I set up a cell saver and autotransfuseur kit that I found in the back stockroom covered in rat poop. Fortunately, the heavy plastic sealing it's sterility was intact. Simeon searches for a second IV. We give her a spinal anesthetic. The scalpel quickly reveals dark, uncoagulated blood that we suction into the cell saver to give back to the girl later. I scoop out mounds and handfuls of placenta and blood clots finally isolating her right adnexa which I remove between stick ties. I leave in a drain and we start the autotransfusion as well as a bag of O+ blood from the little fridge that serves as our blood bank.
It's now a little after 6 AM. By 6:30AM Ndilbe, one of our nursing students, and I are on the road in the old Hiace mini-bus affectionately known as "scalded dog." I'd just brought it back through a round about road through the bush that was really bumpy but had no water. The main road is still covered with water where the hippos hang out and so people and motorcycles are ferried along the road in dugout canoes. Needless to say, "Scalded Dog" doesn't want to go there. Last night, someone told me of a shorter route that is passable as well. I try to find it. Right after the bridge I turn left at the flag pole and wind through the village until coming to a Y in the road. I'd come from the left last week so I assume the right one is the short cut.
This road is not only shorter, but it's flat, packed sand and we're able to make good time until I come to a 30 foot section of mud. I make a bad decision. I go right and am soon stuck and spinning deeper and deeper in despite four wheel drive. The right front wheel is deep in some watery, slippery clay mud lifting the back left tire up onto some other slippery mud taking the weight off it so neither of the two that are spinning are getting any traction. Ndilbe and I get down and get dirty. We shove sticks underneath, try and scoop out mud. try going forward and try going back. We're in the deep bush and don't see anyone around.
We try our futile efforts for 10 more minutes until we spot an old man coming out of the bush on the road and heading away from us. We call him back and he waddles slowly over. Meanwhile, a middle age, stocky man comes up from nowhere headed to his field with his throwing knife hanging casually over his shoulder. He dives right in and starts hacking away the earth that has stopped up under the axle. He is soon covered with the gray, slimy mess. Before we know it we are surrounded by 10 stout farmers who all just get busy. We push, we lift, we dig, we stuff things under the tires. Finally, we lift the entire care up and stuff branches under the right front tire. Then I put it in 4-wheel low. The same thing starts, just spinning. Then I turn the wheel a little left and with a big push from everyone behind it starts to get traction and then inches slowly out of the mud and onto solid sand.
I think them profusely and hand them two 2000 franc notes to split amongst themselves. They wave good bye and we're on our way.
Just think, if I the woman hadn't of showed up just right before I was going to leave, she probably would've died and as a bonus, our leaving late allowed us to get stuck just in time for the farmers to be on the road heading to their fields! I drive on through the tall grasses and narrow tire ruts in the sand with a silly smirk on my face as I reach into the plastic pail and pull out a square of watermelon.