Tales of the Unexpected

16/09/2021

Pav graduated in Medicine at the University of Nottingham, she specialised in Adult Internal Medicine and General Practice in London. She is currently working at Mweso Hospital in North Kivu, Democratric Republic of Congo where she is responsible for the Medicine, Maternity and Paediatrics department and the Laboratory.

This morning I saw a baby who’d been eaten by a rat. I have never seen anything like it. I never imagined I would ever see anything like it. As the Director of Nursing said “Aaaah, ça c’est la vie au Congo, toujours triste.”

So I arrive on the intensive treatment unit this morning and the nurse says “We have a problem, a baby with a neonatal infection…that’s been eaten by a rat.” Imagine. I first thought that I’d misheard. But sadly it was true. It looked like the half munched pumpkins that we often used to see in our outdoor kitchen before the arrival of the cat. This little tragedy has superseded the woman with the horrific pus-leaking burn, superseded the teenage girl who died with the ano-rectal cancer, superseded all. Something so small and yet so terrible: a little wound, a tiny baby - almost certain now that she will not survive. She has a wound the size of an orange on her head, despite the fact that she was sleeping on the same bed as her mother, despite the fact she was on ITU, a fever despite the antibiotics, and a high risk of developing tetanus. We changed the antibiotics to Ceftriaxone because it’s as strong as we’ve got, and Metronidazole because it gives good coverage against anaerobic bacteria and gave her a shot of serum anti-tetanus immunoglobulin. And ordered six rat traps to prevent a similar event in the future. I will let you know what happens.

The head of mission’s voice comes over the radio “ok, actually the baby’s just delivered…The thing is… We’re not really sure what to do now….”

And if that wasn’t enough, in the same afternoon, whilst I was walking to the 2pm teaching session on “Management of Normal Labour and Delivery” I was called on the radio for an emergency on the road. The project co-ordinator and the head of mission had been visiting Mpati camp for internally displaced people up in the mountains to look into the situation there, and they’d been transporting a woman back who had been in obstructed labour for two days. Except that on the road back, she’d magically unobstructed (the bumpy roads tend to have that effect, no joke) and she proceeded to start to deliver. With no medical person on board. Myself and one of the hospital midwives, jumped into a jeep with the driver hell-bent on getting there before it happened. We didn’t make it. The head of mission’s voice comes over the radio “ok, actually the baby’s just delivered…The thing is… We’re not really sure what to do now….” So the baby’s not breathing and I have to give medical advice on a jeep radio whilst clutching furiously onto the door handle to stop my head hitting the roof whilst the driver ignores every bump in the mud road in his hurry to get to the scene. Life’s not dull around here, that’s for sure.

Luckily all seems well; baby started breathing soon enough and has been named Bahati, Swahili for “Chance.”

I am shattered. And still, it continues.

Post script: Happily, “rat baby” (as we affectionately started calling her) healed well and miraculously was discharged home within a week. And every morning when I arrive onto the intensive treatment unit, the nurses proudly announce how many rats they have managed to kill in the night. All’s well that ends well, I guess.

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