Friday, August 01, 2014

Giving birth in Niger– risky business!

*note- all pictures were just taken with my camera phone as I did not want to bring my big camera into this setting, so sorry for the low resolution!

My dear Tuareg friend Miriama was pregnant. I remember when I came back from home assignment this past December that she was newly pregnant and processing all the changes that would mean in her life. As this precious baby grew inside of her we had many long talks about being a Mom, what birth was like, cultural practices for Tuaregs about babies, who gets to name them etc. It was my first time being really close to the expecting mamma so I could ask all my questions about how things went here in a Niger cultural setting and she could ask all of her questions to me.

Just before we went away for 2 weeks vacation this end of June we talked about when she would give birth in mid-August. She really wanted me to be able to come into the clinic with her and deliver with her. I told her about birthing classes that we can take in North America and she asked if when I came back from vacation I could prepare and teach her birthing classes. I was a little intimidated by the idea but know it is a real need here! Young women have no idea what childbirth is about. No one talks about it and they are scared and misinformed and nervous. They WANT to know about it, but either won’t ask culturally or else have on where to ask. So her strange and outspoken but bestie Canadian friend was the perfect person right?

I came back from vacation late at night on Tuesday July 15th. On Thursday the 17th at noon I got a frantic call from Miriama’s sister that she had been tested at the clinic and shown to have severe pre-eclampsia and they were headed to the central city maternity hospital for an emergency c-section. Wow! That definitely took all my plans for the next week and threw them right out the window! The idea of a 35-36 week preemie in Niger was terrifying, a country where even full term babies fight incredible odds to survive. There are some simple facilities and baby incubators for preemies, but no where near the range of options we are familiar with elsewhere in the World.

I called Paul home to take over the kids and as soon as he walked in the door I rushed out to the hospital. When I got there they had Miriama in an emergency triage room, along with about 30 other women. This small space only had a dozen beds so they women were all lined up sitting on the floor as well. And there were no doctors. The few nurses took care of any absolute necessities but kept waiting for the doctors to come. I sat with her sister just outside the emergency room (we were not allowed in- armed military at the doors) and we waited. And waited. At one point Miriama came out to pass on a message to another Tuareg family waiting and when she returned to the waiting room, someone had stolen the $1 plastic sheet she had had to buy for her “clean delivery” kit. Unbelievable. Her sister told me that since it was Ramadan and everyone was fasting all day it was not uncommon for people (doctors) to not come to work until after they had broken their fast at dusk and eaten. I can’t say for sure if this was the reason, but sure enough, after dusk and eating time, the doctors filtered in. They decided to giver her some medication to try to reverse or stabilize the pre-eclampsia overnight. So she was hooked up to an iv overnight, while sitting on the floor on a plastic sheet. I went home around 8pm and her sister and another friend set up their plastic mats and a few blankets outside on the courtyard under the trees to stay the night and watch over Miriama if anything was needed. Here, if you need a new medicine, they call out to your waiting family member and give them a piece of paper with the medicine name written on it. You go to the pharmacy yourself and buy this medicine and then return with it to the ward where they will administer it. So you dare not be left without a support person standing by.

The next day just after noon I arrived back at the maternity ward to spell off her sister so she could go home and shower and rest and change while I was on call as Miriama’s support person.

I sat outside under the trees in the courtyard with a group of other Tuareg women who were there visiting other people. 2 other women from the Tuareg community were also in this same hospital at the time. It was actually a good time of visiting, practicing language, asking questions, watching culture and just being with them. But the place we were sitting did not feel like any other waiting room I had ever been in.

There were dozens of little groups of women scattered around a treed courtyard, with their bright plastic mats set up on the dirt and their little pails of food, water, clothing, etc beside them. The mosquitos circled overheard and at least 4-5 different languages could be heard. Because the majority of them were fasting you heard the constant noise of spitting as they would not even swallow their saliva and many were lethargic and lounging and waiting for news, or pharmacy calls, for their loved ones. If you don’t get your name called to come and get information, don’t even bother trying to get it yourself. Not only are there armed military guards at the door who are quite serious about their job of keeping you out, the nurses were quite abrupt and kept telling me I just had to wait for the doctor and they didn’t know anything. I know medical care is very different in this culture and I found it hard to accept that the family was not involved in their care and there was no information available.

Sitting with the groups of women in the “waiting courtyard”



The second day Ella came with me as I am still a nursing Mama and can’t be away for that long! All the ladies loved her and she went from person to person and smiled and cooed at them all.


