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Another mother, child dies hours after cesarean section at Atirir Health Centre IV

With no ambulance available at Asuret HCIII, Akwi’s attendants used motorcycles to transport her to Soroti Regional Referral Hospital, arriving at about 10:00 pm.

Soroti, Uganda | THE INDEPENDENT | Alice Akwi, 36, passed away on Tuesday evening, September 3, 2024, following a cesarean section at Atirir HCIV. Earlier that morning, she had also lost her newborn baby.

Akwi leaves behind her husband, Joseph Okou, and their two sons. Okou was miles away from Soroti, at work, when the news of her death reached him.

Akwi experienced labor pains on Monday evening and was taken to Asuret HCIII around 8:27 pm. Upon examination, the midwives discovered that the baby was in a breech presentation, a condition where a baby is positioned on the feet or buttocks first. As a result, they referred Akwi to Soroti Regional Referral Hospital, a larger facility better equipped to handle her condition.

With no ambulance available at Asuret HCIII, Akwi’s attendants used motorcycles to transport her to Soroti Regional Referral Hospital, arriving at about 10:00 pm. However, all the midwives at the hospital were busy delivering other babies, and despite her sister, Prossy Asekenye, repeatedly requesting help, they received none. Asekenye eventually forced her way into the labor suite, screaming for attention.

By midnight, a midwife examined Akwi and found that she had started to bleed, declaring an emergency. Phone calls were made to doctors from Soroti Regional Referral Hospital and nearby health facilities, but due to the lack of space or equipment, Akwi was transferred to Atirir HCIV, 30 kilometers away. She was taken to surgery around 3:00 am, but the newborn baby was pronounced dead shortly after.

Following the cesarean section, Akwi was transported back to Soroti Regional Referral Hospital for further management, as her family buried the newborn in Serere district. Hours after her return, Akwi’s condition worsened, and she was rushed back to the theater in Soroti Regional Referral Hospital around 1:00 pm. After hours of surgery, the family received the devastating news of her death around 9:00 pm.

Preliminary medical reports suggest that Akwi’s baby had died in the womb before she went into labor on Monday, a condition referred to as intrauterine fetal death. This had a detrimental effect on her uterus. According to health workers in Asuret, Akwi had not undergone any scans during her pregnancy, which could have identified the problem earlier.

There have been reports of referrals from Soroti Regional Referral Hospital to lower health centers, such as Atirir HCIV.

Dr. Joseph Epodoi, a senior consultant surgeon at Soroti Regional Referral Hospital, told URN that, “It’s not routine for us to refer patients to lower health units but depending on the prevailing circumstances at the time of referral.”

He added that sometimes cesarean sections are handled in lower health facilities, allowing the regional referral hospital to focus on more complicated surgeries.

Dr. Stephen Elasu, a medical officer at Princess Diana HCIV, said, “I am alone here but sometimes, I conduct 10 cesarean sections a day, yet there are still mothers lining up for cesarean birth. What we always do is start with the serious emergencies.” He also pointed out that some mothers delay seeking help and rush to the hospital when conditions are already severe, making it difficult for medics to perform necessary investigations in time.

Prossy Asekenye, Akwi’s sister, believes her sibling could have been saved if she had received proper attention from the moment she arrived at Soroti Regional Referral Hospital.

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