I Heard Their Cry

It was a hot, muggy afternoon and thirty people were waiting patiently outside the clinic for my attention. An hour earlier a young woman and man stood outside the clinic. While I was trying to finish reading and math classes for Tad and Ken, Tad informed me there were sick patients waiting for me at the clinic. So I quickly finished the classes and we had recess.

As I neared the clinic I heard the young woman moaning with pain. She had a very swollen leg. I took her in to the clinic and began the usual process of taking a verbal history: “Your name? Your age? What village are you from? What is wrong and how did that happen?”

The young girl, Celia, who was seventeen years old and from a village seven miles away, had walked in. The two were not married but lived together. Three days ago her leg began to swell, but she had not injured it. I performed a physical exam and found she had a fever of 103° orally. Her right leg was swollen from the hip to the ankle and it felt warm. There was no obvious injury or localized infection. I focused on the assessment of the leg and my diagnosis was cellulitis of the whole leg. As my usual custom, I prayed with the couple and asked God for wisdom and healing for the girl.

I decided antibiotic therapy was indicated for the obvious infection. I prepared and administered an adult dose of Penicillin and I prepared a packet of antibiotics for her to take at home. As I was doing that, I noticed Celia groaning and holding her abdomen.

“What is it?” I asked.

“I am pregnant,” she stated.

“Pregnant!?” I asked since she did not look pregnant at all. “How many months pregnant are you?” I asked.

“Seven months,” she told me.

So I proceeded to examine her abdomen. ‘Sure enough! She is pregnant!’ I exclaimed to myself. ‘Oh my goodness,’ I thought. As I watched her for fifteen minutes I realized she was having labor pains. ‘We can’t have a delivery of a seven-month-gestation baby here in my rustic clinic. We’re way out here away from any help. We’ll have a dead infant on our hands! Please God, help me! What should I do?’ I felt desperate for some help. Ray had left earlier in the day to run errands in Morales using our pickup.

My desire was to get this girl to the nearest hospital and doctor which was three hours away (if the ferry was running).

“Miguel, I want you to walk out to Seja and get someone to come in a vehicle to take you and Celia to the hospital,” I ordered. “Go on quickly, please hurry!”

Miguel, her common-law husband, reluctantly obeyed and walked out of El Florido toward Seja. Celia’s contractions began in earnest.

‘What could I give her to calm the labor?’ I asked myself. I had stocked the clinic medicine supply with a pretty good variety of medicine to treat the anticipated medical needs. But at that moment I knew that I did not have anything to purposely slow down labor.

‘Oh I know a little bit of phenobarbital could help her relax,’ I reasoned to myself as I prepared a small injection of it. “Now relax, I have a little injection to help you,” I stated out loud.

“Okay,” she groaned.

And I administered it. “Now just relax,” I calmly said over and over to her. I kept one eye on the clock and the other on the road into the village hoping Miguel was coming with a vehicle. Suddenly Celia gave out a cry and her contractions began strong every five minutes and lasting thirty seconds. I knew she was in real labor and it was going to happen before I could ever get her to a hospital.

“Gloria, come here to help me,” I calmly called over the small intercom between the clinic and the house.

“No, Doña Virginia, I can’t,” she replied.

“Gloria, come down now. I need you to help me.” I knew she was my only hope for help.

“No, Doña Virginia, I get sick in things like that,” she responded.

She knew very well what was going on in the clinic because Celia was calling out, “Help me, help me, I’m going to die!”

“No, you are not going to die. Take another breath,” I calmly told her.

Then in her panic she again called, “Help me! I’m going to die!”

“No, you are not going to die,” I reassuringly told her. “Gloria, come now, you have to help me,” I demanded. Then I saw Gloria reluctantly step through our front door and slowly walk across the road to the clinic. ‘Oh thank you, Lord, she is going to help me,’ I whispered to the Lord. She walked directly to the door since the entire crowd waiting for medical attention had left. Gloria stuck her head inside the clinic door. “Look, please bring me the empty shoe box that is on the chest inside the house. Also, put a clean baby blanket inside the box and bring it here,” I instructed.

She left to do as I asked and she returned within six minutes with the box and blanket. “Gloria, this girl is going to have a tiny baby in a few minutes and we will put it in this box. Now once it’s born I want you to hold the box and gently blow into its face,” I explained.

“Okay,” she agreed, relieved that was all I was going to ask of her.

The labor progressed. I coaxed Celia how to breathe and then relax until the next contraction. I was concentrating my full attention on the birth process. I had completely forgotten about Miguel.

I donned my sterile gloves and put gloves on Gloria. With the next contraction, the water broke and two little FEET appeared. ‘Oh no, this is a footling presentation on top of everything else!’ I then told myself, ‘I have been preparing for this type of birth over the past two weeks [because of another expectant mother]. I know exactly how to handle this.’ Very gently I grasped the tiny baby’s body and guided it out and into my hand. His legs and feet lay three inches past my wrist.

Suddenly he took a weak breath and began crying a very small cry.

“He’s alive!” I exclaimed out loud, amazed at that tiny body that was breathing weakly, crying and moving a little bit. I tied his umbilical cord with the sterilized string and cut the cord with the sterilized scissors. I then laid the little baby in the box and Gloria took over very gently blowing into his face. His cries got stronger and soon he breathed steadily.