It’s as if they are detached, milling around oblivious to a crisis in their midst. Disconnected. Doing things for formality without finding meaning or interpretation. Why did a woman die in an open 12-bed labor ward with midwives surrounding her? Why didn’t anyone notice that she was slipping away … bleeding … a lot … over hours? Why didn’t anyone stop to check her? To feel her fundus? To take a blood pressure? Or a pulse? Why wasn’t a simple blood pressure cuff available? Why did they wait so long to call for help?

It was daylight … doctors were around … even visiting doctors … expert help was just down the hall. But the call came too late. Precious resources poured in, blood, FFP, hysterectomy, DIC, and then death.

They want fancy machines and new buildings but miss the bare basics, the foundation. What about vigilance? What about a finger on the pulse? That could have told something. That didn’t cost anything. But it cost a woman her life. Needlessly.

Why have there been so many courses … “Life Savings Skills” and others, but blood pressure cuffs and other essentials are kept tucked away in an office … considered as an afterthought. No one moves to replace the missing parts, even when they are discovered after “the event.” No one wants to take responsibility.

How can a woman slowly bleed to death in hospital where resources are there to save her? A baby is now motherless, for no good reason.

What will it take to break the resistance? What will it really take to improve hospital care for young mothers in Africa? To change attitudes? To stop the cycle of needless loss? So much could be avoided. Why is something so easy, so hard?

This is the dilemma of global health.