“Of course Lifebox pulse oximeters increase the safety of patients,” says Giri. “But they also increase the security and confidence of anesthetists to join rural services, which they haven’t done before because of lack of technology and poor infrastructure.”
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One woman was 38 weeks pregnant when, lifting a heavy load while setting up camp in her felt-walled ger, she felt a sudden sharp pain in her abdomen. It was September 2015 and she knew straight away that her baby was at risk.
The nomad family’s ger was pitched in Khovd Province in western Mongolia. It’s a natural paradise: a vast area of snow-covered peaks, rocky deserts, and salt lakes that is an adventure playground for tourists in the summer and a favored location for Mongolia’s nomads to graze their herds of sheep, goats, and yaks.
The woman used her mobile phone to summon the rural soum doctor from a small surgery a 20-kilometer, off-road drive away. He examined her, and confirmed that she had suffered a placental abruption, the pressure from the load she was carrying almost certainly causing a swathe of blood vessels that feed the fetus to detach from the wall of the uterus.
“The rural doctor reported that the fetus was distressed and that it was out of the question for the mother to travel to us,” recalls Nansalmaa, an obstetrician based in the main hospital in the city of Khovd. So the obstetric team, Nansalmaa, an anesthetist and a neonatologist went to the woman’s ger, together with the basic equipment needed to carry out an emergency caesarean section, including an oxygen concentrator and suction machine, an operating lamp, a Honda electricity generator and, perhaps most importantly, a pulse oximeter.
Within hours of an incident that until recently would have consigned the woman and her baby to becoming yet another obstetric fatality, both mother and baby survived thanks to safe spinal anesthesia followed by a caesarean section.
Ger surgery is rare. But when necessary, it happens without fuss. For nomadic patients, that instils confidence: not just in the health-care system, but also in their chosen traditional lifestyle. That’s what I discover when I call on Tumurdavaa Gursed in the ger that was the location for her emergency surgery eight years ago, when she was close to death due to a ruptured ectopic pregnancy. She too was unable to travel, and would have died had the emergency surgical team not already been in operation and ready to travel through the night to carry out the emergency operation—albeit without a pulse oximeter—at first dawn.
I sit on the low bench used for the operation, reflecting on the commitment of the team back then—carrying out a two-hour operation in a roasting hot ger, the anesthetist bent almost double throughout to monitor his patient.
Tumurdavaa, serving boiled horse with blood pudding and potatoes along with fresh cream and biscuits, is silent as we eat. I take it for shyness at first, but then realise it’s simply a lack of interest in small talk. When I ask her about her brush with death, she talks at length, eloquent in paying tribute not only to the medical team but also to the impact of the policy of safe surgery on nomadic life. “I’m so joyful and reassured,” she tells me, “that I can continue living blissfully beside my animals.”
This article appears courtesy of Mosaic.