By Nkono Yeeko
Kampala: It’s a well-built and facilitated storeyed national hospital specializing in women and newborn babies. As you enter its gates, you get a feeling of safety. The hospital is clean, dustless and free of any unbecoming scent. It’s under 24 hour CCTV surveillance. Their Neonatal Intensive Care Unit (NICU) is one of the best places to be for an pre-term baby for it has all needed to support life at that stage.
Our nasty experience began when we had our third daughter. She was born prematurely and we spent 14 days in MSWNH. It wasn’t the best experience with then. Nevertheless, we kept quiet because we saw our baby get better everyday. We chose to bear every unbecoming ordeal.
And we got her out alive. Previously, the worst experience was the NICU cleaner who would stop us and other parents from going to feed their pre-term babies every time she was cleaning. Only those who have been there know the pain of being refused to take breast milk to a pre-term baby by some insensitive cleaner.
This time, it was a nastier experience. On Thursday 28th September, 2023, we rushed to the emergency ward of MSWNH. My wife was having an abrupt little bleeding. The sister at the emergency ward rushed to find my wife; Grace’s file using the card I handed her. She handed it over to the doctors who were sitting in their room. We waited for sometime and no one was calling us in.
They were updating their files. My Grace kept telling me to go and inform them to attend to us. I did so twice and they were promising to let us in. On the third try, we were finally attended to. During that time, I kept wondering whether the doctors at the emergency ward understand the meaning of the term “emergency”.
They recommended for a scan, which I paid for, and we did right away. The scan results showed that everything was normal and there was nothing to worry about. However, my Grace was admitted because they realized she was having contractions prematurely. A few hours later, the condition normalized.
Two days later, the doctor recommended to have my Grace undergo an emergency C-section operation. On Saturday 30th September, 2023, my Grace was operated at around 3:00pm.
During the operation, my Grace was conscious and she heard the whole communication of the doctor who operated her and his assistants. The child’s hand popped out first during the operation. The doctor instructed his assistant to push the hand back, which she did. On getting out the baby, it was a boy. His right hand which they pushed back was red and the redness stretched up to the whole shoulder area. In their verbal interaction, the doctor told his assistant that it might be necessary to do an x-ray of the baby’s hand.
However, this recommendation was not captured in the written report. One wonders why? The doctor said it might be “ecchymosis” – a discoloration of the skin resulting from bleeding underneath, typically caused by bruising. One of the common causes of ecchymosis is trauma (e.g. blunt force to the skin, leading to the rupture of capillaries) and it may affect various regions of the body. The ecchymosis therefore might have come from the effect of pushing the baby back.
The baby was shown to my Grace before being taken to the Neonatal Intensive Care Unit (NICU). The assistant requested to talk to the doctor about the child’s hand. The two moved into another room where they spoke from what my wife; Grace never heard. None talked to her about the conclusion they had made. My Grace thought it was just a birthmark since she equally has one on her left palm.
The operation team’s negligence comes out at this point. They knew very well that the baby had been hurt during the process of delivery as the cause of the ecchymosis. However, they took it lightly. The doctor’s recommendation for an x-ray wasn’t captured in writing for the team at the ward to take on the case with the urgency it deserved. Additionally, even when the doctor was present, he was never courteous enough to follow up the case the following day. And that is sheer negligence.
Apart from the redness of the baby’s right arm, the baby was healthy. Even the medical team in the operation theatre scored him 8/10.
That evening, I was let to the incubation machine where my newborn son had been put to receive special care since he had been prematurely born at 7.5 months. Finally, I set my eyes on my son for the first time at around 6:00pm. That whole night, I would go back and check on him every after two hours.
The following day (a Sunday morning), as soon as the doctor on duty saw our baby’s hand, he recommended for an x-ray because he noted that the baby was in pain. He would cry every time that arm was touched. He also took pictures that he sent to his colleagues via whatsapp. And that was great effort and concern.
I paid for the x-ray and took the receipt and x-ray request to the x-ray department. Unfortunately, being a Sunday, it was closed. An old lady staff in a pink blouse advised me to go to silver section where scans are done from. She told me someone there would help me out. I found a lady radiographer who was already overwhelmed. She had three mothers waiting in line yet she also had to leave the scan department and go to NICU for an x-ray of our baby. I told her the doctors at NICU ward had told me to tell her to go for the baby at NICU. She told me she couldn’t go there because it was only her on duty and she had mothers waiting in the line.
As I walked back to NICU, I kept wondering how a full National Referral hospital could have only one radiographer on duty just because it was a Sunday. Ironically, they had 3 cashiers on duty. In other words, they had more staff to receive money from us than the radiographers to offer us the service we had paid for.
