I had been already one week in Darfur. Giving birth at home is a common practice there, very often without the presence of a traditional birth attendant. So sometimes complications occur. And very often, these patients with complicated deliveries would present in our Clinic very late. Therefore, normal delivery in the clinic was encouraged, with help from the traditional birth attendants. For an anticipated difficult labour, our expat midwife would be involved. But sometimes things just would not run as smoothly as we could wish. Yesterday we sent a pregnant woman, who had a previous Caesarean section, to the hospital because she was in labour. Knowing that she would need another Caesarean section this time for delivery, she had been told to come back to the Clinic for a follow-up. But she did not come, not until she was already in labour. When I went to see her in the hospital this morning, she had already had an emergency Caesarean section. She looked very tired. Lying beside her was a little creation. A beautiful baby girl was suckling her mother's breast. I ran into the hospital obstetrician. He was furious. He accused us of not sending the patient to the hospital earlier. I tried to take all the blame, yet explain to him that patients sometimes had their own ideas of taking care of their bodies, especially if they were not well educated and not well informed. I promised to make better arrangements next time. As mentioned before, the Kerenck team had called via Satellite phone saying there was a man with gun shot wound, and that the woman travelling with him had been abducted and her whereabouts were unknown. Owning to the recent upgrade of road insecurity, we had decided to reassess his condition and road safety before deciding on our next action. Finally, we had sent him to El Geneina hospital. Later this afternoon he had arrived. Both the midwife and I went to the hospital to receive him. He looked all right, except in walking with a limp due to his injured leg. As waiting for the attending doctor in the Emergency Department sometimes takes a long time, the midwife asked the patient to sit outside in the shade, because of the heat in the afternoon. She went back to the Clinic and I waited with the patient and a national nurse for the attending doctor. When the attending doctor finally came and admitted the patient, he was reluctant to go to the ward. The patient spoke to me in Arabic, which I do not understand. He then had a long discussion with our national nurse, who speaks Arabic and French, both of which I do not. This went on and on, and some of the hospital nurses also got involved. Later I found out that because the midwife told him to sit outside of the Emergency Department, the patient wanted to wait for her to return. Since she hadn't come back when he was warded, he didn't want to go to the ward on his own. Such obedient people. Two days ago I had a bad dream. I dreamed that my mother at home had fallen. She is 76 years old and suffers from dementia. She lives with me and I have a maid to look after her. I wrote home an email about this dream. Today in a reply email I was told that my dream was true. She had fallen at home and incurred lacerations on her head. I was totally heart broken. I wanted to call home and speak to her and ask how she was doing. But of course since she suffers from dementia, she is at this stage not able to communicate with me. As I thought more and more about this, I wanted to cry and I just wanted to be at home. While I was deep in thought, the Clinic called on the radio. A woman had just delivered at home and been brought to the Clinic unconscious. The midwife and I jumped into our jeep and went to the Clinic. All other thoughts had to be temporarily put aside. Arthur
Dr Arthur PANG obtained his first degree in Biochemistry in Canada in 1991 and graduated from Faculty of Medicine of University of Hong Kong in 1998. He started his first mission with MSF in December on an HIV/AIDS project in Xiangfan, Hubei, China. In August 2005, he packed again and left for another mission in Darfur, Sudan.