Turmoils of Labor

For the last six hours, Betty was agonizing under the excruciating spasms of child birth. Her last three deliveries were spontaneous normal deliveries but this seemed unlike before. Being an experienced young mother, she attempted to synchronise her expulsive efforts with the painful spasmodic contractions of the baby-filled uterus. She gasped for air intermittently as sweat trickled down her forehead, over her dark brown eyes, and mixed with tears of agony as she cried –‘mama’, when labour-pain was unbearable.  Betty’s mother stood beside her in the dimly lit aid post. She watched her daughter endure the anguish and pain of motherhood. Her joy of welcoming her newborn grandchild was soon overtaken by a deep concern for her beautiful daughter. All efforts seemed to have sipped out all energy from Betty.  Rising from between Betty’s parted legs; the lone male Community Health Worker (CHW) looked up to Betty, turned to Betty’s mother, and attempts to explain the situation.

Standing beside Betty’s mother, inside the dimly lit aid post was a short stout young man, whose overbearing shadow of concern plastered against the unpainted battered walls of the aid post. Chin cupped in the palm of his hands, Betty’s husband seemed lost for words. He turned his attention to the community health worker, dreading to hear any bad news as the community health worker began to explain the difficulties Betty is experiencing. As simple as he could, he explained that the baby is a big baby and is also not lying in alignment with the birth canal. It would require an urgent referral out to save the baby and Betty. Before the community health worker ended his last sentence; tears welled up Betty’s mother’s eyes, overflowed and trickled down the sun burnt freckle face. She squeezed her daughter’s hands that was in hers most of the time, and rubbed gently with a motherly love. Betty felt the concern and care of her mother that words cannot express. The words of the CHW were news Betty’s mother would rather be deaf to. She knew the difficulties and challenges that came with such news – money, transport, the rugged terrains and the bad roads, which they have to hurdle if they have to save her daughter and her grandchild.

With a bit of effort, Betty's husband degutted bitter sputum down his parched throat and cleared his voice. In a rather low cracked voice he asked “bai yumi kisim em igo Butaweng?” (Are we going to take her to Butaweng?), knowing well that was the only place to go to. Butaweng is synonymous with medical emergencies in their village and region (Finchaffen, Tewai-Siassi & Kabwum Districts).

Butaweng is an ELCPNG mission health station in Finchaffen district, Morobe Province of Papua New Guinea. The health station is nestled at the neck of what I would call the Godewac Peninsula where the majestic Mape River curls around to pour gracefully into Langema Bay. To the north is the historic site where Johann Flierl sailed into the quiet shores of Simbang village on the 12th of July, 1886, thus rightfully, Simbang village is regarded as the birthplace of the Evangelical Lutheran Church of Papua New Guinea (ELCPNG). Despite Butaweng's proximity to the historic Simbang village, it has its own remarkable history. It is widely known for the health and medical services of the Braun Memorial Rural Hospital through its dedicated doctors, nurses, paramedical and non-medical staff; and later popularized through the music industry by Mr. Jason Hershey (aka O-Shen). 



Satellite view of Butaweng, surrounding communities and the remarkable Mape River emptying into Langema Bay.

After six hours of many cycles of uterine contractions-relaxation of various intensity, there was no progress. Betty was drained of all her energy. Her skin felt cool and sweaty. She inhaled mouthfuls of the humid air and desired for more, but the contractions interrupted.

Betty's husband disappeared into the night as the aid post's door closed behind with a creaking sound. In the dark, in front of the aid-post, a crowd of men began to gather. Betty's husband informed the young men that gathered of the complications Betty is experiencing and they needed to get her to Butaweng (Braun Memorial Rural Hospital).

Eighteen months back, Betty had her third child delivered without complications at Braun Memorial Rural Hospital. During the usual obstetric ward rounds, the doctor spoke to her about family completion. She nodded in approval after the doctor informed her of the health benefits for the mother, and the benefits of having a manageable size family. Unfortunately, when the husband was asked for his informed consent for family completion, he was reluctant. He gave some reasons for his decision: (i) my wife will not be able to carry heavy loads and work in the garden after the operation, (ii) she will develop chronic (long lasting) abdominal pain. The doctor took time again to carefully explain the benefits of family completion and tried to clear the misconceptions he had, but Betty's husband's decision was firm. He assured the doctor that he will use some traditional herbal medicine to make her infertile.

The young men quickly constructed the all too familiar bush stretcher from bamboos and bags under the light of the flickering lantern. The improvised stretcher was moved into the aid-post and Betty was transferred onto the stretcher. Four brave young men carried Betty on the stretcher and walked through the night with the aid of a torch. Behind them, Betty's parents, husband, her third child straddled over his dad's shoulder, the CHW and a few other young men followed. Right at the back was Betty's mum who walked under the load of a string bag half-full with plantains and taro (taweng). Along the way, the men had to stop several times to catch their breath and change. When contractions were painful and Betty moved about, they laid the stretcher down and waited, then continued.  The journey was about two hours before they reached the nearest health centre. The nursing officer at the health centre made an assessment of Betty's condition and advised that she cannot manage her so she had to be taken  to Butaweng immediately.

Betty was taken to Butaweng in the  health centre's ambulance (trooper) where her baby was delivered.  The baby was very sick though, but was successfully managed by the dedicated staff of Braun Memorial Rural Hospital.

Three days later, Betty developed further complications and sadly passed on leaving behind her young family and loved ones. The baby will grow up without  her. I know, one day, she will manage to ask her father about her mum. It will be a pain in the throat experience for the lone father to recount the tragedy.

 

• May Anutu (God) continue to bless the hard working staff of Braun Memorial Rural Hospital in their daily strive to dispense adequate medical and health services with the meagre resources they have.
• May  one day, every Papua New Guinean especially the 87.5% rural based population will have access to better health services.