I was late for my meeting with her which was a bummer, because I prefer to pick out sitting spots for my interviews. She kept time. Most medics do.
That morning, the sky was cloaked in gloom. It had rained the night before so the ground felt like sponge beneath me. As I walked into the restaurant, a waiter stopped me.
“Habari,” I greeted her my eyes skimming the place. See, I had no idea how the lady I was to meet looked like. All I had in my arsenal was her name — Huwaida.
I eyeballed the waiter impatiently and saw she was pointing at my hand. ‘What?’ I asked. She made eye contact and pointed at her ears. I felt my face collapse. “I am so sorry,” I began but she nodded her head and pointed at my mask. Of course she was trying to read my lips and here I was ignorantly talking with my mask on.
After several minutes of ceaseless apologies, she ushered me in.
I spotted Huwaida easily. She was seated facing away from the entrance, her head covered in a white scarf. I tapped her lightly and when she turned I drew a sharp breath. She was beautiful. Her caramel coloured skin was unblemished with well done make up. I smiled apologetically at her. In response, her lips curved upwards parting slightly, “It’s nice to finally meet you Susan,” she said, her words coated with oil.
Looking at her, one couldn’t tell that several years ago she was a Medical Officer working in Garissa county. “I loved it there actually. People knew me as that Somali doctor who fought with patients’ husbands to give consent for treatment of their wives.” She worked in the Obstetrics department for most of her time there.
One day while walking from the hospital to the staff quarters a man stopped her,
“As-Salaam-Alaikum,” he said to her.
“Alaikum-Salaam.”
He took a breath before he spoke, “Daktari I have been watching you.”
Her face was smiling but oddly strained. ‘Who have I annoyed now?’ she wondered.
“I have two daughters at home.” He continued, “One is in class seven the other in class eight. I took them out of school.”
“Oh.”
"But now I want to take them back because I can see what they can become.”
His words knocked her a step back.
“That man is a constant reminder, that you never know who is eavesdropping on you as you do life. You just might be the lifeline for someone else.” Huwaida told me.
This is why she wants to tell her story.
Huwaida’s wait to conception of her first child was long. Not long enough to despair but long enough to worry. After several tests and a bit of intervention, she and her husband conceived their first child. The pregnancy was uneventful and she proceeded to deliver a bouncing baby girl.
They say a baby brings joy to a marriage. But the long wait had put a strain to their tight cord of marriage until it started to slump.
“Have another baby.” She was told. “It will fix the relationship.”
So she did. After a few months she was pregnant.
This pregnancy was tense. The desire to restore their relationship was fore in her mind. So when she went for her routine ANC visit at 16 weeks and the scan showed no cardiac activity, it didn’t register at first.
“Huwaida,” her OB began. His pause was like silence after a gunshot.
“I know. I can see.” She said quickly.
“Huwaida this is not what we were expecting.”
He sent her for a re-scan which confirmed the diagnosis. She had lost the pregnancy.
Her gait back to his office was uneven. By that time her mom had joined her. As the two of them spoke — her mom and the doctor — she felt like they were discussing a patient who was in the waiting room. So she joined in the discussion like a fellow doctor managing another patient.
She remained in this fog for 48 hours and carried on as if on an escalator heading somewhere. When her appointment for induction was due, she went in, they inserted the meds and asked her to go back when the pain started.
“We decided to run a quick errand then have a bite before we came back.” She had been accompanied by her husband, mother and sister. While her mom and sister were on the errand, she and her husband sat in Java ordering some food. Suddenly, she felt a sharp pain course through her lower abdomen. “Ouch,” she flinched and dialled her mum.
“Mum I think the pain has started. We need to get going.” After she hung up she felt some warmness in between her legs.
“Aaaah,”she doubled over clutching her stomach. “I need to go to the bathroom,” she said to her husband and stood. She was not fully upright before she felt something trickling down her legs. When she turned to look at her seat she let out a strangled wail; there was blood everywhere.
Trembling she dialled her mum again, “Mum come now! I am bleeding!”
When her mum arrived, Huwaida stood and walked out escorted by curious eyes. A stream of blood marked her path as she hurried to leave the cafe. Her mom put pedal to the metal and in a blink they were back at the hospital.
In the ER, medics in scrubs filled the room as if they had been blown out of a confetti machine. “Different hands held different parts of my body. I was being pricked, prodded, examined all at once. By now it felt like something was ripping my body apart.” Her hands and feet started to feel cool. ‘Oh no,’ she thought, ‘am I going into shock?’ She tried to turn to look at the monitor but her head felt like a cinder block. The most she could see was two gentlemen squeezing IV fluid bags between their hands.
“I need a theatre now!” She heard her OB bark.
A few seconds later, her stretcher was being pushed through the corridors. “I was hit by a wave of bright lights and I knew I was in theatre.”
“Huwaida, don’t worry, we got you,” Someone in maroon scrubs held her forehead.
“I have a two year old daughter, I need to…” Huwaida started to say.
Everything went black.
She woke up an hour later disoriented. But alive. And was discharged home later that night in a ‘what just happened’ state.
Her OB urged her to talk to someone and that is how she started therapy. A journey that has lasted to date.
Three months later, Huwaida conceived again.
