A Rwandan Miracle
by
Ann Kerr

The first time I heard about Mary was from the ward midwife who was working with us in the temporary hospital in Kigali.

My telephone rang at home one rainy, cold morning. It was the agency, asking if I would be willing to go to Rwanda to replace the existing operating nurse, who was coming to the end of her mission.
      I did not have a permanent job, which left me free to leave at a moments notice. I had seen some of the devastation wrought by the civil war in Rwanda on the TV, giving me some idea of the dreadful hardship the people had suffered and were still suffering. It would be a challenging undertaking.
      Having agreed to go. I rummaged through my papers to find my list of ‘must take’ items? With experience I travelled light as it is often necessary to carry ones own luggage, which encourages the packing of minimal possessions.
      After being given the statutory briefing regarding the political situation in this war torn country and being told of the somewhat difficult travel arrangements, our team of three set off. We had not met each other before, coming as we did, from three different countries. This is an interesting situation having to understand people whose language and culture is unfamiliar and who it is vital to get along with in harmony for a number of months.
      The first member of the team I met was a nurse from Germany who looked as though she was well versed in the nursing business; she was well endowed, attractive and, at our first meeting, seemed to have the very essential sense of humour.
We exchanged the perfunctory greetings,
“My name is Heidi,” she said, “have you been on a mission before?”
“Yes, one or two but never to Rwanda"  

