Flight into the night: saving a precious Bosavi baby

Dr Pondikou with baby. Proud father looks on

KEVIN PONDIKOU

I RECEIVED the call from Keith Kedekai in Tari at 2.30pm. A woman was in labour at Mt Bosavi. The people there wanted a doctor’s opinion about whether she should be referred.

My day had begun with an operation for an infected abscess on a woman's finger then a regular ward round and other work in the wards that ended at two when I went for a break.

Receiving the call from Tari, I said I couldn't make a decision without more details. This type of case would need a medivac which means that an MAF plane would have to be located.

It turned out the Rumginae MAF planes were in Kiunga but the pilots had reached their maximum flying hours and were temporarily grounded.

Then the community health worker at Bosavi called me. She’d had to walk a long distance to get to an area with phone reception.

She said the woman had been in latent labour for nearly a week.

She was 4cm dilated and her waters had broken. This was her fifth baby and all four previous babies had been stillborn. The community health worker thought the presenting part was transverse with arm or knee presentation with other complications.

This mother definitely needed an emergency evacuation to the nearest hospital by MAF.

I let Dr Brandon know and she agreed the woman was for medivac to whatever hospital was convenient for MAF.

It turned out MAF’s Mt Hagen based plane was in Kiunga and was able to fly to Bosavi to pick up the patient.

Rumginae pilot Marcus arranged the flight which would cost k7,200 - a 50% discount because Rumginae is a church-run organisation.

Keith Kedekai agreed to pay the money, saying that's the price to save a life.

I gave the community health worker at Bosavi the go ahead and she asked the sub-health centre people know to prepare the mother for travel.

That done, I reviewed a critically ill patient in the ward - poor prognosis – and then went for my run.

Our staff were notified that the mother mom was flying from Bosavi and would arrive at Rughaz by 6.30.

It was now was five.

I went for a 6km run and I arrived back to hear the drone of the MAF plane in its red, blue and white lifesaving colours.

I couldn't believe the plane had picked up the woman because it was so late in the day.

MAF can only fly during daylight hours. It turned out that there was just one minute of daylight left as they landed, which left the pilot stranded in Rumginae for the night.

After reviewing this woman and who was well overdue and with all previous children stillborn, it was decided to undertake a caesarean section.

I did the caesarean assisted by our resident, Dr Sakias. And so a bouncing 3.2kg baby girl was born at 9.15pm.

There was major bleeding and Dr Brandon stepped in to locate the source and managed to arrest it. Then the power went off as it was 10pm and time for the hospital generator to shut down.

For a while we were in total darkness fixing the bleeder but thankfully the solar power kicked in and the lights came back on.

Locating the marker stich would have saved a hassle but thankfully everything was under control and I took over to do a bilateral tubal ligation and close up the abdomen.

Thanks to all the staff members, students, Dr Brandon and Dr Sakias for helping to save this woman and her child. And not forgetting MAF for going out of their way to fly her to Rumginae.

Comments

[Lindsay F Bond]

Kevin, in 'real time', you are writing and making known achievements that in times past, the telling would remain dormant till a teller, in later life, might publish a biography, (eg. of events based on Saiho in Oro Province). As likely there are others of places elsewhere in PNG, but yours is now and so soon succeedingly and splendidly.

From a map-glance, it might seem that your patients are in proximity to PNG's western border. Can a thought be supposed that news of Rumginae (and similar service delivery facilities) in PNG, is known to folk living beyond that western border? What facilities similar to Rumginae exist beyond that border yet not so distant as (say) Agapun and Warooko? Has facility in PNG excited measurable responsive within Indonesian governance?

[John Bennett]

Dr Kevin, you are an inspiration to us all. Keep up your superb humanitarian work.

[J Campbell]

Hmmm, the bilateral tubal ligation. That is a sterilization procedure, correct? Did the woman know/give consent?

Was wondering if that is standard procedure in rural PNG in an emergency c-section with that sort of history (multiple stillbirths, med-evac, etc.)

I do know many times the wife does want birth control/sterilization and the husband will refuse.

Not upset about it, just curious.

[Jordan Dean]

Thumbs up doc. Had a similar experience when I was taking care of the Provincial Health Office in Daru in 2014.

The Director for Health and deputy were out of the province so I was acting Director. A radio call came in from Morehead Health Centre, near the Indonesian border.

A mother had complications and was bleeding heavily. I am not a clinician so don't know the clinical term. She needed urgent medivac to Daru hospital.

I arranged with MAF and the lady was flown to Daru that same day. I then arranged with Daru hospital to have an ambulance pick them up from the airport. I was at the airport too.

A few days later I dropped by the hospital to see how she was doing. She was in asleep with the baby next to her. Her husband was with the Morehead Health Centre OIC.

When I entered the husband shook my hand and said thank you very much for saving my wife and child's life. It wasn't an ordinary thank you.

I stood there speechless. I told him I was only doing my job and was happy to save two lives. I gave him the apples and oranges that I bought on the way to the hospital and had a chat with him and the OIC. That encounter gave me a whole new perspective of real job satisfaction.

[Daniel Kumbon]

Dr Kevin Pondikou, it’s good to see you hold this infant in your hands.

Your good mum held you close to her bosom once, never knowing that you would be a doctor one day saving lives in some of the most desolate places on earth.

Dedicated people like you, the MAF pilot, the airline staff and all the health workers seem to me like the ‘Saints of Heaven who keep marching on’ despite the odds. God bless you all.

My heart pains when three infants in incubators died and a mother delivered a still born infant when people destroyed Wabag General Hospital last week.

It is a modern health facility in the heart of town but why it was attacked and forced to shut down is hard to explain.

There could be more serious problems in Syria or Afghanistan but it has certainly been a hellhole for Wabag town residents in the last few days due to election related violence.

[Monica Thompson]

I've said it before and I'll say it again. You and the rest of the staff are God's hands on earth. Proud to be your friend even if we never meet

[Hugh Tavonavona]

God bless you all.

[John K Kamasua]

You deserve to be rewarded with a star!

[Daniel Doyle]

Kevin, you and your team are worth more than all 111 members of parliament.

[Bomai Witne]

Dr Pondikou, most urban health care facilities deteriorate in front of health workers, making it difficult to save lives. There are cases where patients die while queuing for medication.

I cannot imagine enough how you and all the selfless individuals and organisations can save a mother and a child.

In the Kuman language of Simbu, we describe rare people like you as 'yal wakai wene' (good man).

[Robin Lillicrapp]

A dramatic reminder of the importance of a well organised service to the communities.

[Ulu Pawa]

A true spirit of humility