Saving lives in Samburu County, Kenya


Nurse-in-charge Lucy Kingee organises the drug store at Lolmolog Dispensary

Lucy Kingee is a nurse at Lolmolog Dispensary in Samburu County, Kenya.

I was born and raised in Maralal, Samburu County. And ever since I was little, I wanted to be a nurse. As I grew up, I realised that being a nurse in Samburu County would be challenging, due to a range of cultural factors. But still, I wanted to be a nurse, so I made sure I had the right grades to go to nursing school.
Looking back, one of the things I was most scared of while in nursing school was maternal death. I could not imagine a mother losing her life, or a baby dying, during birth. I worked for several years and I can tell you that I avoided maternal and child health. This was until I was made the nurse-in-charge of Lolmolog Dispensary, where I'm the only health care worker in the facility. Back then, I would receive an average of 500 people per month, with only one skilled delivery. In Samburu culture, women are supposed to give birth on their own, at home. For a woman to come to a health facility to deliver, it had to be an emergency. Emergency during birth in this county is very common due to several factors including Female Genital Mutilation. But I did not have the skills to handle such emergencies: any sign of complication, no matter how small, I would refer to Maralal District Hospital. Many mothers died, and more lost their babies due to these referrals: they would walk all the way to Maralal as we did not have an ambulance to help them get there.
One year back, I was invited to a one-week training workshop in Basic Emergency Obstetric and Newborn Care (BEmONC), organised by Amref Health Africa under their Uzazi Salama project. The training was very intense, but I enjoyed every bit of it. Our teachers were knowledgeable, and understood the challenges and emergencies we faced in our facilities. They not only imparted crucial knowledge to us, but they made us less afraid of emergencies.

Facing my fears
One week after my training, I received a mother ready to give birth. The birth was normal, but afterwards, I realised the mother was still bleeding. I was confused at first as I had never handled post-partum haemorrhage (PPH)* before; I always referred. I remember thinking that there was too much blood and that the mother would not survive.
I had received training on handling PPH as part of the BEmONC, so I did not have an excuse to refer the patient. I checked her airways to make sure they were not blocked. I asked her [mother] in-law, who had accompanied her to the facility to start a fire and ensure the room was warm and well ventilated. I started the mother on both normal saline and oxytocin. In just five hours, she had lost over 1000mls of blood. The sheets kept getting soaked in blood and I had to change them all the time.
By 3am, I was exhausted and worried that the bleeding had not stopped. Almost losing hope, I sent a message to our BEmONC WhatsApp group. I typed down everything I had done up to that point, and asked my fellow nurses and teachers what I had done wrong. Why was she still bleeding?
Barely a minute after sending the message, I got my first response. One of my teachers assured me that I had done everything possible. That I should now monitor the patient and everything will be fine. The rest of the group sent me reassuring messages all through the night. They did not sleep, and were with me all the way. As the dawn broke, the patient woke. The worst was over. She recuperated and went home two days later, with a happy and healthy baby girl.

The first of many successful skilled deliveries
I will never forget that woman, or that day. That experience made me more confident in my abilities. I have handled many other PPH cases since, and I have never recorded any maternal deaths. The BEmONC training I received really helped me give better services to my community.
After that experience, more mothers started coming to the facility. With the help of Community Health Workers, we have encouraged women to deliver in hospital. We will still push to make sure that the message reaches everyone, and that all mothers in Samburu County embrace skilled delivery.
For me, mothers in Lolmolog know that when they come to the facility, I will be right there with, and for them. And I will offer nothing but quality service to them.
* Post-partum haemorrhage is the leading cause of maternal mortality worldwide, according to the World Health Organization (WHO).
Narrated by Michelle Dibo, Communications, Institute of Capacity Development in Amref Health Africa. The Uzazi Salama project is funded by the M-PESA Foundation.