Only 40% of all mothers receive skilled assistance during labor and delivery [
WHO]. Medical Teams International is providing a portable ultrasound for the N’Torosso health clinic in Mali so staff will be able to identify complicated pregnancies and intervene as necessary.
Case study: Minata sits outside the Koutiala Hospital before undergoing surgery for an ectopic pregnancy.
After several blood transfusions—many from his own staff—and hours of surgical repair, the surgeon packed 50 meters of gauze inside Minata's abdominal area and closed her up for the night. A baby had begun to grow outside the mother’s womb, causing severe internal bleeding. The next day, hospital staff gathered in prayer and song, in hope that the bleeding would stop.
The hours following would be critical to her survival.
New ultrasound machine detects problem with pregnancy.When Minata arrived at
Koutiala Hospital in Mali with severe cramping and internal bleeding, surgeons used a new ultrasound machine provided by Medical Teams International. They determined that she had an
ectopic pregnancy—a baby growing outside the uterus.
Dr. Dan Nesselroade, the hospital’s lead surgeon, and four other resident surgeons began operating immediately. Nearly a day and seven blood transfusions later, including a transfusion from Medical Teams International volunteer Dr. William Marks, Minata emerged from her ordeal. "Just a few days later I watched her walk out of the hospital," says Dr. Marks, who says these types of emergencies are quite rare and has seen only one case in his 30-year medical career. "Having access to ultrasound will allow earlier and more accurate diagnoses of ectopic pregnancies," he says.
Making a lifesaving diagnosis in the most remote clinics, Dr. Marks trains the physicians at Koutiala Hospital to use the portable ultrasound machine. Dr. Marks works as a radiologist in Seattle, Washington, and recently took a month off to volunteer with Medical Teams International in southern Mali. He spent his time training hospital staff to use a portable ultrasound machine the size of a laptop computer. Medical Teams International purchased the refurbished machine from
SonoSite, using funds from generous donors.
"The system is generations better than the equipment they had at the hospital," says Dr. Marks.
Thousands of Malian women and babies die of obstetric-related causes every year. “It is hard to get the statistics,” says Dr. Marks, but women who do encounter complications during their pregnancy often cannot reach care before they bleed to death.
Access to an ultrasound during the third trimester will help the N’Torosso clinic staff diagnose problematic pregnancies and refer the patients to larger hospitals equipped to manage their complications. Conversely, a proper diagnosis at the clinic-level ensures that patients will not have to spend a month’s wages or more to travel to the capital for a diagnosis.
"I saw one newborn with a soft spot on his head and the staff wanted to refer him to the capital, more than five hours away, because they thought he had hydrocephalus," Dr. Marks says. "I performed an ultrasound and didn’t find a hydrocephalus, but normal cranial anatomy. The ultrasound ultimately saved the family days of travel time; and in their estimation, the equivalent of three month’s wages."
Bogolon fini is their mudcloth, in Bambara. We had the most interesting visit at the factory in Segou. The cloth is made of their own cotton (grown in Mali), and dyed (Basilon cloth) with pigments from local leaves or bark. The colors are rich and fascinating - ranging from ochre to mustard to indigo and anything inbetween. 
We had the opportunity to make our own mudcloth designs. This is done by painting 'mud' onto the cotton fabric. The mud dyes the area black, so all kinds of shapes and messages are communicated in these cloths. 
like a compound and could house many generations and families, along with the cows, goats and chickens. There appear to be individual family rooms. This courtyard is typically gated and fenced with mud walls.
Wow, another great day at the hospital. We start each day with hands-on scanning with our main students, Abel Kone (Farakala Clinic) and Alleye Coulibaly (Farmarila Clinic). Youssouff Dembele will be joining us for the hands-on portion for a refresher. The other trainees Drs. Pierre, Luther and Yohanna join us in the afternoon for the lectures. They have received training and scan tres bien. Daniel (Dir of Admin) has also joined the group. We're finding more people expressing interest in joining us and learning about this exciting new technology that they have already seen make a difference in the care of their patients. Our new students are very bright, eager to learn, grasping the concepts quickly and studious. They were outside the scanning room with their French Obstetrical Ultrasound book, before we got there in the morning.
