A hectic week

A birth unit can not come soon enough - it is in a long pipeline.

This past week has been peppered with high risk cases from our remote regions. All in a single day we had a woman with pre eclampsia, a woman post dates by 2 weeks with a baby lying sideways and as if that wasn’t enough a complete placenta previa. This lady was treated to a prompt referral to the hospital for a c section. We had a lady who had come because her Traditional Birth Attendant had informed her that the baby had no head. We easily located the baby's head under her left rib cage- it was breech! Then there were women who just needed a little extra attention. Late that same night a 17 year old girl was whisked from a remote location whilst experiencing the effects of undiagnosed pre eclampsia that had suddenly become eclampsia. Stabilising care was commenced at T-RAD by our on call team and she was soon whisked off to the hospital for urgent delivery.

Now one thing we know and teach our students is that there are 3 fatal delays when it comes to medical care, this woman experienced each of those delays, the first being the realisation that she needed referral. She had not had antenatal care and there was no realisation she had a problem until she started having seizures. She was taken to the local clinic where the hard working midwife jumped into action to organise emergency transport - this is no simple feat at the best of times but at this time of COVID and strict lock downs the second delay - that of delay in getting to the clinic. The third delay is in receiving the appropriate care when you are transferred. We were able to give stabilising care - but we were not able to manage her delivery. We referred her to the nearest hospital with an Obstetrician. However it was the Obstetricians day off and a junior doctor without her experience was in charge. It was a difficult case, and each of those delays led to a hairy situation. God is good though and despite those set backs, both mama and this sassy little girl are fighting and should be soon discharged from hospital.

Not all weeks are this intense, but we have reason to believe that they may prove to be as we are able to roll out more services without interference of COVID. The birth unit is coming - it is just hitting every hiccup along the way.

Monica Parker
Midwife Program Director

Monica Parker is from New South Wales, Australia and is a registered nurse and midwife. She has been living and working in Thailand and Myanmar since 2009 and is the Co-ordinator of SPM’s Maternal Health Program. She is seconded to work with Earth Mission Asia’s Physician Assistant program based in Kyaukkyi, Myanmar. It is Monica’s dream to train a strong core of professional midwives to serve the Karen people in the remote areas of Karen State. She also wants to help set professional standards in maternal health care. This includes identification and appropriate management of high-risk pregnancy and birth.

Mon is based in Kayaukkyi, Myanmar. She is married to Saw Eh Hsu and, they have two precious twin boys.