Tuesday, September 2, 2014

Ignorance is Death

With their babies in Special Baby Care these 3 young mothers have just collected the supplied hospital food 
I saw a headline announcing that according to  millionaire, pot-smoking pop star Miley Cyrus, Google is more harmful to your brain than drugs are. I know I shouldnt take any notice of what vacuous media creations say, but other people will, and if they only read the headline they might think that she was saying that Information is dangerous. A bit like the line from Pink Floyd anthem, sung with gusto by all those English school children “we don’t need no education”.

Those kids, and Miley Cyrus as well, can no doubt read and write, and so if they want knowledge and information or advice they can easily get it. But out here, illiteracy and ignorance is normal. According to the midwives NONE of our patients can read or write, which is why when they have to give consent for surgery, they blacken their finger tip with ink and print it onto the page as their signature.  And when someone comes to take a way a corpse, a dead baby or mother, the parent signs in the same way.

I mention this because illiteracy and ignorance is really the real enemy out here. Knowledge and literacy and access to  Text messages  the internet and Google on their smart phones would change everything for these women. Literacy and education would  have meant life and a future for the  woman whose footwear was left behind under the bed when her family took her home the other day, but instead they took her home to bury her. She was 17.

And why would literacy and education have helped? Well, they would have known about anaemia, that it is common here and more common in pregnancy and that a sign of it is loss of colour in the nail beds and the insides of the eyelids, that it makes you feel tired and weak and breathless. They would have known  something about the signs of  a healthy  and an unhealthy pregnancy . They would have been able to read about  the value of health check-ups in pregnancy, and known to seek help early.

And when this young  pregnant woman over recent weeks was finding it harder and harder to walk about the house, and she was feeling more and more breathless, and her tongue and nailbeds were getting paler and paler – someone would have understood something wasn’t quite right. Whats amazing is that it seems nobody noticed she was  slowly sinking into desperation - they said she had been fine till the night before, but none of us believes that she was “fine”  - she would have been deteriorating for weeks, and more noticeably over recent days.  But nobody noticed, or if they did, nobody did anything till she collapsed. Then it was obvious something was wrong but before that, surely it is mostly ignorance, a plain and simple lack of knowledge that meant nobody recognized what was happening?

So they brought her in, by which time she was deeply unconscious, gasping desperately for air, her white hands and tongue and conjunctivae the give-away to her severe and profound anaemia, her heart racing at 160 beats per minute to try to pump what remaining blood she had to all parts of her body, but failing. Her brain wasn’t getting the oxygen it needed, neither were her kidneys and her heart itself was under massive strain and about to fail. My own Haemoglobin level when last checked was 15. Anaemia is below 10. Serious anaemia is below 5. Hers was 1.8.
Much too late
So we gave her oxygen and called for blood. Her own blood looked like pink water. I did a scan and the baby  had already died inside  from lack of oxygen. And then just as the blood arrived, so did the mother. Her heart just stopped. I did CPR but it was pointless.  She had been in the ward 35 minutes.

I looked  across the bed at the distressed older women who had come in with her “Why didn’t you bring her sooner?” I said in exasperation, almost shouting at them – I just felt angry -  but they couldn’t understand me,  and they said nothing.

And looking past them, on the next bed literally two feet away and watching the whole thing unfold was another pregnant young woman who had come in the day before, breathless weak and tired, she also had severe anaemia and had already received blood. When she arrived, her Hb was 3.4. She was going to alright.

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