He Arrived -- Alive!

2014
Nagji, Ashnoor

I have not seen a cooler way to enter the world than this.  It’s 2 am and I’m called stat by one of our guards to deliver his baby.   Down the dirt path we dashed as our hollahooping cherries splashed pulsations of red light against theVHA antenna.  Eyes strained, suddenly I saw mama waiting roadside, wrapped in her kitenge and shimmering headdress.  Ever agile and eager to be escorted, I steered her back to her hut for a cursory yet crucial assessment.  In sheer darkness, she delicately draped herself on the tiny wooden bench that was their only piece of furniture.  With the faint flicker from my “flashlight” (aka cell phone) the snapshot I saw in that split second was seriously stunning.  Between her splay was a pregnant watermelon sized waterballoon...with a foot dangling in it!  Incredulity, anxiety and awe wiped me awake at once.  Certainly, we all (will) kick the bucket, but few of us kick our way out into the world with an intro like this. 

As we raced to the nearest place, I tried to tame my thoughts to take the track of what I was trained to do.  Clearly, we were trapped between two tricky options:  either attempt a delivery isolated in a suboptimal setting for something that would surely be a surgical case back home, or risk the nearly two hour drive to town down dirt roads that demand diabolic dips and dances from our four wheel drive –and us.  With such slim pickings and a seemingly imminent arrival, I opted to have (generator driven) light, water, space and solid ground on our side.  In retrospect it sounds like simple choices, but then and there, I really wondered (and worried about) how this tale would unfold and be told.  Indeed, in most moments in life that seem nebulous and precarious, isn’t the part we (think we) play particularly petite in what presides?  As I mused etiologies, evidence and existential elements, my fingers met a playful baby foot that responded and recoiled from my tickle, punting some play into our predicament. 

But as time passed, his shyness to slide out persisted.  And as I (again) reweighed options, as if to douse the risk that was swelling, rain began pelting.  The creeping feeling of being handcuffed was diluted only by the grace of his heart rate –but to rely on this reassurance indefinitely would be daft.  Despite the logistical difficulties that dominoed, with the rising ante, his failing arrival and the falling appeal of Option 1, we piled into the (land rover) ambulance.  Who is Murphy and was s/he in a remote Ugandan refugee camp when the law declared itself?  For no sooner had we began our departure in the downpour that the dude decided to show up.  Great.  So here we are squished in the rear of the ambulance surrounded by tenuously tucked emergency buckets and boxes (amid a timid and terrified local assistant), mama flopped atop a mattress covered in garbage bags (an interesting spin on the notion of plastic protection), barefoot me sheltered solely by a supersized apron perched over her in a posture suitable only for yogis as I schemed and beseeched this baby to be born.  When he (finally) arrived, we all smiled, sighed and re-realized if we’re meant to be on this planet  (Exhibit A kicked and squirmed in my hands) then surely our time and toil ought to be capitalized.

No sooner had I managed to get mama’s (massive) bleeding under control that the merry-go-round of emergencies and deliveries unravelled non-stop over the next 12 hours.  Somewhere in that time, on bended knee in the middle of a humble hut (and a slew of supportive spectators), I welcomed another wee one to our world.  But here, things like this are not done in private.  So when communal trumps personal, like kangaroos with backpacks, suckling toddlers in the front with newborns strapped to their torso, women with their own loads are constant cheerleaders and caregivers in this community.  In fact, this ethic underscores the notion of unity in adversity and ecstasy.  So, when my marathon overnight call bled into the beginning and beyond of the next day (keeping severe malaria, dehydration, hypertension and the like at bay), my MSF team mates rallied for my belly, and spirit.  In sending Nutella, PB&J sandwiches and (clean) hot water for a cuppa chai (!) to the Health Centre with the driver, they reiterated that we too were in this together.    

Back at home, the grinning guard greeted me with gusto and great gratitude–obviously, he’d heard about the hoopla of his son’s birth.  I suppose too that his wife relayed my suggestion that the boy should receive a strong and solid name for his sincerity to arrive alive.  Honest, Patience, Innocent –with such haute selection like this to choose from in Ugandan culture, I was surprised when he expressed his conviction for having his son carry the name of my family.  However we arrived on the planet, magical moments in medicine remind me that regardless of how slim or strong the sign, somehow, we are all tied.

Theme: Birth | Naissance
Theme: Community | Communauté
Theme: Family | Famille
Theme: Health Care Delivery | Prestation des soins de santé

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.

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