Once she’d determined the baby’s position she placed her stethoscope on the abdomen at the point where she should be able to hear a heartbeat. Her chest felt tight. She could feel Hasana’s anxious eyes burning a hole into the side of her head.
“Has Hasana got any other children? Does she have any medical conditions?” The questions were rudimentary. They weren’t going to change the outcome. But Violet felt she had to go through all the steps methodically.
Urbi shook her head. “This is her first. She has no medical conditions. There have been no problems during the pregnancy.”
Something twisted in Violet’s gut. It could be her they were talking about. No past history. No previous births or complications. A textbook pregnancy. No signs or cause for alarm.
She took the stethoscope from her ears and switched to the Pinard. She waited as Hasana was struck by another contraction and once it subsided she placed the Pinard on Hasana’s abdomen in the hope something might have changed.
She was met with deathly silence.
Her eyes met Urbi’s. “What have you told her? Does she understand English?”
Urbi shook her head. “Only a little. I will translate for you, Dr. Violet. I have already told her that I couldn’t hear the baby’s heartbeat. That was when I sent the family away. She knows I was just asking you to check again—to confirm what I suspected.”
Violet nodded. Her brain was having flashbacks. Her own delivery room couldn’t have been more different from this birthing room in Africa. Hers had been white, bright and modern with all the technology in the world. That hadn’t made a bit of difference to her baby.
The gel being squirted on her stomach. The Doppler unable to find a heartbeat. The change of position. The blank looks on the faces of the delivery room staff—aware that she was a physician and would know exactly what they were doing.
Finally, her obstetrician speaking to her in low, gentle words. The progression of labor. The pain and frustration of knowing that there wouldn’t be a euphoric and happy moment at the end. Her mind filling with the preparations she’d made at home. A bassinet, a stroller, a car seat and drawer after drawer of tiny little clothes.
The bright, colorful letters spelling out the name she’d chosen for her daughter on the nursery door. How could she go back home to all that without her daughter?
She lifted her eyes to meet the dark eyes of Hasana. She had a job to do here. And as much as it pained her, because she understood, she realized she might be the best person to do this job.
She took a deep breath and reached out for Hasana’s free hand. She shook her head and spoke slowly. “I’m so sorry, Hasana, but I can’t find a heartbeat for your child. Your baby isn’t moving. I think your baby is going to be born asleep.”
She hated the word stillbirth.
She couldn’t explain why. It just sounded so cold. So distant.
For some reason, to her, a baby being born asleep sounded easier. Even though she knew the reality was that nothing could make it easier. She wasn’t going to keep talking. She wasn’t going to bombard Hasana with anything else.
She wasn’t going to tell her she couldn’t give her a reason why this had happened to her baby. She wasn’t going to tell her there was no reason that she couldn’t have a healthy child in the future.
Because right now this was all about this baby. Hasana still had at least an hour of labor to go through.
A first labor. A long labor. And what should have been labor of love had turned into a labor of sorrow. And in that moment Violet knew. She wasn’t going to go anywhere. She was going to stay right here and hold Hasana’s hand. It was one thing she was absolutely sure of.
Urbi translated her words. Another labor pain gripped Hasana’s body, the tightening of her abdomen apparent. But her sobs were reaching far and beyond the labor pain. The noises she was making sounded like her very heart had been ripped out of her body. Her friend kept her arm wrapped around Hasana’s shoulders, holding her close and letting her sob. Silent tears dripped down her cheeks as she tried to be strong for her friend.
Violet put her hand on top of Urbi’s. “If it’s all right with you, I’ll stay. I’ve got some experience in this. I’ll help you.”
Urbi nodded her head. “Thank you, Dr. Violet.” Her dark eyes watched her carefully. “Most people want to leave the birthing room when they know there isn’t going to be a joyous celebration at the other end.”
Violet could feel the tears pooling in her eyes. She had to stay strong. She had to stay professional. It was the best way she could support Hasana. “Every baby’s birth should be celebrated, Urbi, no matter what the outcome.”
