Team work - 1 Augustus 2016
door: Erdi Huizenga
On Friday Fatmata Kamara came to the Lion Heart Medical Center. After being seen by one of the CHO’s, (clinical health officers) her file was placed in the scanning room for one of the doctors to do ultrasound on her.
She had abdominal pain and had not seen her menses for 2 months.
So I called her in. She is able to speak a bit Crio, so did understand me, but later also Fatmata Zaro came in to translate in her own language: Temne.
I asked her if she has any children, she tells me she has born tree, but two are alive.
I did scanning on her and saw that she had free fluid in her abdomen (which is not good) and looking further also fluid in her uterus and something like a pregnancy outside of her uterus (ectopic).
The ultrasound scan
After explaining to her I pricked in her abdomen to see what type of fluid: blood.
That made the diagnosis of ruptured ectopic pregnancy very likely.
With the help of Fatmata, our nursing aid, I explained the problem to her and also that she should undergo an operation today to stop the bleeding in her abdomen.
She was very very scared. She had come alone to the hospital, without family. Quickly she thought of the excuse to leave the room by telling she had to urinate. I asked Fatmata to look after her, so she would not go home and risk dying at home.
And also to take her to the laboratory for blood testing – she might need a transfusion after loosing so much blood (internal bleeding).
Luckily it was not too busy, so shortly I checked for her and found her on the door step of the hospital, I sat down next to her and start explaining that I want to be her friend and wants what is best for her. I told her that her 2 other children (she had told me before the scan) will need their mother healthy.
Also Isha Sesay, working in the pharmacy, and others from the OPD spoke encouraging words to her.
She agreed, although still very much afraid.
It was only then that Fatmata Zaro, our nursing aid, explained to me that she met her in the village, where she was receiving traditional treatment for her abdominal pain.
Her diagnosis there was that she was a witch or was bewitched and had to make sacrifices to get healed. But unto now there was no improvement yet, so more sacrifices were needed.
Fatmata had not argued her or the traditional healer, but just advised her to come to the hospital on Friday.
Morlai our accountant had seen and heard what was going on, and despite not being medical, understood this young woman needed help. He spontaneously volunteered to donate his own blood to safe her life!
Morlai donating blood
I requested Alhassan, our local trained anaesthetist to prepare theatre and also Mohamed Nuyabah, our surgical CHO to help out.
In the ward the SECHN Isha and the other nursing aids prepared her for the operation and brought her to the operating theatre.
Isha Sesay, me, the patient and Isha George in front of the operating theatre.
The operation, done by Mohameh, assisted by me went smooth, we managed to collect also one bloodbag of her own blood from the abdomen for autotransfusion and we removed the ruptured ectopic, the sack with the fetus was even still intact (but the fetus had died due to the bleeding).
After the operation still the family had not arrived, so the nurses and the other patients and caretakers looked after her, while she was waking up from the operation.
The next day she was already much better, and very happy that we did not see her as a witch.
I explained again that she is no witch, it was just a ‘sick’ that we now removed from her abdomen and now she will get better.
Also the staff in the ward, from cleaner to nursing aid to CHO were encouraging to her.
Fatmata recovering after the operation
Later her family did come to be with her and after some struggle managed to get the money to pay the (highly subsidized) hospital bill, so we could discharge her.
Next week she will come back to have the sutures removed.
Before going home I ask both Fatmata’s to be on a picture – but only after looking proper dressed ;-)
When things like this happen I am very proud of the staff at the Lion Heart Medical Center. Since the start we are working on being a team, and that makes that people can receive good health care in a country were proper health care is so rare.
I hope the Lion Heart Medical Center will continue to receive the support from different donors to be able to make a difference in the centre of Siera Leone.
As it is only with the help of our donors that we can keep the prices affordable and the quality good!
Our donors are part of the team!