     “Nor I. It has all been rather a rush, still, no time to consider the implications!”
“In spite of our briefing we will not get the true
picture until we get there” I replied.
      The surgeon was English on his first mission and somewhat younger than us two girls. It did make communications easier both speaking the same language.
“Where are you based in the UK?” I asked him. On these occasions I have found it easier to ask a man a question, then he can reply at length leaving me to ponder if he is going to fit in with the team ethic and if he realises the work and circumstances will be far away from his everyday work in the UK. He told me he was a junior consultant in a London teaching hospital. “Oh boy I hope he can cope with experienced nurses giving him advice” I thought to myself. During this first encounter I had a gut feeling he would adapt quite well.
      Thus we set off on our somewhat hazardous journey, carrying well travelled suitcases and clutching identification documents. A scheduled flight to Kenya was a pleasant beginning to our journey before the fun started. At that time the airport at Kigali was out of commission due to the war so the next leg of the journey was in a Hercules aircraft, not the most comfortable and very cold. This giant of a transport plane, looking rather like a huge moth, I always think, took us to Entebbe in Uganda where we spent long hours waiting while the powers that be tried to organise the next stage of our journey.
      Fortunately Heidi had had the foresight to pack us some sandwiches and bring along bottled water, she was living up to her German efficiency. Entebbe passenger lounge left a lot to be desired in the comfort
stakes, hard seats and no food; we would have been mighty hungry by the end of the day without these meagre provisions. This respite gave us valuable time to asses each other wondering if our respective capabilities would match up to the requirements of the
mission. Even at this early stage I felt we would work well together.
      Eventually a helicopter arrived and we were bundled onboard trusting it was going in the right direction. The solders did not enter into unnecessary dialogue so we did have to rely on them to deliver us to the right country.
      In fact it was a beautiful flight over Lake Victoria on
the way to the border between Uganda and Rwanda. We realised the mountains we could see through the small windows were where the famous gorillas were to
be found. It felt so near yet so far, we would not be able to visit this famed part of the world at least not on this trip. Apart from the lack of security in the whole of the area we would be working six or seven days a week. On reaching the border we landed in a field where a truck awaited to take us on the final leg of the journey.
      At the check point we were stopped by a very young and very short soldier wanting to look into the open back of the truck but due to his lack of height he was unable to do so. A solution was found when one of the officers travelling with the convoy picked him up plus his rifle so he could see over the side. When this little man was satisfied that we presented no threat we proceeded on our way. This journey would not rate highly in the comfort stakes! I think we were all too tired and thinking of what lay ahead to enjoy the scenery.
       We reached Kigali late in the evening where we were housed overnight in makeshift quarters. Food and water was scarce but we had managed to bring a small bottle of whiskey, some of which we drank out of the bottle top, no glasses being available. It was not the most peaceful night trying to sleep on beds with no
mattresses and one blanket each, the temperature drops appreciably at night so we stayed in our clothes to try to keep warm. The next day we were advised by our agency delegate that it could be some time before we could travel the few kilometres to the hospital due to the unstable situation in the town.
      After a frustrating two days we were finally able to leave the confines of the camp. The vehicle transporting us to the hospital allowed us to see the devastation all around wrought by the war, houses with only walls still standing, personal possessions lying about sometimes blown by the warm wind, huge shell holes in the road, children wandering aimlessly about with no apparent place to go, what senseless destruction.
      The temporary hospital had been a Nunnery built on the side of a hill which made the erection of tents as wards difficult. It did not make for comfortable resting for the patients either.
      Fortunately the operating theatre and maternity ward were housed in brick buildings which, due to the lack of maintenance over the years, were not ideal but at least had level floors. Most of the patients, men, women and children, were victims of the savage war, recovering in body but recovery of their minds would take many months if not years. Some of the women had been admitted with obstetric complications due to being left many hours in obstructed labour.
      One of the first tasks was to clean the operating theatre, not easy when I had to work through a translator and the staff were untrained, not understanding the concept of cleanliness let alone sterility. The way of disposing of rubbish was to drop it
on the floor! However I set to work with a bucket and a mop and found that the staff were quick to understand what I was doing and joined in with a will. Water had to be transported by road so economy was the order of the day. No running water out of taps, that luxury would only be possible for us on our return to our own country.
      At a surgical meeting I heard about Mary. She had been admitted to the hospital in labour with her first child. Her beautiful face managed to smile even though she was in pain, obviously eagerly awaiting the birth of her baby. Her family was gathered round anxious to see if we could succeed where the traditional midwife had failed.
      Our midwife had been unable to hear the baby’s heart beat for some considerable time and with the condition of the mother deteriorating by the hour she considered a caesarean section was the only answer to save the life of the Mother. Having discussed the problem with the surgeon, who was in full agreement, we prepared for the operation.
      It was not an easy undertaking given the language barrier, to explain to Mary that her baby had died and to convince her relatives that an operation was the best treatment. There was a great deal of discussion among the family before permission was given to go ahead with the operation.
      Heidi administered the anaesthetic and gave the surgeon the go ahead to start, at that precise moment there was a loud explosion outside the building which rocked the walls and left us shaken wondering what had happened. All went dark and the initial thought of the staff was that the war had started up again and a shell had landed near by.
      Obviously the patient and staff had to stay where they were and a porter was sent to find out what was happening. On his return he was able to reassure everyone that the war had not started again but that the generator had blown up.
      Here was a difficult situation, a patient asleep all prepared for an operation, a surgeon ready to start and no lights. Under these circumstances it was necessary to improvise. The battery run emergency lights were called for plus two torches and the operation commenced with lights waving about all over the place, in the hands of the staff, making the surgery doubly difficult
      After this interruption all went according to plan and the baby was delivered sadly dead as expected. The surgeon continued with the procedure by attempting to deliver the placenta but to his amazement and that of the staff he produced a live baby boy.
      It had been impossible to know beforehand that Mary was carrying twins as there was no modern equipment to be able to monitor the babies before their birth and multiple births are not usual in Africa.
      The local staff were very excited by the event of this lovely lady having a live baby after all.
      When she was back on the ward and awake the midwife tried to present her with her beautiful baby boy
but she said, in gestures and words in her own language, that the baby was not hers, her baby was dead. When it was explained to her that the baby really
was hers the joy on her face was a picture to remember and treasure. Thus took place a miracle in the midst of so much mayhem.