A Malto tribal couple, married for 11 years and never conceived had adopted a little girl, and then were overjoyed when Manju became pregnant. Their joy changed to anxiety when Manju began to get severe pain in her tummy, and so on 3rd May they travelled 50 miles to get an ultrasound scan. Manju had an ectopic pregnancy with already evidence of bleeding into her tummy. Normally a pregnancy grows inside the womb, but in rare cases it grows outside the womb in the ovary or in the tube between the ovary and the womb. Manju's scan showed the pregnancy seemed to be growing in the right tube. This is a life threatening condition, because unless the pregnancy is removed it will make the tube rupture and there will be heavy bleeding and women even today in the West die if the diagnosis is not made in time and an operation carried out to remove the ectopic. In India many women die even before there is the chance to diagnose, but many more die after the diagnosis has been made, but the scan doctor never tells the patient.
This was exactly what happened in Manju's case - she and her husband William were never told at the scan that this seemed to be an ectopic pregnancy, and that already the scan showed blood in her tummy. They were just sent home with the report. Seven days later on May 10th, they went to Prem Jyothi Hospital because the pain in her tummy was excruciating, and Manju was clearly becoming unwell. Dr Barnabas saw her, and having examined Manju he was taken aback to see the scan report William handed to him from one week earlier when Manju was already bleeding from the ectopic. Barnabas immediately phoned Elisabeth - it was just after mid day on a Saturday, so we quickly finished the clinic while Prem Jyothi sent their ambulance to bring us over there to operate. And Shubhro had the same blood group as Manju, so came too.
Manju did have a ruptured ectopic on the right side, but the amazing thing was that although it was still actively bleeding there was not too much blood in her tummy, and having removed the ectopic and stopped the bleeding, she did not even need a blood transfusion. The whole situation was something of a miracle, and encourages us, and also Manju and her family that God intervenes and protects in miraculous ways to His people who trust in Him.
In January this year Elisabeth saw a 45 year old mother of seven whose youngest child was only five years old. Kamlini had been for a scan which said her ovaries were normal but there were some lymph nodes in her tummy. Kamlini's story was one of only six weeks of being unwell but Elisabeth found an enlargement of both of her ovaries and was concerned this was a malignancy.
She counselled Kamlini and her eldest son (husband had abandoned her for a younger woman), and they were both keen on having surgery as soon as possible. Dr Benedict kindly agreed to let the surgery be performed in Prem Jyoti, but sadly on opening her tummy Kamlini had a very rare tumour of the stomach which had moved to both ovaries and so Elisabeth removed as much of the ovarian cancer, while Dr Benedict took a biopsy of the stomach and inserted a feeding tube into the bowel below the stomach. We then explained to her son that nothing could be done, and if Kamlini could recover from surgery we would have to send her for chemotherapy but survival in such an aggressive cancer was only weeks. Her poor son could not cope with this news and became very depressed. And sadly, Kamlini died just within 72 hours of surgery. She was conscious and able to talk with relatives but became delirious and unconscious over just 2 hours before she died. Although a blessing for her, we felt so very very sad for her children who had already lost their father…..and now their mother also.
Another Santali tribal lady with a huge tumour of her ovary, but a happy outcome.
Then Barnabas sent me a 44 year old lady - Shibha, who has an ovarian tumour the size of a six month pregnancy, We operated on her together at Prem Jyoti, but I took Shubhro with me for the anaesthetic itself was a challenge for her to get through. And we were praying it was not malignant. At surgery, there were no signs of malignancy, and I managed to get the whole thing out in tact, so there was no spill of the contents into her tummy. The pathology report has come back with what seems to be a very low grade malignancy, and I am still awaiting the opinion of the gynaecology cancer surgeon in Aberdeen - to see if we need to do further surgery. But she has made a very good recovery, and did not need a blood transfusion….and the anaesthetic went really well - she was awake throughout the procedure, done under spinal.
Photos : Elisabeth removing tumour. Tumour waiting to go for pathology
Reena is married to an alcoholic and has faced tragedy in her short life - only 18 years of age and married at 15, she lost her first son who died three days after his premature delivery.
She presented to us in her second pregnancy, and although 6 weeks premature was dagerously ill herself with a very high blood pressure. But her baby was moving well, and apart from headache she felt otherwise well. We gave her blood pressure medicine, and also an injection to mature her baby’s lungs, suspecting the first baby had died because of breathing difficulty. We then referred her to the nearest large government hospital with facilities to deal with a premature baby. But Reena never went there - she was too frightened.
God was clearly protecting her and the baby, because she went into labour two nights later, and came to the Hiranpur Hospital. The nurses were very concerned that her blood pressure was dangerously high, so they rightly transferred her to the big government hospital 20 miles away.
But Reena arrived there at 9 pm, and not even a nurse took any notice, far less a doctor.
She carried on having pains, and Reena’s own mother stayed by her side. Suddenly around 1 am the following morning, she felt like pushing they called out to the sleeping nurse who came just after Reena had delivered a premature baby - only 1.9kg. But the baby cried well. The nurse, when she saw how tiny he was, whisked the baby off to the nursery. And poor Reena was again left alone with her mother.
Nobody once checked her blood pressure, and she remained in that large government hospital for 8 days, until the staff were happy the baby had gained weight.
We shall never know, but we think (and Reena also feels) that the difference between her second son and the first, was that she received the injection to help the baby lungs to cope. Reena says, he never once seemed to have breathing difficulties, and took breast milk well from day one. Although she was separated from her baby, every time he needed fed, the nursery staff called her.
Now at 3 months he is weighing 3.5 kg (about 7lb 9 ozs in old money).
Reena went to her maternal home when she was discharged from hospital, which was why we did not see her for 3 months. She came to show us her son, with whom she is delighted. Shubhro examined the little one, and he seems fine, but he gave Mum a telling off because the baby has not had any vaccinations. Poor Reena is dependant on elders to take her for clinic visits, and now she has returned to her alcoholic husband. He came with her, and was sober, and joyful to have a son. But Reena has the added worry of what may happen when he again becomes drunk and violent. Added to that Reena’s blood pressure has not cme back to normal. This was the first time it was measured since the day before her delivery.