A Miracle of Grace

************Warning – story a little graphic – not for the faint of heart************

I was busily working on my porch one Thursday afternoon when a woman came to get me.  She said that “one of her people” was in labor and could I come and check on her.  Frankly, I was a bit tired, having delivered 3 babies that week.   But I told the waiting sick people that I would be back, grabbed my baby bag, and headed out the door with Curtis, the nursing intern who had been with me for nearly 3 months.  The fact that they were now allowing a man into deliveries was a HUGE accomplishment.  When he first arrived, everyone was too nervous to allow him into such an intimate setting – only one other time in the history of the village had a man been allowed in during a delivery.  But we had managed to get him in twice in the previous week – progress!

We arrived at the house and found Fatmata laying on the floor in a cold sweat.  That was a bit strange (not the sweating, at least for me in the 111 degree heat) – but the cold sweat was weird.  I checked her and she didn’t seem to be in active labor.  I asked for her carnet (medical record).  I discovered that several months ago, I had checked her and could not hear the baby’s heart beat for a few days.  But when she came back, everything seemed fine.  I was concerned, because, according to her carnet, she was only 7 months along.  I was not sure about the dates, and she didn’t know either.  For the most part, when a woman goes to the health clinic for the first time for a pregnancy, the doctor writes “3 months” as the gestational age of the baby – regardless of how long she has been pregnant.

I got out my little Doppler for checking fetal heartbeats – and could not find anything.  I started to get concerned.  The midwife arrived at about that time.  Fatmata was complaining about lower back pain.  The midwife started yelling at her – saying that Fatmata didn’t want to have the baby and that the baby belonged to her husband anyway.  I was a little confused about what was going on – I could understand most of the words she was saying – just missed the meaning.  Nothing much was happening, so Curtis and I left to finish seeing our patients, promising to return later.

We saw the rest of the patients, and ran back over to the house around 7 pm.  The midwife was gone and Fatmata was resting quietly on the floor.  I got out my Doppler again – still no heartbeat.  She was not having good, strong contractions and her cervix had not really dilated any more.  We went to find the midwife.  I told her that we were going home and to call me if she needed me.  I thought maybe she was having false labor and maybe it would stop.  We walked home in the dark, using our headlamps.

Around 10 pm, we were watching a movie and heard a knock at the door.  It was the midwife, coming to call me.  “Fatmata is bleeding,” she said.  We grabbed the bag and headed out. 

We entered the small, dark room to find it filled with women.  Fatmata lay moaning on the floor in a pool of blood!  I was horrified.  They were mopping up the blood as we entered. I had her lay on her back and as I went to check her, blood was running out of her vagina.  She was still not dilating – I knew that we needed to get her to the hospital if there was going to be any chance of saving her.  I told them to keep her lying flat and took the midwife with me – off in search of the husband.  I told him that she must go immediately to the hospital.  Unfortunately, the only form of transportation in town besides our truck was a motorcycle – not a great way for her to bounce over the bad roads for 1 ½ hours.

I told them to prepare her stuff and ran home to talk with Jim.  He was okay with me taking her to Faranah so I got a load of medical supplies while Ben and Kaleb took off in the truck – looking for a way to get close to her house (there are no roads) in the village – only foot paths.  They ended up driving through a field to get close enough.  Curtis and I took off on foot to meet them there.  I insisted that the midwife come with me – she was not thrilled as she had a bunch of grandkids in her care – but I wouldn’t take no for an answer.  We got a big rug, laid Fatmata on it, and carried her out to the truck.   There was a big crowd gathered at that point, though I couldn’t make out everyone’s faces in the pitch black.

We got her loaded and I started an IV on her – leaning in the side door of the truck to do it.  At some point during the whole event, I told Curtis, “Man, we need a doctor around here!” 

Four women crowded in the back with Fatmata and Ben drove with Curtis and I squished in the front seat beside him.  We had to stop a few time to make sure that the IV was dripping as it was hard to tell with all of the bouncing and it would stop dripping if she moved her hand in a certain position.  We were glad when she complained in the back about not being comfortable, because we at least knew that she was not dead – a HUGE concern of mine. (She later told me that she didn’t remember ANY of the trip to the hospital.)  

We arrived in Faranah around midnight and I ran inside to find someone to help us.  It was quiet dark – no outside lighting.  I found a few people who had been sleeping.  They came out to help me get her out of the car.  As they were moving her, she had a seizure.  They finally got her on a gurney.  Unfortunately, no one could get ahold of the doctor by phone so they asked if we could go and find him at this house.  So we got back in the car with one of the nurses and took off on the dark streets of Faranah.  We found his house easily, though waking him up was harder.  He is a Cuban doctor and he finally came out and got in the car.  We greeted him – but he barely spoke in his sleep deprived state.

