RUMGINAE - Last week Thursday, after doing the ward round, I was informed there was a woman with antepartum haemorrhage (APH or bleeding during pregnancy).
It had been a long ward round but I had the help of medical students from the medical faculty at Taurama in Port Moresby who were here doing their rural block attachment.
The MBBS (Bachelor of Medicine and Bachelor of Surgery) program is a five year course following which they graduate as doctors.
I was especially excited because we have never had medical students from Papua New Guinea here in Rughaz.
We’ve had medical students from Australia, America and New Zealand but this is the first time we've our own.
As part of their training in remote and rural health, I used the opportunity to teach them how to do ultrasound scans on pregnant women to ascertain the foetal biometrics (including working out the age of the foetus according to the foetal head and femur length).
While doing the scan after the ward round, we found out that the cause of the bleeding was placenta praevea (where the placenta comes before the baby and can lead to excessive blood loss resulting in death of the mother and unborn child).
Medical student Frank admitted the woman who was told that she would need to stay until the baby was delivered.
During ward round, I told the mom that even though she wanted to go home (she had been in hospital for several days with no bleeding), she still needed to stay in case she bled again.
This morning i was in the office talking to community health worker Danwaf about arranging for the medical students to visit his aid post at Senamrae when I received a phone call from Sister Rose saying the mother was bleeding.
I went to the ward to check her and confirmed it was a huge amount of bleeding so we prepared for a caesarean section. Prior to doing the caesar I called an obstetrician friend, Dr Sol, and presented my clinic findings to him. He agreed this woman needed a caesar.
Medical students Tommy and Frank were present and Tommy assisted me in the caesar with Muba also there in case of complications.
Our clinical supervisor Sister Kamura was present to supervise Frank at the anaesthetic end, Sister Dusi was the scout and community health worker Ori was present to catch the baby.
The caesarean section went well and I’m glad everyone was available to take part. It was very fortuitous it happened this day because the next was my day off.
It was a very close call but everything worked out well for staff, students, patient and baby.
It definitely was an adventure in remote Papua New Guinea and I’m glad our medical students were present to deliver health care to our precious citizens.
Then last night I was called to the ward to sadly confirm the death of an old woman who had been referred from the Catholic run Matkomnai Health Centre at 11pm.
After arriving back home, I watched my current favourite show, Dragon's Den, on YouTube then fell into a restful sleep.
Dr Pondikou works in the North Fly District of Western Province