The patients I see in the hospital were women who suffered from burns (usually due to kitchen accidents) and gunshot wounds. But majority of the cases were mothers with complicated pregnancies who could not go anywhere else for free and quality health care. MSF does not charge for its services, so we expect the kind of patient who has already gone to one of the many pay-clinics in the area but can no longer afford the subsequent private care.
Most of the mothers had ‘mishandled pregnancies’. They had been given an undocumented and oftentimes questionable treatment for hastening delivery, which sometimes resulted in a uterine rupture. During my stay, I saw more uterine ruptures than in my entire 10 years as a doctor in the Philippines. What is considered a rare case in Philippines is fairly expected in Timergara. The MSF obstetrician was prepared for anything, from repair of the uterine rupture and iliac artery ligation to an emergency hysterectomy; so we managed to save the lives of many mothers.
Many of these mishandled pregnancies also resulted in fetal distress. In almost 30% of cases, we delivered babies who had just died in the womb. I had been primed before the mission to expect a lot of newborn deaths, but it can still be shocking to deliver a fully formed, beautiful child, its features set in peaceful repose, the eyes closed as if in sleep, yet irretrievable from the grip of death.
I always said a prayer in my heart for these little angels. I wondered if it would have been any easier if they had survived and lived to grow in a harsh, uncertain world. In this work, I just knew that we had to show to our patients that we are doing everything that is humanly possible despite of our limitations.