We arrived back at the hospital and Ben settled outside in the car as Curtis and I went inside to see what was going on.  I was thankful to find that they had lights inside – AND town power – for the first time in a week.  The doctor kept saying– “She has lost so much blood.”  Thank you captain obvious – that is kind of why we were there.  I told him that I was a nurse and that baby was not alive – so he got out his old-fashioned stethoscope and tried to find the baby’s heartbeat – laying the stethoscope on her belly and then his ear on the stethoscope tube.  He couldn’t find one.  

 I said, “I know – I used my machine and couldn’t find a heartbeat.”  His eyes got really big and he said, “You have a machine?”  I felt kind of badly for him – he said, “They want us to take care of people here – but all we have is our hands!”  They got an IV going and he asked if there was a surgeon around or fuel for the generator.  The answer was no.  So he came over to me and said that they were going to give her some medicine to start labor – since it was TOO dangerous to do a C-section (MAYBE because they COULDN’T do one????).  It took a LONG time to find the medicine that they needed – finally having to take it from the supply of a patient who had been there earlier.  They injected it into the IV bag and we waited.

They drew blood to check her counts and went out to find the women with her to see if their blood types matched so she could have a transfusion.  Her lips were getting whiter and whiter as the blood drained out of her.  I kept praying that God would spare her life.

While she was laying there bleeding, Fatmata kept calling my name.  I stood beside her and talked quietly to her in Yalunka.  The nurses there were glued to our conversation.   They were fascinated that I spoke Yalunka and began to ask questions about where we lived, how long we had been here, etc.  One nurse crawled under the mosquito net on one of the beds and fell asleep.  Soon 2 other nurses sat down on another bed – and eventually the Cuban doctor crawled up on the bad beside them.  It was all a little too cozy for me, but we had a good talk and I learned a lot about them.

I sent Curtis out to the car to rest- telling him I would call him if anything happened.  We waited and waited.  She had one semi-contraction, but things were moving slowly.  It was about 3 am by this time and I decided to run out and call my parents and Jim’s parents, since we don’t usually have phone reception. I had a nice chat with both of them – though as I got cut off with Jim’s parents (I ran out of minutes) and was going to get another card to load into the phone and call back, I heard Fatmata screaming inside.  I couldn’t imagine why she was screaming, as I had only been gone about 15 minutes.  I ran back inside and found the door bolted shut.  I knocked and knocked and finally they let me in.

It looked like a war zone in there.  There was blood ALL over the floor and buckets of it at the doctor’s feet.  He had an apron on, covered with blood.  The baby, a perfect little boy, was lying dead in a silver bowl.  Fatmata was crying and there was blood pouring out of her –with clots the size of melons.  I am fairly certain that, because they were tired of waiting, as soon as I left, they started pushing on her stomach, forcing the baby to come before she was fully dilated.  Now the doctor could not get her uterus to clamp down and he could not get the bleeding to stop!   

He asked for more medicine to help – but they couldn’t find one, so he stood there with his fist jammed into her pelvis to put pressure on the uterus.  Finally someone found one more vial and they injected it into the IV and we waited.  Fatmata was sweating profusely and her lips were white as a sheet.  Eventually the medicine took effect and her bleeding stopped.

They got the room and Fatmata cleaned up.  Baby was still lying in a silver bowl – but now they threw some paper trash on him.  I went out to see what we needed to do.  They were able to match blood types with her and started infusing her with blood.

There was a man from her family there so the midwife asked me to tell him everything that happened.  I explained it all, and then went in to take the trash off of baby so the women with me could see baby and Fatmata (as they had been outside the whole time and not allowed in the room.)  The women included our village midwife, Fatmata’s mom, her mate (one of her husband’s other wives – he has 3), and some other woman.)  They were relieved to see her alive and even commented on how big and beautiful the baby was – which surprised me.  

 I kept telling them what a miracle it was that she was alive and that God had saved her life that day.  In over 20 years of nursing, I have NEVER seen so much blood come out of a person – EVER – and the fact that she was still alive astounded me.  I knew I had seen a miracle performed that night.  

Since she obviously needed to stay for a few days, I went to find out what the bill was going to be so that her husband would be prepared when he came the following day to see her.

We ran the doctor back to his house, ran back to the hospital to pick up the 2 women returning with us, and headed home – arriving around 5:30am.

The next day, the WHOLE village was abuzz with what happened.  People kept coming and thanking us for helping.  Her husband came as well.  Over and over, as we recounted the story, we reminded everyone that it was God’s mercy that kept her alive.

We left the village 3 days later for a mini vacation.  When we returned this week, Fatmata came to see us and thank us.  She looked amazing – I felt like I was seeing the dead that had been raised to life.  Her smile was fantastic to see.  I reminded her that it was Jesus how had saved her.  I told her how sorry I was about her baby, but how thrilled I was that she was alive.