Urbi’s head tilted to one side, her years of experience very evident. It was almost as if she was reading Violet like an open book. Instantly understanding all the secrets she’d kept hidden away for the past three years. She wrapped her hand tightly around Violet’s and gave it a little squeeze. “You are a good woman, Dr. Violet. May the Lord bless you.”
There was a loud noise outside. Indistinguishable.
Urbi started. She spoke rapidly to Hasana then turned to Violet. “Let me go and check what that was.”
She disappeared in a sweep of skirts, the dust clouding around her. Violet peeked out of the door in curiosity. Had a car backfired?
She could see people coming out of the houses surrounding them, all walking in the direction of the noise. Men were shouting at their families to stay inside. Urbi was nowhere in sight.
A horrible sensation started to sweep over her, a real prickling of unease.
She ducked her head back inside, holding Hasana’s hand through another contraction. She pulled a pair of gloves from her bag and signaled to Hasana. “Can I check?”
The language barrier appeared to have disappeared. She knew exactly what Violet wanted to do. Violet did an internal examination and found Hasana was fully dilated. Any time now the baby’s head would start crowning.
She pulled her hand back just as her brain realized what the noise outside was. Hasana let out a little shriek.
Gunfire. That was definitely gunfire.
Panic. She instantly felt sick. Adrenaline started coursing through her veins. The fight-or-flight response had never been so obvious.
In the distance she could hear voices shouting, followed by gunfire. What on earth were they in the middle of?
Hasana’s female companion darted outside. Where was she going? Was she leaving them?
Violet tried to remain focused. She had to make a decision in the next few seconds. Hasana might be able to move in the next few minutes, but once she started crowning it would be virtually impossible.
She had no information to go on. How on earth could she assess their safety, their risk? And where on earth would they go?
Her heart thudded in her chest. For the first time in two weeks she wished Evan was by her side. She didn’t feel strong. She didn’t feel ready to deal with anything like this.
The voices were louder now. Fear started to grip her chest. There had been reports about attempted kidnappings, bomb threats and health staff being slain.
All their intelligence had told them it was in the next state. There had been nothing to indicate any trouble at all near here.
But could she wait and take that chance?
What would Evan do?
Hasana’s friend reappeared. She tugged at Violet’s arm. “Go. Now. They are looking for you.”
It was like all her worst fears realized. Her head went from one woman in the throes of labor to the other tugging her arm and pleading with her to leave.
“What about the rest of the team?” She might be the only doctor, but there had been four other community workers with her today. Where would they go?
Now she knew.
Now she understood what it
felt like to have responsibility for the health and wellbeing of team members. Who to leave at risk—the staff or the patients? How on earth could someone make a decision like that?
“The villagers will hide them.” It made sense. The community workers were all from surrounding areas and all had dark skin and wore traditional dress. As long as their equipment was hidden they could easily blend in. Her blond hair and pale skin would make her stand out like a sore thumb. It would put everyone at risk.
Hasana managed to stand up and gripped her other arm. “I need you. Please.” For a woman who couldn’t speak or understand much English, her words were crystal clear.
She’d never felt so conflicted. Evan had given them all clear directions if they encountered any hostility. Don’t hesitate. Get out.
But her Hippocratic oath was bouncing around in her head. She had a duty of care to Hasana. She had to help her.
And Evan wasn’t here. No matter how much she wanted him to be.
She darted around the room, picking up the few things she thought she might need. Bags, gloves, the polio supplies to hide and a few blankets. Her brain was frantically trying to formulate a plan. The truck. Evan had said always to head toward the truck. It was their guarantee of getting out. Their safe passage back to camp.
But the noises sounded as if they were coming from that direction—the compound where they had left the truck.
Then she heard it. A loud, screaming woman’s voice. Urbi. And straight away she knew why. She was making as much noise as she could. Obviously to try and warn Violet to get out.
Her voice was up against another, a male voice shouting back. Their dialogue was a mixture of English and Hausa. “The doctor left this morning,” Urbi was shrieking.
Violet headed for the door, dropping the things that she held haphazardly in her arms. “Leave them,” Hasana’s friend hissed as she scrambled about the floor, grabbing what she could.