How Lucinda Met Marcia
Towards the end of March 2013, Anne, a Registered Nurse and I had been working together to assist a lady in Weberek, Timor Leste who was in labour. The lady became feverish during the labour process and we were concerned that she may have malaria so we drove her from her village to the closest hospital in the town of Same, which was about a two-hour road trip.
We handed care of the Timorese lady to the midwives at the hospital, in the evening and then slept in our vehicle outside the hospital that night. When we returned to the hospital in the morning to check on the progress of labour, we learnt that our lady had not yet delivered and was in her roughly 12 or 13th hour of labour, but was progressing nicely. With nothing else to do, we then decided to visit the small post-natal section of the maternity ward in Same hospital, and that is where we first met tiny baby Marcia and her parents.
Baby Marcia had been born in a village in a mountainous region in the Same area. Marcia and her parents were transported via an ambulance from their village to the hospital in the early hours of the morning, as Marcia had been struggling to breathe properly.
Anne saw Marcia first, lying on her mother’s hospital bed, swaddled tightly in a humid room with the windows closed and an outside temperature of over 35 degrees Celsius. Anne called me over to the bed where Marcia was lying. I was shocked to find a tiny baby on the hospital bed, wrapped so warmly in this very hot, humid hospital room, struggling to breathe. The baby breathing was rapid, sharp and desperate. When I saw this little one I thought that, if she was in Australia, on arrival at the hospital she would have promptly been transferred the NICU (Neonatal Intensive Care Unit) and given assistance to breathe. Quickly, we introduced ourselves to the parents and informed them that we were both nurses/midwives and that we were concerned that their baby was wrapped inappropriately for this hot climate and needed better assistance with her breathing. The parents were receptive to our assistance and allowed us to advocate on their behalf.
We unwrapped the very sweaty baby and opened the window and went to look for a hospital midwife to talk with about our concerns. The midwife followed us back to the room. Her response was unexpected, and she seemed to misunderstand our problem, immediately she went to wrap the baby again, close the window and rebuke the parents as she thought they had unwrapped the baby and opened the window. After this, she left the room and did not return, seemingly annoyed at us for our interference.
At this, we then went to find a doctor to try and draw his attention to this baby in respiratory distress. The first doctor we found said that he didn’t have much experience with babies, so he went to find another doctor. The doctor he found came to look at Marcia. He agreed with our assessment of the baby’s condition and immediately started to ask for assistance to locate the equipment necessary to create an oxygenated environment for the baby. There was only one incubator/isolette in the whole ward. An oxygen tank was located and some equipment to humidify the oxygen. The piece of equipment to humidify the oxygen was broken so the doctor abandoned the plan to put the baby in the isolette. I suggested that Anne & I could take turns in holding the oxygen tube in the isolette and keep moistening the babies nasal passages with drops of normal saline, but the doctor did not agree with this plan.
In desperation to advocate for the wellbeing of this baby girl, I debated further about the need to put her in an isolette, but my request was denied and the oxygen tank and isolette were returned to storage and baby Marcia continued to be nursed in the open. She was then placed with her parents, once again wrapped tightly in blankets, her hair wet from perspiration. Her breathing was so rapid that she had been unable to drink from birth, and now appeared severely dehydrated. Baby Marcia had an intravenous cannula already inserted into her tiny arm so most likely she had been given antibiotics at some point in time. We asked other staff members if any preparations had been made for the baby’s transfer to larger hospitals such as Maubise, by road or to Dili Hospital via the MAF (Mission Aviation Fellowship) plane. At that time there was no plan in place for transfer yet, so we encouraged staff to urgently arrange for the baby to be transferred as it was Marcia’s best chance. By this time it was late in the afternoon and we were struggling to assist further.
We briefly revisited the lady we had originally brought to hospital who was now in established labour. Unable to assist any further that day, we drove to our accommodation for the night in some boarding rooms kindly provided for us at a local Christian church. Early following morning, we returned to the hospital to learn that the lady that we had brought to the hospital had delivered a healthy baby later the evening before, but sadly we were also told that baby Marcia died at about 10 pm, less than 24hrs since her birth. There had been a plan to transfer her to Dili that morning but sadly the decision was made too late for Marcia.
It was during our brief involvement in this very sick baby’s short life that the thought came to mind about needing to help Timor on a bigger scale to provide more health training and lifesaving medical equipment. A sick infant, child or adult in Timor Leste, approximately 700kms from Darwin, should be able to access the same quality level of health care that we are privileged to in Australia. From what I observed in this frustrating and sad situation, is that if baby Marcia had been born in Australia, she may still be alive today.
I shared this story with a friend in Brisbane in about January 2015. We also talked about the diet of many Timorese people living in rural areas. My friend was shocked to learn that the staple diet for many was corn (maize, not sweet corn) and that many of the people’s chickens died due to lack of nutrition and vaccinations. For most Timorese people eating an egg or meat/poultry or fish is mostly only eaten for special occasions such as at Christmas or weddings and funerals. As we discussed baby Marcia and, malnutrition and how chickens were dying in Timor, the idea was brought up about forming a registered charity that would provide us with a vessel to alert others to this young Nation’s ongoing need for assistance from more affluent countries.
Para Marcia is Portuguese for “For Marcia”. The charity has been named in memory of a precious baby girl who died in a country where appropriate care was not available. We recognise the need for ongoing partnerships between Australian and various developing nations and we believe that Australia is in a unique position to encourage healthier communities in targeting developing countries and war-affected regions through development support.
Since the registration of Para Marcia in 2015, we are also partnering with an NGO in the occupied Palestinian Territories.