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Field visit – Jahun #Part Ι

Jahun, Nigeria - December 2016 – Vesico vaginal fistula and emergency obstetric programme at Jahun general hospital in Jigawa State. ©Maro Verli/MSF

They call it ‘Jahun paradise’ and I never got why and how this started until my recent last visit. Jahun is a city in the northern Nigeria where MSF runs a maternity, neonatal and an obstetric fistula unit at the Ministry of Health General Hospital. Yes, I know… I also didn’t understand when I arrived what are all these and why MSF needs to intervene. It’s not an emergency situation! Well… let’s see.

#Story 1

My first visit was in December 2017. We arrived by car after travelling almost 8 hours.

‘Welcome to Jahun Paradise!’ said Ed, the Project coordinator. Let me get you around the hospital. Maternity unit, neonatal, blood bank, fistula and the place for the caretakers…

‘What do you mean?’ I asked.

 

Here are Muslims with a patriarchal social system. Women arrive at the hospital and with the approval of their husbands or of their families and sometimes they need to stay in the hospital for long due to several complications. Usually, the husband doesn’t stay with them all these days. And they arrive from far; sometimes it takes 5 hours to get here. So we need to provide a place for the caretakers, usually, their mother, their sister or any woman from the village community. Caretakers are in an open area under the shadow of one of the few trees in the hospital. Some of them are with their babies and only a few men are around.

A few minutes later the nurse is calling me.

‘We will start the delivery soon’, she says.

In the maternity ward, women are prepared and checked by the doctors for the childbirth. Young women, most of them under the age of 18, with big bellies are waiting for their turn. At the end of the unit is the room for the deliveries. One woman is lying on the bed waiting for the doctor patiently to start the process.

‘Push… breath and push’ the doctor says and the Nigerian nurse makes the translation though it seems that the mother has already understood what she needs to do. The doctor says something. Another nurse is bringing more tools.

‘We are not sure if we can save the baby’, he informs me.

What…? Why? What’s wrong? But it’s not the right moment to make questions.

Two doctors are trying to use the ventouse method with the vacuum device. They are trying, again and again, the device seems to be dysfunctional, they try with another one, another nurse is speaking with the mother, and the mother is on the bed in silence. Only her face expressions reveal her pain. After almost 20 minutes the baby is coming into the world facing the first light. A nurse is taking care of the baby, the doctors are smiling and the mother is in that bed… still in silence. After only a few minutes she is getting up, she is wrapping around her African fabric and she is moving to the next room.

 

No. Here there is no nurse to announce the gender of the child to the happy father. Probably the husband has already some more children and maybe more than one wife.

No. Here there is no screaming from the maternity ward. Women here have learned not to express their pain.

No. Here there are no blue and pink balloons. Here the priority is to have medicines, equipment and free and available beds.

The placenta is in a basket on the floor and, parents need to bury it soon according to the local tradition.

If there are no complications for the baby and for the mother, they will move to the annex. It’s the busiest ward in the hospital. There are two or three women in each bed, with their babies.

The following day the doctor informs that they are preparing for a Caesarean section. I follow all the hygiene process, I wear the particular uniform and I am sitting in the corner of the surgery room to take the pictures during the surgery.

Oh my God! It took only a few minutes and it took me days to get over the shock.

The first thing I did is to call my parents ‘Forget it! This will never happen!’

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