Caring for babies in Pakistan
Volunteering with MSF has been surprising and rewarding for paediatrician Aoibhinn Walsh
Moving to Timergara in northern Pakistan is definitely the biggest culture shock I’ve ever experienced. As a young woman who lives away from my family and used to doing my own thing, it’s an adjustment to live in a society where I must be completely covered—with only my eyes showing—when I’m outside of our house and the Médecins Sans Frontières/Doctors Without Borders (MSF) office.
Even though it’s worlds away from what I’m used to, I have to remember it’s just as normal for these people as it is for me to wear jeans and a t-shirt. It has led to some funny situations, most often when I am examining a baby in the emergency room but can’t find my ears under all the layers to use my stethoscope.
I happily spend most of my time outside the house in the mother and child health unit, run and staffed by MSF, where men are not permitted. As soon as we’re in the door all scarves, face covers and burquas are removed and suddenly the atmosphere is like any other hospital I have worked in with chatting, laughter and gossip.
The women I work with are amazed I have had a boyfriend for four years and am not yet engaged or married. I have had plenty of well-intentioned but concerned warnings he might escape if I don’t tie the knot.
The walls of our house are very high, but we can see the peaks of the mountains that run along the border with Afghanistan about 30km away, and it’s absolutely beautiful, especially when the sun sets. So far, my favourite part of the local scenery (glimpsed through our scarves on our brief drives to and from the hospital) are the goats wearing coats in the cold, rainy winter season.
As for the main reason I’m here: the babies. There have already been 27 babies admitted to the neonatal unit and most of them, thankfully, have been discharged home very well, but one little baby who has been there from the very first day has touched my heart. Sometimes you just fall for these little ones.
I have nicknamed him “Baby Chinda” (chinda means frog in Pashto) due to his uncanny resemblance to the animal. Even his mother now calls him Frog – I think it has stuck. He was born at 11pm the night the ward opened.
I was called to see a premature baby: 28 weeks old, weighing 1.2 kg. He had been delivered feet first, was bruised to above his hips, had two black eyes, and a little wrinkled, shriveled face, but he screamed and roared and demanded to live. We had a long talk with his mother and grandmother, saying he was very small, very early and that we would support him as best we could, but if he deteriorated, we would have to let him go. They understood and agreed.
Seven days later he was fabulous: breastfeeding every two hours, off all fluids and oxygen, had finished his antibiotics and was only happy when being cuddled in somebody’s arms. We were all thrilled—he was gaining weight and looked to be heading home soon. Then one morning he stopped breathing. I couldn’t choose not to resuscitate him; it would have broken my heart. We used a bag and mask for five minutes and got him back, but he really didn’t look great.
His mother was devastated. She had lost one son in an accident at 11 years of age, and I think seeing this one being treated brought back memories. We started antibiotics, put him back on oxygen and stopped his feeds. We told his mother we weren’t sure what would happen, but would give him 24 hours to see. We sent her home to shower, sleep and spend time with her family, with a promise to call if anything changed.
He slept, lethargic and quiet—not something I like to see in a baby—and by the next day I had made up my mind to let him go after talking with his mother. I think he heard me discussing this with the nurse, however, because he opened his mouth and roared. I was surprised how happy and relieved I was. I normally don’t get this attached to these babies—there are just so many—but this little one’s wrinkled, old man face, and sheer determination to live have completely stolen my heart.
He is still an inpatient and we’re taking things very slowly, but he is doing well. Every day his mother brings him a new knitted top from the bazaar. It’s always too big but we wrap him up neatly in it and now he is the most stylish, and probably most loved, little frog in Timergara.
Dr Aoibhinn Walsh is a paediatrician from Dublin. She is currently on assignment with Médecins Sans Frontières/Doctors Without Borders (MSF) in Pakistan. For more, see msf.ie/irish_volunteers