On reaching NICU, the doctors looked puzzled at the response of the radiographer. Shortly, one kind sister Nalongo (the most caring staff at NICU), offered to take our son to the x-ray department on the ground floor from the third floor at NICU. She requested me to escort her because she needed my support. She transferred out baby from the oxygen at the incubator to one from a portable cylinder. I pulled the oxygen cylinder ahead of her as she pushed the baby on the bed from behind. We took the lift and finally walked to the door to the x-ray rooms.
Unfortunately, the room was still closed and there was no sign of business that day. The sister (Nalongo) suspected the oxygen in the cylinder our baby was using was soon running out. She had to run and look for another cylinder. As soon as she left, the oxygen ran out as she had suspected. I wished I could shout for help but the place was dead silent. It was only us there. Fortunately the sister (Nalongo) arrived with another oxygen cylinder which she picked from somewhere on the ground floor.
Her and I helped one another to transfer our baby from the empty cylinder to the one she had brought. I then ran to call the only present radiographer from the scan department at Silver who later came to work on us. As we stood at the x-ray main entrance, I overheard (Nalongo) calling a gentleman out there to ask for oxygen. The gentleman also had to pick oxygen from another person. He told her to approach the person who had the oxygen by herself because he is complicated. And that shocked me but in kept my mouthed zipped.
In the x-ray room, I had to put on some protective gear and support in holding my baby’s hand – a role I thought would have been played by one of their staff if the hospital itself wasn’t sick.
After the x-ray, I had to pull the oxygen cylinder from in front as Nalongo pushes our baby on the bed the way we came. I was surprised that she insisted not to leave her empty oxygen tank behind even when I told her that I can come back for it because someone else might take it. She had therefore to push our baby on the bed with one hand as the other hand pulled the empty cylinder.
As we walked back to NICU, I wondered why a pre-term baby would run short of oxygen in a National referral hospital that even manufactures its own oxygen? Why would a staff be so worried about leaving an empty oxygen tank behind? Doesn’t the hospital have a system to know how much oxygen is received, given out and one that is still available at every time?
I was sent back to the x-ray department to pick the x-ray report. The lady radiographer told me I would be given the report the following day since the person to write it wasn’t present. That also puzzled me since the doctor was urgently waiting for the x-ray results at NICU.
As I took the lift from the ground floor to NICU on the third floor, I wondered why a National referral hospital would fail to give me an x-ray report which we needed urgently just because a staff is off on a Sunday as if sickness goes on holiday during the weekend. The hospital system is getting sicker everyday.
I handed over the x-ray images to the senior doctor (a consultant) who told me she couldn’t see anything in the x-ray images. Everything in it pointed to no problem. However, personally, I had checked on the x-ray images and they showed a bend in the bones of the baby. I wondered why she couldn’t comment about that? Instead, she told me we should wait for the report the following day. I felt like I had wasted all my energy, the whole struggle for an x-ray paid off nothing yet it was our hope for finding the problem with our newborn son’s arm. I felt betrayed by the hospital system.
I remembered that the cashier had put a bill on top of the incubator where our baby was. The cashier is very swift. He reaches every baby’s bed and he also stretches up to the labour ward on other floors but the radiographer was too incapacitated to go for our baby at NICU. How ironical that is! The one who distributes the bills is flexible while the one who offers the service is inflexible.
That day, I fed our son twice on expressed breast milk through the tube that ran to his stomach through the nose. I had also changed his diapers. All seemed well.
That evening at around 8:00pm, I went back to NICU carrying his milk to feed him. On reaching, I was dumbfounded to find the doctor and nurse around our baby. They had pushed away all the other beds / incubators. They were suctioning blood from him. The doctor quickly told me that our son was having internal bleeding from the lungs and other body organs. His oxygen levels were dropping very fast. It was impossible to trace his heartbeat. I ran back to the ward and told my Grace about the deteriorating condition of our baby. I left her there and ran back to see the progress of our baby’s condition. My wife too joined us shortly regardless of her painful fresh C-section wound. A few minutes later, our baby died before us. The doctor had tried all his best. He was equally disappointed about the fact that our baby had died.
My Grace broke down in tears. I wished we had gone to another hospital. Maybe we would have been given the best care. Even if our child died, we would be satisfied that we received the best service. I picked up my Grace and we took the journey from NICU on the 3rd floor to the labour ward on the 4th floor. That journey seemed longer than always. Every regret snaked through my mind as I fought to hold back my tears through the corridors of MSWNH.
