Army Reserve Nurse Delivers Baby in Rural Uganda

KITGUM, UGANDA

10.23.2009

Story by Maj. Corey Schultz 

U.S. Army Reserve Command

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KITGUM, Uganda -- When 1st Lt. Victoria Lynn Watson deployed to Uganda for Natural Fire 10, she never imagined using her labor and delivery nursing skills during the exercise.

But when a Ugandan woman, Linda, arrived in labor at Pajimo medical clinic, where the Army Reserve's 7225th Medical Support Unit was partnering with East African medics to offer healthcare to the Kitgum community, Watson sprang into action.

She checked her watch. It was nearly 2:30 pm when medics hurried the 19-year-old expectant mother from the clinic gates where hundreds had gathered to receive care.

During the 10-day exercise, the medics run a daily clinic to treat upwards of 700 Ugandans a day for ailments such as arthritis, minor wounds, skin infections --and dental and optometry care. Soldiers from Uganda, Rwanda, Tanzania, Kenya and Burundi are working alongside U.S. troops on medical, dental and engineering projects in the Kitgum region. Meanwhile, each nation is also taking part in security training and a simulated disaster relief exercise.

While pregnancy was not a planned treatment, the Pajimo clinic staffs a midwife and Watson was eager to assist. If the U.S. Army Reserve officer were back home in Abilene, Texas, she would do the same.

"This is what I do. I'm a labor and delivery nurse in my civilian job," Watson said, hurrying past Ugandan families clutching medicines and awaiting dental checks, "This is what I live for."

Watson serves with the 7231st Medical Support Unit in Lubbock, Texas, but volunteered to augment the 7225th for Uganda.

Once in the clinics maternity ward, Watson and Pfc. Kendra Hinds, a U.S. Army Reserve medic from Lubbock, Texas, joined Stella, the Ugandan midwife. Stella asked the lieutenant to work with her to deliver the child.

Stella and her Ugandan assistant prepared the delivery room. Watson's examined the woman - nine centimeters and having contractions. Her watch read 3 p.m.

Hinds never helped a woman give birth. So, Watson talked her through the exam as they felt the mother's stomach to see where the baby was.

"You can feel the contractions," Watson said to Hines. "Her sides and belly get hard. Feel here ... that's the head. It's in the right place, that's good. The baby is aligned right."

The midwife, Stella Betty Lamono — who goes by Stella, produced a Pinnard Horn - a wooden listening device not often seen in America that is used to hear the baby's heartbeat. Watson and Hinds took turns listening.

Then Stella posed a question.

"You are delivering," Stella said. "You should name the baby."

"OK, I'll name the baby," Watson said, in a light-hearted way. "How about, let's see ... Gracie for a girl? Yes, I like Gracie."

"And a boy?" asked Stella.

"Okay, for a boy ... Cage. I like Cage."

Stella translated. The mother smiled, amused despite her obvious discomfort. It was nearly 3:30 p.m., the baby was coming but the delivery team still had things to do. They tried to start an intravenous drip.

There was a problem, they couldn't find a vein. They spoke with the mother and found she had not eaten anything for two days.

"She's dehydrated, she needs something with sugar," Watson said.

Soldiers offered sweet powdered drink pack from their daily rations - MRE's, such as lemon-flavored ice tea and a lemon-lime electrolyte drinks.

Watson stirred each drink in a green plastic cup and gave it to the mother, who drank thirstily.

The team then found a vein for an IV, the mother tried to relax. From time to time, she would lift a pink curtain and gaze through the window into the dusty yard. Things quieted.

Meanwhile, her sister arranged swaddling clothes on the receiving table at the other side of the room.

"How many weeks is she?" Hinds asked.

"Thirty-eight," Stella said, confidently.

Ugandan midwives determine the duration of the pregnancy by feeling the stomach for the size of the baby's head versus the height of the fundus -- how high the uterus has pressed upwards into the diaphragm.

"This is amazing," Watson said. "In the States, doctors run a sonogram over the belly, ask for the date of the last menstrual period, and go from there. We learn the 'old school' way, but we never actually do it like Stella has."

Certified Ugandan midwifes attend a three-year school, Stella said, herself a midwife with seven years experience who delivers up to 28 babies each month -- often in rural clinics.

The contractions continued. The mother remained stoic despite the lack of any pain medicine. Sweat beaded on her face, veins throbbed along her neck. She would lay calm more moments, the moan softly and slap the nearby wall. Hinds grabbed a cloth and patted her face and held her hands through contractions.

"Most girls in the States would be yelling and hollering by now," Watson said.

Unlike in the States, the clinic had no monitors, electrical gadgetry or air conditioning. It did have clean water, sterilized equipment and a trained midwife, plus her U.S. counterparts.

It was around 4 p.m., when the mother groaned and slapped the wall again.

"She's in second stage," Watson said. "All she has to do now is push."

A few minutes passed, the mother began to push — Hinds held her hand and continued to comfort her. Then came a loud cry from a healthy baby boy. It was 4:30 p.m.

Watson wiped him down. He waved his tiny hands and stared around the room with large, alert eyes. Stella tied up the stump of the umbilical cord

"You delivered the baby, what name did you pick for a baby boy," Stella said, reminding Watson.

"Cage," Watson replied. "But I can't name her baby. It's her baby!"

Hinds placed the infant into his mother's arms. The new mom smiled.

"What is she going to name him?" Watson asked. Stella translated. The mother answered --and Stella began to laugh.

"What did she say?" Watson asked.

"She decided she liked the name you picked," Stella said. "She named her little boy 'Cage'."

Outside, U.S. and East African medics were closing up for the day, handing out the final doses of vitamins and routine medications, when they learned the good news. An officer took out the records reflecting the number of people treated, changing 714 to 715, to add Cage - Kitgum's newest resident.

"It's pretty amazing there's a little one out here that I named and that I helped bring into this world," Watson said. "Pretty amazing."