A thorough investigation should be conducted into the treatment of Preya Eshwar and her twins

Dear Editor,

Just when I thought that the Guyanese healthcare scene was normalizing, I was forcibly thrown into a mental tailspin, on reading in yesterday’s Stabroek News of the grossly inhumane treatment that  Preya Eshwar, the 16-year-old mother of twins received at the West Demerara Regional Hospital.  The lingering question reappears—-When will they get it right?  Will they ever?

The displayed behaviour and actions of the midwives should be of grave concern to the General Nurses Council, from the point of view of the calibre of their current registered members, who clearly demonstrated the absence of a caring attitude as a constituent of their professional practice, and total disregard for ethics by offending the vulnerable expectant mother’s sense of dignity. Needless to say, empathy is the pivotal aspect necessary for providing impartial and compassionate care to clients of all ages.

The age of the mother and her gravid state with multiple pregnancies automatically puts her in the category of “high risk” requiring careful ante-and intra partum monitoring to ensure a safe and live delivery.  Incidentally, there is no mention of a doctor being informed of the presence of this primipara at the hospital, and one wonders what diagnostic means was employed to determine that the patient had an infection. What was the name of the infection, as it is apparent that the expectant mother was ill informed of her condition, or unable to articulate the appropriate questions. Why was treatment for the nameless infection not instituted following diagnosis? 

What type of medical referral/ summary was given to the mother following transfer from Leonora Diagnostic Centre to the West Demerara Regional Hospital? Was the urgency of the situation clearly indicated by the transferring doctor, given the fact that the mother was experiencing abdominal pain, indicative of the onset of labour?   On arrival why was she then allowed to wait in the hallway, instead of receiving priority triaging and immediate appropriate nursing care?  Are the nurses/ midwives the final determinants of whether the patient has a delivery or an abortion? Why was abortion alluded to? What was the name of the blue pill that the mother claimed to have received, that augmented the pain? Cytotec (Mistoprolol)?  On whose medical orders was the pill prescribed and administered? 

Further reports state that the mother after taking the pill was then sent back to the Maternity Ward, pushed in a wheelchair by her father. Was a vaginal examination conducted to ascertain the stage of labour? 

Although the gestation of the mother is not stated, it is apparent that she was in the second trimester of pregnancy, based on her statement that the babies were fully formed, moved, breathed and cried  at birth and that she requested they be placed in an incubator.  Should the obstetric paediatrician not have been summoned once it was apparent that delivery was imminent, especially with an initial breech presentation?   Who is tasked with certifying post-natal death?

In an article entitled Uncaring Midwives, Eliasson, Kainz & Post (2008), a woman’s first childbirth experience and encounter with the midwives remains forever in her memory. Hence the attitude of a midwife while caring for this group during pregnancy , delivery and motherhood  may impact on the outcome.

It is blatantly apparent that this teenager was the victim of all-round gross negligence which ultimately robbed her of motherhood.

It is further reported that while the mother laboured the nurses were chatting and laughing nearby. If the truth be told from a politically correct stance, there is absolutely nothing worth laughing about, and I reiterate nothing.  Both the medical and nursing staff should hold hands and hang their heads in collective shame at the blatant mismanagement meted out to a vulnerable member of the population. 

On November 1, 2018 out of the 251 graduates of the Georgetown School of Nursing, 56 were midwives.  Almost immediately the wary onlooker is forced to ask, what have these 51 been taught, if the others before are not performing as they ought?  Needless to say, as a retired health care professional I am deeply saddened by this incident.  A thorough investigation should be conducted with all guilty parties being at the receiving end of punitive measures so severe that they serve as a blatant and enduring deterrent.

 If you cannot be a nurse then pray to God that you don’t be a curse.

Yours faithfully,

Yvonne Sam