I went back to NICU that evening to find out from the Nurse on duty where I can get answers to how our baby had lost his life. She referred me to the management who would be available the following day (Monday) at 9:00am. We had one of the longest nights.
The following day, I was led to meet the NICU ward management at around 11:00am after over two hours of waiting. None could give me the answers to my questions of dissatisfaction about their service. The head of NICU (a very professional and caring lady) took me to the office of the Head Clinician (I hope I have quoted his title right). He was some defensive gentleman with a closed mind based on his answers. Among other things, he could not explain why we hadn’t received the x-ray report 5 hours into the new day.
I requested not to interact only with the heads who had been reported to. I needed to meet the doctor who operated my Grace. They agreed to have us get into a bigger meeting with more of their staff who had handled our case. The clinical head (not sure of the title) promised to get us the x-ray report by the time we get into the third meeting.
In our meeting with the NICU head, the Head clinician, the doctor who operated my Grace, the nurse who was on duty at the operation ward / theatre and the social worker, the following transpired:
1. The head clinician went ahead and gave us a verbal x-ray report that he had received through a phone call. There was no justification for us not having a written report over 6 hours into the new day.
2. There was no justification for the doctor who operated my Grace not having put his recommendation for an x-ray for our newborn baby in writing.
3. There was no explanation as to why a radiographer meant to give us the x-ray report was not available just because it was a Sunday. All they said was that they were going to act upon that internal weakness.
4. None justified why a pre-term baby could run short of oxygen in a National referral hospital which even manufactures its own oxygen.
5. It was not clear as to why the senior consultant at the NICU ward couldn’t recognize a bend in our child’s born in the x-ray image yet the head of NICU had seen it through a whatsapp image which the doctor on duty had sent her.
6. The nurse on duty at the theatre ward who was in and out of the meeting lied that there was no bend in the born yet her two senior heads had already admitted it.
7. We noted the lack of compassion in their staff and system where they mind more about the money than the service. Regardless of being a cashier, one must acquire the value of compassion since he works in a hospital. You can’t just insensitively drop bills on pre-term babies’ beds without even finding out the struggles we are bearing.
8. I asked whether they are charging me money to give me our child’s body as a token for their hospital system / staff having contributed to his death. They were quick to waive off the bill right away.
9. At some point, they thought I wanted to sue them. But that wasn’t my intention because money wasn’t my target. All that took me to the hospital was to come out with my Grace and son alive that never happened. After losing my son, no financial compensation would make meaning to me.
10. At the end, they all apologized to my Grace and I for the anomalies in their system and service.
Two hours later, I was sent to the accounts section by their social worker. I don’t know how they worked on the bill. All I received was a discharge form that indicated that I the bill for my deceased baby had been paid.
We drove to the mortuary to pick our child’s baby. There was no one at the reception of the mortuary. The doors have 6 telephone numbers written in pen. All the airtel lines were off. The MTN lines were on but no one answered regardless of the numerous trials. We got tired of waiting and sat on the grass at the mortuary entrance. Later, we asked for help from one lady who was passing by. She looked to be familiar with the place. Luckily, she made a call on our behalf. And a gentleman on the other side answered her call and said he was coming. We again entered another long wait. After over two hours of waiting, a certain gentleman arrived in a blue surf. He worked on us in around 30 minutes. I kept wondering why one would be away from his workstation for over two hours on a Monday afternoon. That late evening, we trekked the long painful journey to the village to bury our newborn son.
While in the village for my son’s burial, my Grace was presented with a hospital bill of 1,340,000/= for her C-section operation, medication, care and accommodation among others. I painfully paid the bill via mobile money while in the village.
This morning, I have woken up to see my Grace in pain. She can neither walk nor turn in bed with ease. She was discharged without a single drop of painkillers to use at home. As she goes through the physical and emotional pain, there is no cry of a newborn baby in the house. A bag full of clothes meant for our son is looking at us in one corner of our bedroom. The names we had discussed to be given to him are still fresh in our minds. Every call and message from our loved ones about the incidence sounds like opening a fresh wound. It’s one of the toughest realities my Grace and I have had to face.
Dear Mulago Specialized Women and Neonatal Hospital (MSWNH), we feel betrayed by your system. We came for a baby but we left with a dead body and minds full of pity, regrets and trauma on top of my wife’s painful C-section wound and funds lost just like that. I had and still have no intention of suing you as a hospital or any of your staff. Make life better for mother and father who are coming to you after us. I am still looking for the grace to forgive you. God knows best.
The Author Is An Unsatisfied Father Of Deceased Pre-term Newborn Son –0774235929
