Zawadi is a young 19 year old woman who arrived at the Selian hospital with a cord prolapse. This is an emergency, and the baby can soon die. The midwives did very well to get her to theatre in time and the baby came out kicking and screaming – a great joy all round. The week before, we had had a similar situation, but due to delayed action by inexperienced staff sadly the baby was stillborn. The staff had learnt from the previous experience and acted swiftly. This was a great encouragement to all.

However, one of the challenges of working in a teaching hospital is sometimes inexperienced surgeons perform the Caesarean Section. Two days after her CS, Zawadi was in extreme pain and there was an offensive odour from the wound. She had to return to theatre, where it was found that the lower segment of her uterus was necrosing (tissue dying) due to poor surgical technique.

Dr Freddie Mbise, our excellent Tanzanian colleague, under the careful guidance of Dr Andrew, did a lifesaving repair for her and hence began her slow recovery. It is not just about access to CS that is so valuable, but also the quality of the surgery.