Maternal Mortality

It has been a while since I last communicated with you folks back home. All is well here in Papua New Guinea. Tyronza and I have been healthy and enjoying the nice weather in the mountains. We have not had any further natural disasters. The temperature here has been nice with sunny days and rainy nights. My cistern has been full, so regular showers continue to be nice. Hope you are enjoying an early spring. We have only one more month before we start back home.

I believe I have written concerning this before, but it needs to be mentioned again. PNG is such a medically primitive nation that many of their health care statistics are woefully bad! Such is the case when talking about maternal mortality. When I last looked, this sad piece of data was the worst on the planet and it seems to be sinking even further!

During my career of nearly 30 years doing obstetrics in Cape Girardeau, I never experienced a maternal mortality. I would like to believe it was because of something I did right, but maybe I was just lucky, or maybe God was looking out for my patients.

The record here has not been so stellar. The first year I came to PNG there was one death under my care. She arrived on Labor & Delivery following a home delivery with considerable blood loss. She was fully arrested and, unfortunately, so deep in shock, I could not bring her back.

The second year there was three deaths. One had postpartum cardiomyopathy. Unfortunately, there is little that can be done with that diagnosis and death is inevitable, at least in the highlands on PNG. The second patient had taken poison. That, too, was ultimately fatal, although it took 3-4 days. The third patient developed acute hepatic failure and died. We were never sure of the cause and lacked the ability to diagnose or treat the problem.

This year I really was feeling good about the situation, until this past week. The woman’s name was Nancy. She had delivered a live child in a nearby village five hours before she arrived on L&D. She had lost much blood and had a retained placenta. Her hemoglobin on arrival was 3.7 gm, but she seemed stable. However, shortly after I got 2 units of blood going she arrested. We worked on her for 45 minutes, but were not successful. I have been a little depressed over this situation, but really don’t know what else I might have done.

On a positive note, a family member is adopting the child. She has come in and is being given ”Lactogen/Lamictal” to start lactation.

You folks stay healthy. Looking forward to seeing you soon.

God Bless You,

Dr. P & Tyronza