(*) By. MSC. Maria Ines Alvarez Garay
Dr. Carlos Alberto Rosabal Ramírez has in his long professional life two missions in Africa, Angola (2011-2013) and the Republic of the Gambia from 2015 to the present.
He graduated from General Practitioner in 1987, and
Gynecologist in 1990, he also has a Diploma in Intensive Therapy and Perinatology.
It has already been 34 years dedicated to this incredible work of bringing rays of sunshine to life and snatching many valuable lives from death.
Since 2015 when he came to The Gambia, he has worked in three of its Regions: Soma, Brikama and Bundung.
In the latter Region there is the only Maternal and Child Hospital (BMCHH.) In the country.
Thanks to the maintained work of an entire administrative, medical and nursing team, he maintains the best Maternal Mortality indicators among all the Hospitals that have this Service.
Postpartum Hemorrhage is one of the main obstetric emergencies, which if not acting precisely can ruin a woman’s life.
Our dear doctor, in his long and fruitful 6 years of humanitarian mission in this West African nation has taken many lives from death, we tell him a case that is a reliable example of what these brave Cuban health titans are capable of doing. with very few resources but with a will of iron, which makes them miraculous.
This 36-year-old patient, with obstetric history: Pregnancy 4, Births 3, Abortions 0, with a Gestational age of 38 weeks, is admitted to your Service with a diagnosis of Stillbirth in Labor.
She occurs spontaneously and immediately after her delivery begins with postpartum hemorrhage, diagnosing Uterine Atony and possible Disseminated Intravascular Coagulation, a very frequent complication in this type of case.
General measures are taken, volume replacement with fluids and whole blood, use of rectal Oxytocin, Ergonovine and Misoprostol,
curettage of the uterine cavity and massage through abdominal coverings.
She maintains strict surveillance of vital parameters and new hemorrhagic events as is customary to see in these cases.
Even with all the measures taken, another hemorrhagic event appeared and Subtotal Hysterectomy was decided as an emergency Obstetric Conduct, they signed consent, as established in these cases, and it was taken to the Salon.
In the intraoperative, it maintains stable parameters, although it was difficult to handle because these cases tend to bleed anywhere even after ligating all the pedicles as indicated by the technique.
She comes out stable but with a serious report. It was decided to transfer her to the Edward Francis Hospital in Banjul, capital of the Gambia for management in the Intensive Therapy Room.
She is discharged after a few days due to her good clinical evolution and the magnificent attention of a group of Cubans and Gambian colleagues who work in this service.
The very grateful patient returns to the Bundung hospital to express to our dear Dr. Rosabal how much gratitude there is in her heart and how much admiration she feels for Cuban doctors, «they are angels who came to our country to give us hope, health and happiness,» she comments.
Doctor Carlos tells us:
«Cases like this are snatched from death in our Service and returned to the family and society.
With this grain of sand we contribute to the Maternal Mortality Index and improve the quality of life of the Gambian population and its health indicators.
I feel part of this country to which I have dedicated a few years of my life and to which I have served as if it were my own homeland. I am proud to be Cuban and to be able to savor the nectar of internationalism, humanism and solidarity that we Cubans carry out by conscience and conviction. «
With good reason, the largest of the Antilles has won the affection, respect and admiration of many peoples of the world, who today appreciate this precious work, there are no defamatory campaigns that can change the altruistic and solidarity course of the Cuban Revolution.
(*) Professor and collaborator of the Cuban Medical Brigade in the Gambia
"An Island on a Continent" 