Mobile Clinic to Kikio. A remote location on an hour's drive. We have just departed and the midwives get there scarves above their heads and tie them around. Too much dust blown up. Their braided hair cannot be washed and is due to be maintained for a couple of weeks, that is the reason why. Suddenly Veneranda starts: ‘Let us pray…’ and a why rosary follows. I quickly understand why. For a successful day and a safe return home! The ride is really off road. Steep hills, slobbery winding roads. With desolate moments. Dry but beautiful, many baobabs. We get the store hut for maize at our disposal. (Ugali, a porridge of maize flour is basic food here.)

In the beginning, there are only a few mothers seen, they come dropwise and, without exception, they get a good scolding from the midwives. ‘They just have to leave their homes earlier, because this way, our schedule is slowed down, and it will get very hot here and we are tired after all’. Hum. Some hundred pot bellies go through our hands again. A pregnant woman, almost at the end of her pregnancy, accompanies us to the hospital. Her blood pressure is much too high; there is a risk of preeclampsia. The delivery is going to be initiated in order to avoid other problems. In the hospital, we are all concerned about Pilli. A month ago, she gave birth to beautiful twins via a Caesarean section. Her general condition is bad and does not improve. It is considered to be a heart problem. Her children cry from hunger. Her breast feeding declines. Should we then better prepare the artificial feeding we have brought along? I show how to prepare it and how to give them cup feeding. Starved, the babies have a go at it.

Wednesday 24th November

We get another two premature infants. 1200 grams, 28 weeks and 1000 grams, 24 weeks. They are very small, born much too early and they have only little chance to survive. However, an attempt is made. Now, the lesson taught in reanimation becomes practical, a good exercise. The babies of Sabrina and Angelina must make way in the incubator. Then it is better for them to be on their mothers' comfortably warm skins. All the caring mothers, beautiful to see. In the evening, we are called to a non-demanding work concerning a twin pregnancy. The mother is exhausted. Eise carries out a Caesarean section and I may assist. A nice and educational experience. The mother is very happy with her two boys and throws us a kiss when we congratulate her. Moving.

Thursday 25th November.

PPH or postpartum haemorrhage. It is knocked at the door for advice. When taking a closer look, we discover a cervical tear and this is sutured in the operation quarter. This woman is lucky; she does not lose too much blood. It is better not to think about the consequences should something like this happen in a home situation. Bleeding is responsible for 25% of maternal mortality! The message must be to act appropriately and quickly. Total volume and rate of infusion, litre per 24 hours, ml per hour, drops per minute, calculating sums and stress risks. In the paediatric department, I give a hands-on lesson on the usage of an infusion pump. Great interest. And now let's hope that there are not too many electricity outages. The load of hugs gets its destination.

Smiles everywhere.:-)