'Oh God, please let there be a plane coming' I prayed as I dashed to the radio to find out the latest progress of the rescue plane. I stammered our call signal and the radio crackled into life. 'Please tell me they can evacuate her' I pleaded. 'I'm really sorry Natalie, the plane can't come until tomorrow morning' said the distant doctor. 'You may have to go ahead with the symphysiotomy' and instructions followed. I realised this might be this woman's only chance, so overcame my initial horror and panic to write the directions down.
The day had started with a young mother beginning her first labour in the early hours. By 7am she was fully dilated and pushing. Mid-morning there was still no progress and though we could see baby's head, it would not fit through the pelvis. I had to wait until the noon medical schedule on the radio to alert the nearest hospital and ask advice. I then spent an agonising afternoon in the labour room helplessly watching mother battle with ineffective contractions, surrounded by relatives who blamed her for displeasing the spirits.
It was 6pm when I finally heard the plane was not coming and I might have to try something more radical. I raced down to the labour room only to find baby had just delivered. I was handed the white, limp, flat baby to resuscitate. There was a faint pulse but no breaths so I commenced mouth-to-mouth, but after 20 minutes there had been no change. How long should I keep this. up? I was kneeling in meconium and mud, surrounded by the family, and between breaths I was praying for God's help. I'd just about given up hope when his little nostrils flared and he took a breath; he had come to life! He continued to breathe for himself whilst I nursed and tube fed him. I returned him to a much healthier mother in the early hours of the morning. As I lay back in bed that night I could hardly believe what I'd been through - the agony and the ecstasy.
The next day he had taken a turn for the worse. His chest sounded horrible and his breaths were becoming laboured. I sucked him out, but then had to decide whether to start positive treatment or leave him without. It was really hard to give him back to his mother and explain it was best to do nothing more and he was going to die. I could hardly get the words out and as the family all began to cry, I did too. The baby did die that day and it left me feeling oddly empty.
On my elective I learnt more because I had sometimes been by myself, and I had to make the effort to get to know people and learn procedures. Some of the experiences I went through were harrowing, but I feel they have helped me grow in confidence and I pray I can transfer the things I have learnt to my life back in England.
Natalie Byles is a medical student in Nottingham. She did her elective with UFM Worldwide at Rumginae Health Centre in Papua New Guinea this year.
The day had started with a young mother beginning her first labour in the early hours. By 7am she was fully dilated and pushing. Mid-morning there was still no progress and though we could see baby's head, it would not fit through the pelvis. I had to wait until the noon medical schedule on the radio to alert the nearest hospital and ask advice. I then spent an agonising afternoon in the labour room helplessly watching mother battle with ineffective contractions, surrounded by relatives who blamed her for displeasing the spirits.
It was 6pm when I finally heard the plane was not coming and I might have to try something more radical. I raced down to the labour room only to find baby had just delivered. I was handed the white, limp, flat baby to resuscitate. There was a faint pulse but no breaths so I commenced mouth-to-mouth, but after 20 minutes there had been no change. How long should I keep this. up? I was kneeling in meconium and mud, surrounded by the family, and between breaths I was praying for God's help. I'd just about given up hope when his little nostrils flared and he took a breath; he had come to life! He continued to breathe for himself whilst I nursed and tube fed him. I returned him to a much healthier mother in the early hours of the morning. As I lay back in bed that night I could hardly believe what I'd been through - the agony and the ecstasy.
The next day he had taken a turn for the worse. His chest sounded horrible and his breaths were becoming laboured. I sucked him out, but then had to decide whether to start positive treatment or leave him without. It was really hard to give him back to his mother and explain it was best to do nothing more and he was going to die. I could hardly get the words out and as the family all began to cry, I did too. The baby did die that day and it left me feeling oddly empty.
On my elective I learnt more because I had sometimes been by myself, and I had to make the effort to get to know people and learn procedures. Some of the experiences I went through were harrowing, but I feel they have helped me grow in confidence and I pray I can transfer the things I have learnt to my life back in England.
Natalie Byles is a medical student in Nottingham. She did her elective with UFM Worldwide at Rumginae Health Centre in Papua New Guinea this year.
