He came bearing gifts: yams, bunches of plantain and freshly smoked catfish.
“I hear you are leaving today” he said
“Yes,” I replied
“I want to thank you for keeping my secret”
I wished to tell him that he didn’t need to thank me but since we were speaking in vernacular and my grasp of the language was poor, having only started learning it the previous year, I merely said “it’s okay.”
The secret was nothing big or numinous. It was the consequence of his action that had been huge.
My one year service in the village was over and I was glad to be leaving. I had been posted there the previous year under the one year mandatory national youth service scheme.
I drove into the village the previous year in the little red car that had been a gift from my father on graduation, with my tools of trade, eager to commence practice. The village was about 200km from the closest town, if you could call that a town, by road. Another town accessed only by water was preferred by the villagers. I lacked the ability to swim thus I never ventured near the rickety canoes used to cross the river. Most of the villagers lived in mud huts roofed by palm fronds although there were a few concrete buildings. Narrow pathways lined by palm trees served as routes for moving from one place to the other and I soon discovered that my car had access to but a few places. I found the village without difficulty with the directions I’d been given but locating the hospital was more difficult as most of the women in the village could barely speak English. I managed to find it and I made my way to the hospital I was posted to dreading what I would find but to my delightful surprise it was a cute little brick hospital with laboratory facilities and a theatre out of place for such a remote place. I would later discover that it was built by the last governor of the state whose wife had hailed from there. The village was currently without a doctor as the previous one resigned and the new one who was sent refused to stay after seeing the place. I was shown the doctor’s lodge and a satisfied sigh left my lips at my quaint one bedroom apartment with its little kitchenette. It was more than I could have hoped for and so I settled into my new life.
Born and bred in the megacity of Lagos, my life hitherto had not prepared for this one. The environment was like what I saw in Nigerian home movies depicting rural life. My experiences there were varied and I was often shocked by the attitudes and way of life of the people. The secret to which the old man referred was one of the experiences I’m unlikely to forget.
I was still sleeping that Saturday morning when I was jolted awake by a banging and rattling noise. I woke up confused and it took a few seconds before I realized the racket was coming from my door. I hurried to it and found the Orderly behind it.
“Is there a problem?” I asked unnecessarily as though it wasn’t obvious that something was wrong.
“The nurse asked me to get you”, she replied a little out of breath. She was the only Orderly who spoke good English and I often wondered where she had learnt to speak so well and why she didn’t have a better job.
“Do you have any idea what it’s about?”
“There is a woman in labour,” she replied still panting
“Is she bleeding?” I queried. I’d asked the nurses to always try to give me a hint of the situation when they sent for me.
She shook her head as she told me she didn’t know.
“Tell her to give me a minute.” I said to the Orderly as I sent her off and quickly changed to my day clothes.
I was in the labour room in less than five minutes and there met a young, heavily pregnant lady in her early twenties in obvious pain on the bed.
“What do we have?”
“a multip about 5cm dilated but the foetal heart rate just went up to 180 and liquor is meconium stained.”
“Foetal distress,” we both said at the same time.
I picked up a pair of gloves and went to the patient’s bedside.
“When did the membranes rupture?”
“About an hour ago, caput is also beginning to form” the nurse added as I donned my gloves to begin the examination. We were obviously dealing with foetal distress secondary to caphalopelvic disproportion. My findings were in keeping with what the nurse had told me and the patient’s vital signs were stable.
“We’ll have to take her in. Can we get the laboratory scientist to run the necessary investigations and group and crossmatch two units of blood? I’ll talk with the husband. In the meantime put her on her side and commence 5%dextrose water. When was her last meal?”
“About six hours ago”
“Prepare her for surgery while I discuss with her husband”
As I walked out of the labour room I mentally went through all I had to do. I thanked God for the existence of a theatre and the surgical skills my father had passed on to me. Having a gynaecologist as a father had its perks as it afforded me more hands on training.
I found her husband, Mr Bass sitting in the waiting room with his sister. I took him to my office and explained the situation to him in simple clear terms and I tried to get feedback from him to be sure he understood the situation. Finally I was sure he understood so I then proceeded to tell him we needed him to sign the consent form for us to begin the operation.
“Before you operate I tell her people” he said to me slowly picking his words carefully. He was not very fluent in English but he was better than most.
