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Life lessons of a midwife in South Sudan
Kirsti is a midwife from the USA who was on mission for Médecins Sans Frontières / Doctors Without Borders in South Sudan. She writes about her experience with a first-time mother and trying to learn from her patients.
There is a certain level of acceptance that I’ve had to find living and working in Lankien, South Sudan. In the beginning I wanted so much of this new world to change and be different than it is.
Life here has its own rhythm, one that I’m still trying to learn
Among other things, I wanted all five wells in town to function, and I wished that all the kids could go to school. But those things were not mine to change. So while that vision has not faded, I have stopped resisting the way things are. I’m not trying to put on rose-colored glasses. And as a result my experience has become so much more real.
You see, life here has its own rhythm, one that I’m still trying to learn.
The instability of the region has meant that people have to temper their expectations and find creative solutions to life’s difficulties. The people I’ve met seem to understand that life will go on, so they can’t get too caught up wishing for things out of their control to change. They’re teaching me, and slowly I’m learning.
A few weeks ago a woman walked into maternity after four days of intense labor, accompanied by her sister-wife and her husband’s brothers. Her husband had been killed five days prior in some clan fighting. She was pregnant with her seventh baby, and something was not right.
The men left while I admitted and evaluated her.
She was completely dilated, and the infant's heart rate was stable, but the shoulder was coming first.
Babies cannot fit out of the pelvis that way.
While we generally can’t do cesarean sections in Lankien, we had a doctor with surgical training temporarily in the project. We gathered supplies and waited for the men who brought her to return to the hospital - in South Sudan a male relative needs to give consent for any procedure. It took nearly two hours to get her to the operating theater, but she delivered a baby girl, her first, that afternoon.
The recovery was difficult for both mother and baby.
The infant developed an infection, while the mother first hemorrhaged, dropping her hemoglobin from 14 to 6, then couldn’t produce milk because she was so malnourished.
I checked on this woman and her baby twice a day, just like I check on all of my patients twice a day. Her sister-wife was there, helping with every step. Both have survived so much, and this is true not only of these women, but of every patient I’ve seen here. While I was torn up by the injustice of the whole situation, I knew that there was nothing that I could do change these women’s circumstances.
My role was to bring good medical care and perhaps a little tenderness into their lives.
Before she left the hospital she asked me, through one of my medics, if I would name her baby.
I chose the name Nyawal, meaning "born with medical help". She looked at the baby, smiled, and agreed that it would be a good name.
I could not and did not alter the long-term suffering for this family. The only difference I made was in that one moment, while the impact they had on me, ironically, was life-altering.