Thursday night: 8:00 pm rounds in ER
-- Patient with acute peritonitis. No general surgeon.
We leave for ward; our anesthesiologist goes to pharmacy for pain meds.
On ward rounding...

Anesthesiologist comes back — Emergency! Need all of you at ER.
Pregnant woman with eclampsia, seizure at clinic; transferred 2.5 hrs in a FLATBED truck to ER.
She is placed on mat on ground in front of ER, hemorrhaging.
Baby born on mat; mom in distress.
Grab baby with placenta wrapped in someone’s jacket.
Take baby to room; cord cut. No formula. No infant attire

Mom in acute distress, bleeding. O2 65, hypertension 180/130, heart rate 155
Father in shock

Baby; formula; no hot water... also no electricity!
Teammate to guest house; heat water
No GYN, no general surgeon.
Our team stays with pts until 12:30am
Baby fine, but Mom in coma
Dad standing: use a half clean sheet on empty bed for Dad to rest
(patients have to bring all linens, food, etc. - family not prepared)