At 3pm on the afternoon of Wednesday August 13, 2008, a dispatch was received at AMREF’s Flying Doctors control room at Wilson Airport from Nyahururu District Hospital, where a woman had given birth to Siamese twins. The little girls were joined in the chest and abdomen, and their only chance of survival was to get them to a hospital with scanning facilities to see which organs they were sharing and perform the delicate surgery of separating them.
At 5:30pm, an AMREF Cessna Caravan piloted by Captain Daniel Baton was cleared for take-off. On board were Dr Kizito Osundwa and nurse Kilda Begisen. Both had taken part in countless evacuations, but neither had been involved in a case involving Siamese twins.
After 45 minutes, the light aircraft landed at an airstrip in Tabor Hills, 20km from Nyandarua. An ambulance was waiting nearby, as well as a large crowd of adults and children. On touch down, the AMREF team rushed to the ambulance, where they were briefed on the action taken by the medical team at the hospital and the condition of patients. The babies were then put into an incubator in the airplane where there condition could be monitored electronically. Their mother, Monica Wairimu, still suffering the after-effects of a caesarian operation, was assisted from the ambulance to the plane and immediately put on a drip. Her husband Elijah Maina accompanied his fragile family.
When everyone had settled in, Captain Baton prepared to take off again. It was 6:45pm. The plane’s rotating propellers pushed the swelling crowd back. Once airborne, an easy calm descended in the cabin. As Kilda did some paperwork, Kizito made sure the twins and their mother were comfortable.
Most rural hospitals are ill-equipped to anticipate or handle emergencies such as this. An obstetric ultra sound scan could easily have detected the nature of the pregnancy, protecting the mother and her children to unnecessary danger. As it is, doctors only got to discover that Monica was having twins after the incision for the Caesarean section was made. They had noticed that the baby’s presentation was peculiar as it was lying across the abdomen rather than head down, prompting them to perform the C-section.
The quick evacuation would ensure that Monica’s babies received the specialised care they needed. As the plane touched down at the Wilson Airport at 7:30pm, a waiting Flying Doctors ambulance moved in, ready to whisk them off to the Kenyatta National Hospital.
