Where better to start than at 2am last night…

The lights in the new surgical building start are turning on one by one. The team are arriving – woken from their beds by a phone call, followed a few minutes later by a knock on their door from the hospital driver. As the team gathers, we exchange tired smiles. All of us have worked all day, and not spent enough time in our beds so far tonight. But no-one complains – not even a hint. Because we all know why we have come – we are here to save a life.

The anaesthetic machine is checked, drugs are drawn up, surgical instrument trays are opened – there is no time to waste. Moments later a young pregnant lady arrives on a trolley from the maternity ward. She is cold, drowsy and afraid. She is in shock – bleeding inside her abdomen. After a day in labour, unable to push out the baby, her womb has split.

The life that she had nurtured for the last 9 months slipped away at some point in the last 24 hours. It’s desperately sad, but for the team, this is not the time for emotions – they will have to wait. For now, it is into action. The laboratory team are working to find a blood donor, but we know this will take up to an hour. So we need to stop the bleeding straight away – this lady needs an urgent operation to remove her bleeding womb. One of the anaesthetists puts a compassionate hand on the lady’s shoulder – there is time to quickly pray for her – a moment of calm before the rush of activity resumes.

What happens next might look to an outsider almost like a choreographed dance. Antiseptic skin prep liquid is painted on the abdomen, drapes are laid, instruments are passed from hand to hand. The injury to her womb is worse than we feared – she has also badly injured her bladder. But right now the priority is to stop the bleeding. Clip, clip, cut, suture, clip, clip, cut, suture goes the rhythm. At the other end of the patient the anaesthetists treat her shock. They are relieved when the surgeons announce that the bleeding is controlled, and even more so when a knock at the door signals the arrival of a bag of blood.

Moments later, a message arrives in theatre. There is another lady who needs urgent surgery – this time a pregnant women in her 40s with eclampsia (convulsions). She is unconscious after convulsing multiple times. A key part of the treatment of this condition is to deliver the baby, and for this lady, that means a Caesarean. The theatre team look at each other, and we exchange a little smile – not of delight, but of determination – let’s get ready to do this all again.

A while later, the second lady is wheeled out of theatre to the intensive care room. Equipment is washed, floors are mopped, the table is made ready for the next patient, whenever he or she arrives.

It’s been a hard night. Although two lives have been saved, two lives were also lost before they properly began. Lives that should have been lived. Lives that in the west would have been lived. There’s been so much pain in and around this room tonight. You might take a moment to reflect on the brokenness that brought these women to this place – poor or non-existent antenatal care, stunted growth from chronic undernutrition, primitive farming techniques, lack of education, lack of healthcare infrastructure, traditional healthcare beliefs, lack of skilled birth attendants – I could go on. But out of all this brokenness something beautiful has also happened. God has been gracious to these two women. Gracious to bring together everything that is needed to save their lives - in this obscure corner of rural Madagascar. God has shown his power – through the small sacrifices and service of those who call Him their Lord, He has been at work.

And let’s pray for something even more beautiful to happen over the next few days. God-willing, as they recover, each of these women will have the opportunity to hear the Good News of Jesus. Let’s pray that the brokenness that has brought them to Mandritsara, might also bring them to see the beauty of Christ in the gospel.

1. Pray for Ted, the surgeons and the theatre team, that God would give them skill, compassion and strength to care for similar patients night and day.

2. Pray for the patients, that not only may they recover from their ordeals, but that in hearing the gospel message they may turn to the Lord Jesus, the Author of Life.

3. Pray for the maternity ward and the team of midwives as they receive such obstetric emergencies day by day, that they may have quickness of action along with calmness of spirit.

4. Pray for the planned expansion of the maternity unit – see the details at https://www.mandritsara.org.uk/maternity