Tangulbei is a small and almost unknown town, in the far North West of Kenya, with a formal population of 4,979. However, it lies in the heart of the territory of the semi-nomadic Pokot people, who number almost 150,000.
There has been a constant state of war and peace between the tribes in the region for over 1000 years.
The Pokot way of life is a simple one and it hasn’t changes in centuries. Unfortunately, this means that ‘the old ways’, of pagan traditions such as female genital mutilation, child marriage, polygamy, and families of 18 or more children, are still very much the way of life; women are treated like children and certainly not as equals.
The Pokot women traditionally give birth at home, but this brings with it enormous risks if there is even a minor complication, when the nearest maternity hospital is 124km away, over rough and often impassable roads in the rainy season.
As a result, infant and or mother mortality is twice the national average of Kenya. This in main is because the mother is brought to the facility as a last resort and it is often already too late because of the lack of a specialized maternity theatre.
Thanks to the generous support and tireless efforts of the Order of Malta Companions of Kenya, it was possible to build a maternity ward at the Catholic Mission hospital in TANGULBEI.
The original idea of building a maternity theatre in such a remote part of Kenya came from The Apostolic Nuncio to Kenya, His Excellency Archbishop Hubertus Matheus Maria van Megen.
We have just received the reports of our first three emergency deliveries from the Mission Hospital Administrator Fr. Timothy Mutie C. S. Sp.
I am writing to inform you that the Theatre which the Order of Malta Companions of Kenya built and contributed immensely to equipping, has continued to fulfil its intended purpose of providing surgery to mothers with difficulties in giving birth using the normal way. So far we have had three successful Caesarean Sections in the Hospital.
The first and pioneer birth was received at the Hospital on the early hours of 17th July, 2023, at around 2am East African Time. A 16 year old lady who hails from Churo, was brought to the Hospital by her aunt and who presented with a history of convulsions, headache and limb swelling at 38 weeks of pregnancy (Her first pregnancy). Hers was an emergency because in addition to being expectant, she also had elevated Blood Pressures (BPs) of 230/ 150 mm/Hg (normal BP ranges:120/80 mm/Hg) and a pulse rate of 88 Beats per Minute (Normal). After thorough examination by the doctor, a proper diagnosis of Eclampsia was made and to lower the high Blood Pressures, she was administered with some drugs to prevent further convulsions. Subsequently, a decision to perform an Emergency Caesarean section was made after which Pre- operative preparation was done which included: Informed Consent from the husband which delayed pushing the operation to around 5 in the morning (AM), Laboratory Investigations like testing for Haemoglobin levels (HB), Pre-operative antibiotic prophylaxis , Anaesthetic Review, among others. There was also a bit of a delay of about one hour due to the reluctancy of the guardian (her Aunt), who was being advised by her fellow women against going for the procedure because her daughter was the first case to be operated in the theatre. However, in the long run she accepted, and the procedure was done successfully under General Anaesthesia. The outcome of this Caesarean Section was, a live male neonate, weighing 2.9 kgs with an Apgar Score of 9¹10⁵10¹⁰ (very good). For further management the lady with her baby were retained in the Hospital for subsequent days and her treatment included administration of antibiotics and anti-hypertensives, serial monitoring of Vitals and Laboratory Investigations. The mother and baby were happily discharged 5 days later with both in a stable condition.
The second birth was on 18th July, 2023 and was for a 26 year old lady who was on her 4th Pregnancy, but unfortunately, with no living child. Previously she had had 2 miscarriages (1st and 2nd pregnancies) and 1 stillbirth (3rd pregnancy) and with this history her case was handled with a lot of love and care to help her to take home a baby, having lost three babies in the past.
She was presented to our facility in active labour. Monitoring of the progress of labour was done for 5 hours but delivery via Spontaneous Vertex delivery wasn't possible owing to poor descent of the foetus down the birth canal, despite full cervical dilation. A diagnosis of Obstructed Labour was made and an Emergency Caesarean Section was done thereafter, successfully. The outcome was a live male neonate, with a Birth Weight of 3.6 kgs, and an Apgar Score of 8¹9⁵10¹⁰. Both the mother and baby stayed in hospital for 3 days post-operatively for observation and monitoring . They were happily discharged from the Hospital in stable condition.
The case was of a 16-year old female patient who was in her 1st pregnancy. She came in with active labour, meaning she was already having labour pains, but which didn't progress well due to a challenge of a foetal malposition. The doctor felt the only safe way was to take her to the theatre for an operation. An Emergency Caesarean Section was performed under Spinal Anaesthesia, on 07th September, 2023, which was done successfully. Outcome: The outcome was a live male infant, with a Birth Weight of 3.0 kgs, with an Apgar Score of 7¹8⁵9¹⁰. The mother and the child are in the hospital, and both are stable. They have been discharged one day later.
Additional items are being sought, please contact firstname.lastname@example.org if you are
able to help procure these items.
1. An Ultrasound machine for Obstetric Scans
2. there is no blood or blood products. It's a requirement to have these for any caesarean
3. We also need 2 extra caesarean section sets.
4. Staffing – Having an extra qualified nurse to help out during theatre procedures would be
5. Theatre attire…. Scrubs, boots, aprons, Macintosh.
Keep the Faith