By Vicky Wandawa
In the painful aftermath of a C-section, a midwife shouts out to her to leave the bed for a freshly-operated mother, soon to be wheeled in from the theatre.
I silently wonder, “Will she make it off the bed? She was operated upon hardly three hours ago!”
Slowly, she sits up and turns, as though to complain or seek mercy, but it is clear the midwife will not relent on her order. She gathers herself and summons all the strength she can probably get, but it only takes her as far as raising her body just inches off the bed.
She cannot be over 25 years. Her face is swollen and her brown hair looks dry and messed up. She tries to stand up, but when her legs betray her, she groans. Pain is painted all over her face. She finally takes another step and stays still for over a minute, her eyes almost popping out.
Perhaps she is wondering how to make the next step without provoking more pain! She finally takes another step and still gets to her mat, which her caregiver has just spread out on the floor. She has a faraway look on her face as she lies down. I leave her looking into space, as her attendant soothes the baby.
This is in a ward in Mulago Hospital, where mothers who have undergone a Caesarean-section rest. There are 20 beds. It is 8:00pm and I am here to see, first hand, how the low number of staff and limited facilities are burdening the hospital.
A doctor says the hospital carries out at least 25 C-sections every 24 hours, making the 20 beds insufficient.
My next stop is the general labour ward. It smells fresh, save for the entrance, where the toilets are emitting a nauseating stench. It is spacious, with 30 beds. The distance between the beds is a metre.
However, about four of the beds have no mattresses. Ten of the mothers in this ward are moaning in pain. The rest are asleep or simply staring into space.
There are three midwives and a doctor, attending to the mothers.
I witness one of them cajoling a mother to push. Being a first-time mother, it is not until they tell her to ‘poop’ that she finally understands what the midwife means by push. She finally pushes the baby.
In the next hour, three more women give birth. The doctor tells me having only three midwives to attend to more than 20 women in labour leaves them exhausted by the end of the shift, which starts at 5:00pm and ends the following day at midday.
Each time a mother gives birth and blood gushes to the floor, it is cleaned immediately.
In the middle of the labour ward, trying to fit onto a four-seater wooden bench are five petite pregnant women, in the range of 18 to 24 years.
They are waiting for their turn to undergo a Caesarian section. They are not the only ones.
Three more are seated on the floor.
A midwife says the operating theatre can only take two mothers at ago because it has two beds.
“Tonight, we have too many mothers for C-section. They are usually fewer,” she says.
One of the women on the bench, frowned her face in pain, moans softly as she caresses her bump. “I have been in labour for too long. I should be taken into theatre immediately,” she softly tells the doctor. Unfortunately, she is told her name is the sixth on the list.
Jumping the queue to theatre
As the doctor on duty slowly walks through the corridor after examining a mother about to have a natural birth, a woman quickly walks towards him and whispers. She seems to name her fee, such that her sister, who is moaning on the floor and awaiting surgery, can get in, despite being the seventh on the list.
However, the doctor declines and says the queue to the theatre is based on first-come-first-serve basis, but most importantly, urgency. The more C-sections a pregnant mother has had, the more urgent it is for her to be taken for surgery at the onset of labour, to avoid uterus rupture.
The doctor shares with me that sometimes doctors and midwives accept money from pregnant mothers, to help them jump the queue to the theatre, only to find more urgent cases.
At 8:30pm, a mother, Namukasa, delivers a baby boy. About an hour later, after she has been cleaned up, she starts making phone calls to deliver the good news.
While on the fourth call, the doctor shouts out: “Those who have delivered and have been cleaned up, prepare to leave the beds for the others in labour and about to push.”