Melanie is a strong woman and our God is almighty. Melanie suffered from what is far more common than many understand. From a very remote village, she was pregnant but her child did not make it to full term. Something very common in the developing world. The danger though, came when she was not able to birth the child.
We received a call Monday evening from a remote town that a woman had arrived by oxcart and that her baby had died in the womb more than 3 days ago. She was very weak. After receiving the call and realizing that without immediate intervention there would be no hope for Melanie we began to organize a medevac. This in itself is not a straight forward task. It starts with trying to source a doctor willing to accompany the aircraft into the bush to aid in bringing the patient out. At that point it is necessary to find a medical team willing to take the patient to a hospital and ensure that she is taken care of, usually also paying for all the medical bills that will follow and figuring out how she will return to her village. This, all needing to be done after 7:00 p.m Monday night so that it is possible to leave at sunrise to go fetch the patient. Needless to say my stress levels went up slightly knowing that this is what I would be dealing with for the next few hours.
The first doctor that came to my mind was a doctor/friend who has done work with us and frequently flies with us on medical outreaches, also from time to time coming on medical evacuations. He answered straight away and when I explained the situation he was immediately willing to drop what he had planned, and organize his team. I breathed a sigh of relief knowing that with one phone call I could start working on the paperwork for the flight instead of continuing to try to source a doctor. But then I mentioned where we would be fetching the patient and he came back and said why don’t we just bring the team there and do the surgery right in the town? To be honest this never crossed my mind but as I thought about it I realized how much simpler it would be. You see, Madagascar actually has many well-constructed clinics around the island, they are just not staffed. Soalala was one such place. A beautifully built and equipped operating room with no surgeon. As well Soalala happened to be a village that the doctor frequently visits with our medical outreach programs so he was already familiar with the set up.
With that settled I prepared the flight while he prepared all that would be needed to do the surgery. At 6:00a.m the following day we took off.
1 hour and 30 minutes later we were bumping along on our way to the hospital where Melanie was waiting. 1 hour after landing she was in surgery. Had she been transported back to the capital it is unlikely that she would have had her surgery until later that evening after all the procedures and paperwork would be done. She may very well have not survived the flight according to the surgeon.
After a difficult 2.5 hour surgery which unfortunately involved a hysterectomy Melanie was in recovery. It was clear as I watched the doctors that it was a very complicated case due to the length of time the infant had been deceased. The tissue death made things extremely tricky along with her weakened state.
I write this now 6 days after the flight, and I just hear that Melanie just got released today and is on her way back to her village. I remember the surgeon mentioning that she had about 20% chance of living due to the difficulties involved. God is good! I marvel at what I am privileged to witness, the people I get to work alongside, and witnessing the miracles God does with the gifts He has given us.
Sometimes, a medical evacuation means bringing the doctors to the patient, not the patient to the doctors. In this case it was likely the difference between life and death.
Josh Plett, MAF Pilot