throughout...to the poorly maintained infrastructure...toilets...fans...patients' families having to clean up patients as well as their spaces themselves...things which should have been provided in the first place by the hospitals under normal circumstances, in saner societies.
But the circumstances are anything but normal and our society is far from being sane.
The weeks spent hopping in and out of that hospital opened my eyes to the acute inadequacies of our healthcare system.
We are basically running on no steam!
Beyond maternal mortality, lives are being lost daily, unnecessarily in this nation.
So many questions begging answers here. The answers would do nothing to heal the wounds and there can never be closure for any family grieving a loved one in this manner or in any other manner.
The pain never truly go away, regardless of how dull / dim it might grow with time, regardless of how much we believe. It is always silently and painfully present.
That is why I would be taking up the campaign again from where I dropped it...the campaign against maternal mortality. In my own little way, in my corner / space on the web....hoping to create an enduring ripple...so that other families could be spared pain, agony and loss in like manner.
No child deserves to walk through life without a mother's love / care...
Every (wo)man deserves access to qualitative medical care,
No parent deserves to outlive their child / ward in this manner...in any manner
If no other woman have to needlessly die during / after childbirth to avoidable causes, then the battle is closer to being won.
I believe it is possible to reduce these sad incidences to the barest minimum if not totally eradicate them.
No woman deserves to give up her life just because she wants to give life to another being. This must stop.
By God, it will. I believe.
Can I count on you to lend your voice to the call to #endmaternalmortality in #Nigeria?
Maybe our collective voices would result in a deafening sound, loud enough to spur our government to take the necessary steps and act appropriately in putting measures in place.
Maybe the tiny ripple each of us would create in our tiny corner of the web would just metamorphose collectively into a massive force, enough to propel our leaders into taking the much-needed steps to safeguard the lives of our women in this land.
I habour a glimmer of hope, but maybe this is more than enough to make a difference in this battle for the lives of our would-be mothers.