GIVING birth through Caesarian section is a very fragile process for the expectant mother and the baby. The doctors carrying out the process need to be emotionally or psychologically collected, but when the expectant mother is just nine years old, it’s a different ballgame altogether, physically and mentally.
It gets even scarier, but not for Dr Ellen Takaringwa-Hondonga, a specialist obstetrician and gynaecologist. Hers is a story of courage, skill, sobriety, detailed discipline, research and not leaving anything to chance.
She stands tall as one of the specialists who delivered the then-pregnant nine-year-old from Tsholotsho who made history for being probably the youngest child in history to have a baby in the country.
Dr Takaringwa-Hondonga is a specialist from United Bulawayo Hospitals (UBH) where the child was admitted and successfully delivered a baby girl weighing about 3kg on 14 November 2022.
Going back to books of medicine, obstetrics, and gynaecology is what it took for the life-changing Caesarian section to take place successfully. This was of essence owing to the uniqueness and delicate nature of the procedure. Although books of medicine had very little literature on pregnancy in children, there was a need to make reference in order to have adequate knowledge and ensure no lives were lost. The morning of the Caesarean section was particularly tough for Dr Takaringwa-Hondonga and her colleague Dr Gladys Muringani.
“The morning of the operation saw my best friend and colleague Dr Muringani and I crying, it was quite traumatic for us and we had to shake it off and do it. As we were about to even put the first knife on the skin, we had to psyche ourselves up and do the procedure, we are human after all. It was not an easy thing because the whole world was talking and we were there trying to deliver the baby safely. It was not easy,” she said.
Dr Takaringwa-Hondonga said they also put in time for prayer and fasting as they were delving into an area they had never heard of anyone venturing into and hoping to get the best outcome.
“We were also on the lookout six weeks after delivery as anything could have gone wrong but we managed to go past that stage and later discharged the young girl out of our care as she recovered well. We kept a close eye on both her and the baby monitoring for any complications. It was not only our own wisdom as specialists but we give all glory to God,” she added.
The specialist said her biggest fear before she took up the operation was the age of the child and her physiology.
“The physiology alone was a challenge. Then she had hypertensive issues that started cropping up at the very last minute as well, so even for an adult with hypertensive disorders in pregnancy it’s a nightmare. You do not want to have such problems and being a small girl, we also did not want her to go through the trauma of labour. Again, it was an issue if she even understood that she was in labour and what it was,” she added.
The caregivers were on their toes to watch out for any changes and Dr Takaringwa-Hondonga said they did an excellent job of picking them out on time.
“Things like bleeding, the state of the uterus, fluid management, if we had to give her more blood or not, everything in her was different because of the age and frame as compared to an adult so all that was worrisome. There are complications that can arise if you give someone too much or too little blood and we needed to be sure of when to step in and when not to,” said Dr Takaringwa-Hondonga.
She added that with the limelight the case had and the frustrations that came with it, they needed to be sure if they were doing the right thing.
“We were scared of even putting her to sleep as we could lose her to anaesthesia as so many things could have gone wrong.
What was happening behind the scenes was a whole nightmare that the world did not see or know. After the surgery we were running back after every 30 minutes to see if all was progressing well, nurses were on high alert that day,” she added.
United Bulawayo Hospitals (UBH)
Dr Takaringwa-Hondonga said while she never one day thought of backing up when she assumed the case, she said the pressure from the community was overwhelming.
“I remember our boss, Dr Harrison Rambanapasi kept giving us encouragement in the midst of all the pressure we had. There were so many times I had to say no to many things and I came out as rude but it was more to protect the child and get her out of danger rather than getting so many forces and eyes on the case that were not necessary during that time. That was the stressful part but as a multi-disciplinary team. We worked well and came out tops and ironed out all issues,” she added.
She said she was summoned at one time for being “too emotional” and taking things “too personal” in handling the case, but says there was no option but to tackle the matter as difficult as it was.
“What I said to people was, you could not have looked at that child once and remained the same, never. If you are an animal, yes. If you could distance yourself and act robotic, maybe, but I would not have; that’s not me. As much as we were her doctors, I was also a parent, a mother, a friend whose duty was to keep her safe.
She had so much anxiety being away from home and in a hospital, we needed to cover all areas,” she added.
While the nine-year-old was in the care of specialists at UBH, there were mixed feelings on whether the child was to be told of her actual state and more.
“We had a mixture of reactions; we had the old school that did not want the child to know what was going on then, the new school that wanted her to know and have her involved because some people do commit suicide later once things are hidden from them.
So, you would think you have won by hiding information from her but later you lose that patient at teenage level or when they are in college when they then discover what occurred in their past. We gave the psychologist the role to disclose gradually what was happening,” added Dr Takaringwa-Hondonga.
Part of the team that assisted in the case of the girl include and was not limited to, Counselling Psychologist Sheron Gomera, Crocco Clinical Psychologist Nombulelo Thembekile, Specialist Sonographer Candice Mbaita, Anaesthetist Dr Nyemwererai Mathe, Female Paediatricians, Obstetricians Dr Gladys Muringani and Dr Ellen Takaringwa-Hondonga.
The team was carefully selected due to the sensitivity of the case. The nine-year old actually got pregnant while eight years old, after a rape encounter with a 12-year-old relative. The Department of Social Welfare is handling the boy’s case.
Credit: Sunday News 🗞️