- Manolos Aviation
Medical evacuations (MedEvacs) in Papua New Guinea, and especially of pregnant women is unpredictable, such was a recent medivac of a mother near Dinangat Airstrip, in the Yus local level government of Kabwum, Morobe Province.
Saturday 06th of March 2021 was dull weather to fly, but despite that, Manolos pilot Capt. Eduan and medevac midwife Joycelyn were tasked to evacuate a mother in labour. The mother successfully delivered a breech presentation, and was said to experience retained second twin.
Retained second twin is a common child-birth difficulty, especially amongst the rural unbooked mothers. Unbooked mothers are those that have never gone for antenatal clinics, not even once. With little detail of the position of the fetus’, Tommy, the CHW at Dinangat had luck delivering the first baby.
“The mother is having twins, but the fetus’ are lying transversely,” Tommy told Joycelyn on the phone just before the medevac.
Tommy: “Mi helpim mama karim first pikinini nau moning, tasol het ino kam aut pas, ass bilong pikinini i kam out pas. Mama i mas go long bikpela haus sik nau yet, nogut namba tu baby or mama yet i dai.”
This was an emergency, and a medivac flight to be done urgently!
Joycelyn recalls the helicopter landing on a clearing at the tip of a hill:
“It was a really difficult medivac for us. We landed three times at Dinangat Airstrip, just to locate the exact village, where we can pick up the mother,” Joycelyn said.
“Initially, we got the wrong information and landed at the Airstrip. The people at the Airstrip notified us that the mother is at the next mountain top. We were fortunate that a guide hopped onboard and showed us the location.”
“The people made a clearing for the helicopter to land. The locals said it was Tumunang Village, but I didn’t have time to verify the village name,” Joycelyn said.
“On each side of the helicopter and even the back is dangerous to walk because of the cliff, in front of the helicopter is the road leading to the hausmeri. There was a hamlet, and a river at the bottom of the cliff.”
“It was right at the mother’s house that we landed. Well it was a ‘hausline’, like many Papua New Guinean’s would refer to. There are no roads or permanent houses, just green scenery with mountaintops meeting the blue-sky,” Joycelyn said.
She said the mother had just given birth, still having labour pains, and she was carried on a makeshift stretcher towards the helicopter.
“There is nothing much the CHW could say. The sound of helicopter blades echoing, people standing, watching every move we make. We just quickly transferred the mother on to the helicopter stretcher.”
“As soon as we safely got the mother inside the helicopter, we took off for Lae,” she said.
“While stabilising the mother, first I noticed the IV drip needle inserted in her hand; it was fastened with a ‘bushrope’. I quickly removed the ‘bushrope’ and used a plaster and a dressing tape, and then I changed the IV drip,” Joycelyn recalls.
Capt. Eduan made the 30 minutes back to Lae. In bad weather, a health worker is limited to what they can do to support the patient inside the helicopter.
During the flight, Joycelyn asked the mother if there is any fetal movement; the mother gave a positive nod.
“I observed, the mother’s tummy was still too large. Through palpation, I could feel two protrusions on each side of the mother’s belly,” Joycelyn said.
The mother was eventually brought to Angau Hospital labour ward to get assistance. The guardian and the first baby were also with the mother.
On Sunday March 07th, Joycelyn went back to check on the family she left at the Labour ward the other day, but they could not be located. After unsuccessful attempts to locate the mother, she left Angau worryingly. She then told of her quest to standby nurse Naomi. Naomi made some calls to a few friends at Angau, and thankfully, they confirmed the babies were at the nursery.
On Monday 08th of March 2021, Naomi made the follow-up to the nursery. To her surprise, she learnt that the mother gave birth to two babies on Saturday night. Yes, there were triplets!
Their birth-weights were the only concern keeping all three of them at the special care nursery at Angau Hospital. Naomi noted, baby 1 (female) weighed 1.75kg, baby 2 (male) weighed 2.10kg and baby 3 (male) weighed 1.6kg.
Naomi said all four family members have recovered well. The breastfed triplets were given a few more days to at least gain weight above 2.5kg, before they can leave.
Due to the Covid-19 surge in Lae and Angau Staff being infected, Naomi couldn’t get a hold of the mother and her guardian. But she was later told; the father came from the village and took them out of Angau, in fear of Covid-19.
Whatever the reasons for incomplete treatment, the reality is that there are many unbooked pregnant women in rural PNG. It is time we educate and raise awareness to our rural folks that our mothers and sisters need to go for antenatal clinics when they are pregnant. On the other hand, the non-rehabilitation and closure of deteriorating rural health facilities, such as Aidposts and health centres, are realities we need to consider when addressing this issue.