When she went for the 22 week scan she was elated. It was a boy. Towards the end of the scanning session the doctor said, “He looks ok but his limbs seem a little shorter than usual. We will check again in two weeks.”
“Ok.” Huwaida said.
Two weeks later, the discrepancy was worse and a diagnosis of Achondroplasia was made. (Class at the end).
There are some diseases we only read about in text books and it is left to the imagination what they seem like. For Huwaida, the imagination ended as the reality hit her that they were going to have a child with special needs.
“I did what I do best. Researched the hell out of the disease. And started to equip myself on what needed to be done.” They had several meetings with the medical teams just to know what to expect and how to prepare. Towards the end of the pregnancy, a decision was made to have an Elective ceserian section because no one knew if the baby would survive the harsh rigours of labour.
On D day, her family and friends were around. Everyone knew what role they were playing. Everything was set. The t’s had been crossed; the i’s dotted.
The CS was going well until when the baby was delivered. Huwaida waited for the characteristic wail that signifies a baby’s arrival but there was none. Her sister who was by her side had furrowed her brow. “Khalida, why can’t I hear the baby crying?” She shook her sisters hand hard. “Khalida! He is not crying! What’s going on?”
Then, she heard the whoosh whoosh sound of air being bagged into a baby’s lungs. ‘Oh God, is he being resuscitated?’ she thought to herself. Before she could utter another word, the Paeditrician was by her side, “Huwaida we need to take him to the NICU.”
“Can I see him? I want to see him please.”
“Ok. But just for a few seconds.” He was placed on her chest.
“He was so beautiful. I touched him and as if in reflex, he opened his eyes. I wanted him to stay right there but they had to take him.” It was only when he was whisked away that she remembered how short his limbs looked.
Ari was in the NICU for 24 hours. After her surgery, she went to see him every two hours. He seemed to have had a lung development issue due to a narrow rib cage and therefore needed to be on oxygen.
The following morning when she went to see him the doctors asked her if she wanted to hang around during the ward round. While she waited for them to get to his incubator, she took in her surroundings. Most of the babies in the NICU were preemies in oversized nappies reaching their necks. They lay on their backs with their arms and legs spread out making them look as if they were sunbathing.
When the team came to Ari’s incubator, she placed her finger in his hand as she listened to the Specialist speak. She followed the discussion so keenly she didn’t notice that he had become still. Suddenly the beeping machine bellowed a continous screeching sound.
Someone quickly ushered her back to her wheelchair which stood by the wall of the NICU. The events that followed took her back to the day she was being resuscitated. A canopy of doctors and nurses in scrubs surrounded the incubator. They were bagging him, doing chest compressions, giving adrenaline until one of the Paeditricians — who was a friend of hers — walked towards her..
There was a deafening silence. Time stood still. Then she heard, “Pupils fixed and dilated,” and life as she knew it was never the same again.
Ari was gone. And her heart was sliced to ribbons. And then, almost from nowhere the grief rose out of her like bile. She remembered her previous loss. The one that had been shadowed by her close shave with death. The one she didn’t mourn. Then this.
“I sat by the wall staring, unseeing at the wall opposite. They took out the tubes and IV lines from his body, cleaned him up and told me I could stay by him for as long as I wanted.” With liquid eyes, she clothed him and held him, letting the steady beep of the other machines burn a rhythm into her consciousness. All the while thinking that this was a bad dream.
“We buried him and I would go to the cemetry every day to see him until the attendants knew me.”
The pain of losing a child is excquisite. It is a pain you cannot explain and no one can say or do anything to make you feel better. It is a very lonely journey. One that requires an insurmountable amount of strength to navigate.
She became suicidal. Not because she wanted to die but because she could not get rid of the pain. She wanted to erase herself from this world because living meant pain. The pain of a lost promise. Of what could have been.
It wasn’t until one of her neighbours came to her and introduced her to a support group of women who have gone through pregnancy and infant loss that she started to realise she was not alone. Women as far as Singapore would call her and just allow her to cry.
She underwent cognitive behavioural therapy, where her therapist gave her tasks to help her navigate the pain. “He made sure I wore bright or colourful clothes because I had become accustomed to wearing black or navy blue. I had to make appointments to make my hair and keep them. Leaving the house was a must. I have discovered many restaurants as a result.”
Unfortunately, the marriage also ended. Which only served to compound the grief. And as well intentioned as family and friends were, some would say the most insensitive things. “It’s been a few months Huwaida, you should be ok by now.”
The societal pressure is what she is battling now. The labels. Because people label you as a woman who loses pregnancies. Your reproductive life becomes your label. Your story.
This is why she is speaking out. To de-stigmatise pregnancy and child loss. To say that this is not her story. She is not Huwaida the girl whose marriage failed or who lost her babies, she is Huwaida — clear, lucid, apparent, prominent.
As told to me by Dr Huwaida Bulhan
Ps. I am still raising funds for the girls from Maparasha. Anyone who wants to read about them can click here: https://www.medroomeyes.com/post/hills-of-maparasha
Achondroplasia is a genetic disorder. And is the commonest cause of dwarfism.
The arms and legs are short in those with the condition.
Symptoms
The condition can be severe and lethal.
The chest is usually very narrow.
The child may have other abnormalities of the skull, spine and the joints.
Complications
Delayed milestones
Frequent ear, nose and throat infections
Obesity
Spinal cord compression