“Why”? I asked confused
“I tell them so they know” he said
“Time is of the essence….” I began but then realized I had to use simpler terms. “We have to hurry,” I said. “The baby could die if we waste any more time”
“My sister go quick to tell them.” he said as he stood up, “we be fast”
“Come with me please,” I told him taking him with me to the labour room. I asked the nurse to explain the situation to him in his local language.
After a few minutes of talking and gesticulations they both turned to me
“He says he would like to inform his in-laws.”
“That was what he told me earlier. Didn’t you explain to him how important time is to us right now?”
“I did, but he won’t sign until he has told them. That is the usual practice here.”
“My place not far. My sister run” he said.
“The earlier she leaves the better for us “the nurse cautioned.
“Alright” I said in exasperation “but please tell her to hurry.”
“She go quick,” he said as he left the room
“I can’t believe this,” I muttered under my breath. “Have we been able to reach the lab scientist?” I asked. I wanted everything ready by the time the consent was obtained.
“Yes. He has taken the samples.”
“Hope we have blood.”
“He is crossmatching what we have but mentioned that we may need donors.”
“Great! Hope her parents’ don’t have to be informed too before we transfuse.” I said sarcastically. “Do we have her pcv?” I asked a little while later.
I sat there for about two minutes when I realized I had no food and was famished. With guilt I decided to hurry to my favourite food seller in the next village. With my car I should be back before consent was obtained.
“What was the last foetal rate you got?”
“The one before that?”
“Ok let’s monitor closely. I’m just going to step out of the hospital very briefly. I don’t have any food in the house so I need to get something to eat.”
I drove hurriedly and packed with a screech in front of her wooden stall. I picked up my food flask and jumped out of the car. “I need semovita with okra soup quickly.” I said the moment I entered into the shop. It was dark inside and so it took a moment before I realized she was not behind her counter as usual but was standing next to a middle aged man and they both seemed to be fumbling with their clothes.
“You want semovita?” She asked breaking the abrupt silence that had descended.
“Yes yes,” I stammered with embarrassment having deduced that I had interrupted them. “Okra soup please.”
In less than three minutes I was back in my car. When I got into the hospital premises I met Mr Bass, his sister and a woman I’d not seen before.
“Are we ready now?” I asked guiltily.
“No,” he said “my father in-law go to farm. Somebody go bring him.”
“We have to wait for your father in law? What of your mother in- law? Was she not available?”
“See her,” he said pointing to the new addition.
“Madam,” I said addressing her, “can’t you give us permission?”
She shook her head. “No understand.” She told me.
I turned to Mr Bass. “Since you’ve informed your mother in law can’t we go in?”
“We tell my father in-law.”
“What if you don’t find him?”
“He go to farm. Someone go call him.”
I felt like screaming. I left them and went to the labour room “how are we doing?”
“Foetal rate is 192”
“You won’t believe what is going on out there.” I said to her
“They told me.”
“What if they don’t find the man?”
“They’ll locate him. My problem is that the farm he went to is a bit far, it may be too late by the time they reach him.”
“Oh God,” I groaned. “I didn’t know that. Let the patient sign the form please.”
“I don’t think we should do that. If anything happens to her they’ll mob us. Let us wait for the man.”
“But we may lose the baby.”
“I’m telling you that we may lose our lives.”
“We can get this baby out in fifteen minutes. Lets save this baby.”
She shook her head vigorously.
“Have you explained the situation to her?” I queried
“Come and assist me so that I can obtain consent.”
“Doctor…” she began with a warning note in her voice.
“Just do it. Whatever happens will be on me.”
The nurse followed me reluctantly. The woman was not literate so I needed the nurse.
“How are you feeling?” I asked gently
The nurse interpreted while I waited patiently until I could get my feedback.
“She says she’s ok. It’s just the pain.”
At that moment another wave of contraction hit her and we had to wait until it subsided before we could continue.
“Please explain the situation to her again and tell her we are yet to see her father.”
They talked. Hands moved, frowns appeared on brows, more talk and then the nurse finally turned to me and said, “She says her husband will sign.”
“Did you tell her the baby is at risk of dying?”
“And that her father has not been found?”
I frowned, “you gave her the entire picture?”
“I did,” the nurse answered irritably now. I had to drop the issue seeing that I was in danger of annoying her.
“I’ll be in my house when everything is ready” I told her. I went to my car, picked up my food flask and went in to eat. I could barely get the lumps of semovita down my throat because of the emotions coursing through me at that moment. The thought that this woman who had labored for nine months could lose her baby because she refused to take a decision made me furious. This was almost the year 2000.