First and last moments of life in Elissa’s arms

Elissa Shelton writes from Uganda…

I didn’t know I would encounter one of Uganda’s ugly faces today.

The day dawned as another, 72 degrees and breezy with a high chance of mosquito
bites. Our 45 minute commute from Mbale to Bugobero was not any different than any other morning, racing past boda-bodas and flying around pot holes. We pulled up to the hospital where there were approximately 200 patients waiting and got straight to work. We checked for medicine stock, put on our gloves and assembled triage equipment.

There was a 16 year old mother having contractions that took precedence. She had hidden her pregnancy from her mother and father because she was a student. She will be getting her certificate of education this year. The father was a student as well and was not happy about the pregnancy. Her mother was furious and it showed. We do not know her HIV status but she appeared to be seven months gestation according to our calculations and her pain was severe. We got the family settled into the maternity ward and I had just sat down with the first malaria baby on my lap, preparing to administer Quinine treatment when Nurse Nina ran into the room saying that Nurse Hijit needed me to come immediately to assess the mother and child. It had been less than 10 minutes and I had missed the birth?! I sprinted to the ward and the faces that greeted me were grim.

Upon inquiry I found that the mother was physically stable. I approached the baby and was struck by how small he was – no more than five pounds. His head was cone shaped and his lips and eyes were puffy and discolored. I leaned over him and he gasped for air, like a fish out of water, I thought to myself. He was struggling, and again I felt completely and utterly helpless. I wondered if we had an endotracheal tube to insert and if we had a vent to sustain his pulmonary status. Did we have an incubator? He needed to be kept warm and I needed to breathe for him! I needed all the supplies I’m used to having at my fingertips.

His heart was beating strong but he wasn’t breathing. I was frozen with fear thinking in my heart that he wasn’t going to make it. Mbale is an hour-long drive and as I inquired about their equipment, I learned they didn’t have it. I was aware that his fate was sealed. He wasn’t fully developed and needed 24 hour support. I held him as he fought for his life. I thought about the song “God shows grace like rain” and it offered some solace.

Nina whispered in my ear, “His mother doesn’t want him.”

Fighting back tears, I looked around the room at all the faces and I felt the oppression and resignation. I gazed at the baby (“Paul”, as I’ve named him in my head) and I see his translucent skin, his miniscule fingers and toes, his head full of black hair and his tiny heart beating against his perfect little rib cage. I noted how his feet were mottling and he was becoming cold to the touch and I said aloud, “I know someone who would have loved and cherished you.” (Yes, Leah, you…)

I realized the mother probably needed to see Paul. I took him and lay him on her chest. She didn’t look at or touch him. I waited a few minutes, picked him up and checked for a heartbeat again. It was still beating, yet he only attempted two breaths in the previous five minutes.

While I clutched him, Hijit told me that they suspect it was a forced abortion because of the bruising to the baby’s extremities and the family’s response to questioning. I can’t understand and I’m not going to pretend to. I know it’s different here – I’m very aware of that. I’m also aware that God’s plan is perfect. I clung to Paul even more. His tiny heart still beating, I sat with him close to my heart and hummed softly to him. “He shelters us in peaceful love… Spirit, move through me and embrace him…” And I waited with him.

He died there in my arms with my breath on his cheek and the sun warming our faces.

I had to find the strength to get up and bring Paul to his mother so they could properly bury him. It’s tradition, after all. I lay him down and prayed for her with my hand resting on her arm and Paul’s chest. As I turned to go, I realized her father was standing at the foot of her bed whispering his prayers for his child with his eyes clenched shut.

In my head I hear God whisper to me, “Forgive her, for she does not know what she has done,” and peace filled my heart. Tomorrow will still come and we have more work to do in Bugobero. There are many more “Pauls” that need our love.

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