While I was waiting and chatting, Miriama’s name was called (thus actually calling her support person- me). I went and saw Miriama and she said the medicine did not work and they were going to go do a c-section. Right now. And here was the list of stuff I needed to go buy from the pharmacy! So I ran and bought the items, gave them to Miriama along with her “clean delivery items” and walked with her to the operating room. At the door I asked the attendant if I could come in with her. I hoped, but knew it likely would not be allowed. Sure enough, No. ( Another teammate was also there who would have taken Ella for a while so I had hoped to go in). I held her hand, with fear in my heart that something could go wrong and quickly prayed with her. She looked scared but also resigned. She walked in and I had to go sit back down with the ladies. They called me a few other times over the next few hours. Once to take a bag with all her clothes in it. Another time to bring the yards of clean cloth we had ready for her. Another time to go buy a clean razor to cut the cord and then one more time to bring a diaper and first outfit for the baby. By this time Miriama’s sister and other friend were also there and we sat anxiously awaiting the news. Finally the one nurse told us it was over, it was a GIRL and that despite being a preemie, she weighed 2.45 kilos and had good lung function! (Okay she didn’t actually offer all that information but I sure asked!) Praise God!! She did not even need to be put into an incubator! We were so relieved after hours of not knowing what was happening, being told they were “working on” the baby and feeling helpless.

We waited more hours to see how things went. As dusk came and the official “fasting day” was over, I saw all the women in the courtyard prepare. About 30 minutes before they could eat or drink the tea pots and charcoal cookers came out. The pungent smell of burning charcoal and bitter tea filled the air. Many women mixed a sweet drink made of yogurt, sugar and millet flour to be drunk right when they broke the fast. When the time came, you could hear the mosques around the city calling it out on the loud speakers. Women around me raised their hands to praise Allah and then they picked up their drinks and drank deeply and enjoyed liquids for a while. Then they went and did their ritual washings and would lay down mats right wherever they found an empty spot and do their prayers. Then they came back to their mats and meals were pulled out of buckets and everyone ate together. This evening a couple of my previous NVOC student girls happened to be there as well visiting family members and it was a sweet time to visit with them and their families under the trees and dim bulbs with the aroma of all kinds of food being cooked all around us. As dusk fell the women who were staying the night pulled out mosquito nets and hung them from trees and rods or walls and put blankets out on their mats and settled in.

We did not see the baby that day. I left to go home in the evening. I saw Miriama only through the window of the recovery room where she told me she was okay and that she knew it was a girl. She did not see her own baby that day either.

The next day we returned bright and early to the Maternity. This time Arielle and Ella both came with me, as well as a couple of teammates. I was told by her sister that Miriama had seen the baby but she was not with her yet. No one else was allowed to see the baby until the baby was with the Mother. There were more armed military at the doors to the “Neonatal” wing. This is likely in response to the recent arrests over baby stealing and baby selling that had been happening in the country and NO ONE was getting through those doors. We had more hours of sitting outside with the Tuareg families and visiting their loved ones as well.


We were told in the afternoon that she was ready to be moved to her own room, and that they would then bring the baby to her. Of course 20 minutes turned into 2 hours. We got Miriama her own room. It was $40 for a private room for the entire 4 or so days they expected her to be there. With a half functioning air conditioner, no meals and no medication included in the price. Still- quite the deal I snapped up!!

While waiting for Miriama to arrive, we sat on a mat in her room and waited for her. Apparently very culturally appropriate although I am not sure I would want a waiting party if it had been me to just have a c-section and not even be reunited with my baby yet!!


Miriama was finally wheeled in and we rejoiced with her, but were also told it would be several more hours until they would bring the baby as they were still “working on her”. I hate those words. Miriama said she had seen the baby in the night and that so far in the 24 hours or so she had been able to nurse and see her twice. Heartbreaking. The time came and I had to go home, still not seeing the baby!

Of course I returned the next day again and this time our precious little girl was finally there with her Mom. They had brought her in late the night before and of she course kept Miriama and her sister and friend up all night, but i am thankful in this culture you are never alone and always have a support person or two with you. Miriama’s mother came while I was there and met her first grandchild for the first time. Precious moments.

Miriama’s mother (second from right) meeting her Granddaughter


This precious little girl, who was 4 weeks preemie, looked so healthy, with only minor jaundice, that I praised God for His protection of this little family I love. How beautiful she was!


Momma and her baby



Ella doing a “safety check” on the new mosquito dome bed for the baby


We visited again the next few days and were encouraged to see the baby doing so well and that nursing had started. We talked about names for the little girl. The name is not announced publically until the baby “bapteme” (akin to a dedication ceremony and party) a week after the birth. Stayed tuned for another blog about the dedication party and baby name!



All of a sudden my own baby girl, who is lightweight at only 3rd percentile for her age, looks like a giant compared to this new baby!!


We are so thankful that Miriama and her baby girl made it through this surprise early birth and c-section so well. Hallelujah! I am also feeling so blessed to be called on in this time to be her support person, to be present and go through all of this by her side. Blessed indeed. Thanks for your continued prayers for Miriama and her baby!


Pamela said...

Chantelle, thank you for sharing Miriama's story and all the pictures. I was praying along with all of you as the situation unfolded, so it's wonderful to see a happy mama and beautiful baby at the end!!!

I look forward to reading "part 2" about the baby naming, etc. and will continue to keep Miriama and her daughter and all her loved ones in my prayers. Love to you and the family!


Di said...

My heart is so full. Thank you for sharing, the details, ups and downs. Precious in his sight, and in our hearts. Hugs to all.

Miriam said...

I just read the entire blog!! Cried my way through it, for some reason. Perhaps it is because it is so beautiful, in some ways so sad, but in all ways a great blessing. Thanks for sharing in such detail!