Every day at Kantha Bopha, where MSF operates out of, we're full to the rafters with patients. Three floors full. Any empty bed is usually filled as soon as it's cleaned and a new sheet put on. The courtyard is full of patients waiting to be seen in triage, or labouring and being followed by the delivery room staff. Today we arrived to the sight of a woman delivering in the courtyard, on the ground — fortunately being attended to by one of the midwives, but still, this is obviously far from ideal. And yet it is not so unusual an occurrence. As I said, empty beds are turned over pretty fast. I'd guess that most complicated cases stay about two or three days. Uncomplicated deliveries leave in six hours. 

And we can't deliver all the people who arrive. There are just too many. So we try to transfer the less complex, less urgent to other institutions. Transferring patients involves loading the LandCruiser with eight or ten pregnant and possibly labouring women, one midwife — armed with a delivery kit and some gloves, one administrative person, and the driver. The doctor on call for triage calls ahead to the receiving hospital, and then off they go. Busload of bellies.

Often, though, the receiving hospitals won't receive. Right now, one of the biggest hospitals isn't open because the operating rooms are closed. Problem with getting the anaesthetic machine fixed. Another hospital is often lacking surgical kits. Others only have an obstetrician during daytime hours. Another is often without an anaesthetist. I seem to be calling the same departmental heads almost every day to find out how their hospitals are doing, or what they're missing in order to function. Sometimes we can help with that, sometimes not.

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