A New Surgery Ward in Chad Saves Mothers’ and Children's Lives

By David Majagira

	Photo by IMC
	Both Amina and her first-born child were in grave danger by the time she arrived at Guereda Hospital, three days into her labor. Thanks to an emergency C-section, and the surgery ward’s new ventilator, doctors were able to save both of their lives.

Guereda, Chad--Amina, a young woman from a remote village in eastern Chad, had been in labor for three long, torturous days by the time she was brought to Guereda Hospital last May. She was forced to make the 50-kilometer journey from her village, Birak, to the city because frequent clashes between rebels and the military had resulted in the closing of the local health center. The violence had also provoked the exodus of most village residents, including the town’s midwives and traditional birth attendants. By the time Amina was examined by an IMC-trained midwife at Guereda Hospital, not only was she in danger of a life-threatening uterine rupture, but her soon-to-be-born child was showing signs of fetal distress, as well.

IMC established operations in Chad in 2004. While our initial focus was on providing primary health care and nutrition for the nearly 200,000 Darfurian refugees who have fled Sudan for the deserts of eastern Chad since 2003, it soon became clear that they were not the only ones in need of assistance. Already, Chad is one of the most resource-poor environments in the world; the huge and sudden increase in local population put a catastrophic strain on Chadian host communities. Huge swaths of the population were at grave risk for malnutrition, dehydration, and disease.

IMC took a close look at Guereda, which not only serves as our operational base, but is located in one of eastern Chad’s most violent and underserved areas. With just a single, small hospital to serve both the refugees in three major camps and their hosts—a population of over 110,000—Guereda District was the obvious choice for IMC’s capacity-building programming. We established a partnership with the Chad Ministry of Health, with support from private donations, to rehabilitate the hospital, provide emergency medical supplies, train medical and nursing personnel, and build an emergency ward with the only operating room within 130 kilometers.

Thanks to this new surgery ward, Amina received the care she needed. The IMC surgical team quickly performed a C-section, and immediately placed her child, who was not breathing, on a ventilator. The two recovered quickly under the care of Guereda Hospital staff, and Amina and her baby boy returned home to Birak.

Photo by IMC
Thanks to her training by an IMC midwife (left), Nourene (right) knew that that her 23-year-old patient was at risk of uterine rupture, and brought her to Guereda Hospital to be kept under observation before she gave birth to a healthy baby boy.

The day before Amina was admitted, Nourene Bourdjoul, a traditional birth attendant trained by IMC, brought one of her patients in to be examined. Christine, a 23-year-old with a history of complications during pregnancy and childbirth, had delivered her first child via C-section, and Nourene’s training had taught her that she was at risk of uterine rupture with the second delivery. The Guereda Hospital physician who examined Christine found clear signs of pre-eclampsia, a life-threatening condition characterized by a sharp rise in blood pressure and swelling of the hands, feet and face. Although Christine was not yet in active labor, she was kept under close observation and, when labor commenced the morning of May 8th, the medical team performed an emergency C-section. Christine delivered a beautiful healthy boy, whom she was able to hold in her arms immediately.

The Guereda operating theatre, which now has the capacity to respond to surgical emergencies like Amina’s and Christine’s, has been instrumental in saving the lives of many expectant mothers and their children in this remote region. Under the most difficult circumstances, IMC, the Ministry of Health, and Guereda Hospital staff have worked together to provide health care and hope to this next generation of eastern Chadians.