Emma

At 34 Emma was healthy and pregnant with her second child.  On April 27th, she delivered him by c-section. Within 24hours Emma’s abdomen began to swell and when clinicians reopened her surgical wound, they discovered a perforated bowel. Part of her treatment involved the creation a temporary colostomy.  After this surgery Emma remained hospitalized for a month.  In Malawi hospitals provide occasional meals to patients depending on availability of funds, but generally patients rely on family members to bring food.  Emma’s mother and her husband were her only support. To lessen the financial stress on Emma’s husband, her mother took their toddler back to her village several hours away.  Emma’s husband was left to cook and bring meals, wash Emma’s clothes by hand, care for the baby, and search for day labor to keep them going.  Her husband was attentive, but Emma was often alone. Sometimes there was no food.  Emma’s appetite diminished with her hope.  Over the month Emma became emaciated. Her milk stopped flowing. This is how and where our nurses found her. While still in the hospital they began visiting Emma and enrolled her baby in our program.  Once she was discharged, Emma returned to the one room home she shared with her husband.  In her condition she could no longer care for her baby or even herself.  During the early visits the nurses found her despondent, lying on a grass mat.  In response to their questions about her health, she would talk about dying. At each visit the nurses brought enriched porridge and beans, they would assess her baby and educate her husband on how to care for the baby and for Emma.  They met with her neighbors and encouraged them to sit with Emma while her husband was out.  The nurses returned monthly and slowly Emma regained her health.  Eventually she had a final surgery to anastomose her bowel.  Before she was discharged from our program, she received the equivalent of $10 to start a small business. Emma began selling vegetables, her profits now provide the couple enough on a weekly basis to supplement their diet.  Recently Emma told the nurses that she had been sure she would die, but their visits gave her hope.  At times the beans and porridge supplied by the nurses were the only food items in the home and that nutrition enabled her body to recover.   Emma’s story illustrates the impact of severe maternal morbidities, which often are unseen and uncounted. Her unexpected health crisis during delivery led to financial strain, depression, threatened the survival of her healthy newborn and almost resulted her own death.  In the end Emma credits her survival to the compassion offered during brief monthly visits, several kilograms of beans and porridge, and $10.  We can do this.