WHEN I SAW DARKNESS MIDWIVES AND AMBULANCE SYMBOLS OF LIGHT AND HOPE TO MY WIFE AND MY LITTLE ONE
On the morning of May 31st, 2024, at roughly 2:00 am in the village of Tutuluro, within the Post Administrative of Same, Municipality of Manufahi, 22-year-old Oliviana Viera began to experience labor contractions. Simultaneously, a heavy rain paired with strong winds caused the Tutuluro river to flood, creating a significant hindrance for local residents in crossing the river. Oliviana's husband, Bonjono da Costa, 20 years old and soon-to-be father, felt the gravity of their isolated situation; the neighborhood was eerily silent due to the extreme weather conditions and the fact that they were alone at home added to Bonjono's growing concern. The rising fears were enhanced by the daunting realization that they had no prior experience with childbirth and that the swelling river was the only connection from their village to the nearest health facility. Despite the mounting challenges, Bonjono remained determined that the delivery of his child should take place under the supervision of skilled healthcare providers. Reflecting on the situation, Bonjono couldn't hold back his tears as he recounted their ordeal.
"On the 31st of May 2024, at 2 am under the cover of darkness and amidst a severe weather condition characterized by intense rain and strong wind gusts, my spouse went into labor. At the time, we found ourselves alone at home, creating an extremely challenging situation. Considering the efficacy of medical assistance, I contemplated calling the midwives from the local health post. However, the hazardous weather conditions coupled with the potential risks associated with leaving my spouse alone prompted me to delay this action. I attempted to provide comfort in the face of our ordeal, asking her to patiently endure for a few hours. At 5 am, our neighbors assisted in notifying the midwife from the health post, who promptly arrived along with her husband. A medical examination indicated that my wife was in an advanced state of exhaustion due to her prolonged labor—a situation further exacerbated because she had not eaten. The midwife suggested that we seek immediate medical support at the BEmON-Center of Monaco Same. In the face of limited transportation options and slippery road conditions, we sought assistance from the midwife's husband. He managed to convey my wife to the riverside using a motorbike, a location we identified as a potential point for getting help. Upon reaching the destination, we were met by an ambulance and an additional midwife, indicative of immediate medical support. However, the high river levels posed a further challenge. Required to gauge the water conditions, the midwife's husband assisted in ensuring we could navigate through the rising waters. Eventually, with the water levels reaching our waists, we were able to safely carry my wife across the river. Despite the hardship and soaked clothing, we were fortunate to safely cross the river, giving us access to the waiting ambulance."
“Upon our arrival at the ambulance, the presence of the midwife from EmONC Center of Monaco Same inspired feelings of profound relief and optimism. Encountering the dedicated healthcare professionals instilled within us a beacon of hope. At that moment, we felt a stirring tide of emotion as the ray of hope shone brightly for my wife and our unborn child”. He added
In her role as an ambulance attendant and competent midwife at EmONC, Rosalia da Costa shares her recollection of the situation that took place on May 31st, 2024. At exactly 07:24, she received a call from a fellow midwife stationed at the Tutuluro health post.
On May 31, 2024, at 07:24, I was contacted by a midwife from the Tutuluro health post. The purpose of her call was to alert me of a 22-year-old woman who had gone into labor. I promptly departed with an ambulance to the specified locale. Upon arrival, I found the pregnant woman and her family near a river, an area inaccessible by our ambulance. Consequently, I solicited the family's help to transport the expectant mother to the ambulance. Braving the river, they managed to safely get her to the vehicle. Upon assessing her condition, I found she was in good health so immediate compress assistance was provided due to her wet clothes. We then evacuated to the BEmONC Monaco Same Center, arriving at approximately 08:16. At the center, we expedited the delivery process after realizing the patient's dilation was already at 8cm. The condition of both the mother and the baby were satisfactory post-examination.
Inés Cardoso, a midwife professionally trained at EmONC, has informed that she evaluated this particular case at 08:20, indicating an advanced stage of dilation from 8-9cm. Full dilation was confirmed by 11:00.
“Earlier, I took charge of this patient from the evening shift team. I reevaluated her at 08:20, discovering cervical dilation had progressed to between 8 to 9 cm. By 11 am on the same day, dilation was complete and the mother delivered a healthy baby girl, weighing 3115 grams. Tiring from her efforts, the mother required assistance and the EmONC team successfully administered the vacuum extractor procedure to advance the birth. We ensured the safe delivery of the baby and monitored the mother for any complications for 24 hours post-delivery. Upon observing no complications, both the mother and baby were discharged. The key role of EmONC in managing cases like these is evident.
“Personally, I believe without the requisite training from EmONC, we might not have been able to navigate complex cases like these, especially vacuum extraction. I learned this procedure during my training. Previously, if we faced complications, we constantly referred such cases to the hospital. Hence, this training proved to be pivotal in providing a higher level of care to our patients”. She added.
The Basic Emergency Obstetric and Newborn Care (BEmONC) center in Monaco Same began its operations on December 2, 2022. Equipped with modern medical and non-medical supplies, and a dedicated team of four midwives and a doctor trained in Emergency Obstetric and Neonatal Care (EmONC). The center has successfully managed 212 births between January and May 2024, comprising 177 normal deliveries, 2 assisted vaginal breech births, and 33 vacuum extractor births. All of these events were expertly managed by EmONC-trained staff, with zero maternal mortality since the beginning of the year.
UNFPA, in close partnership with the Ministry of Health and the National Institute of Health, continue to strengthen the capacity of the health personnel nationwide on EmONC. We also provide the necessary medical and non-medical equipment to apply their acquired knowledge and skills – and by doing that, contribute to our goal of zero preventable maternal deaths,”
For further details on this remarkable story, the video can be accessed through the following link:https://www.youtube.com/watch?v=B-1nmszblUs
