Fig. 7

Multiple referral pattern 3. She was in her seventh month of pregnancy. She complained of body swelling and fever and was taken by her husband to the village health centre. She was given treatment but experienced no improvement in her condition. Her husband decided to take her to Renk hospital. In the hospital, she had labour pains and after a few hours she gave birth to a stillborn boy. The woman was devastated and severely depressed. She stopped eating and drinking, and was fed by intravenous fluids and administered various pills and injections. Her health continued to deteriorate. Her abdomen became uncomfortably distended. The doctors recognised that she needed a blood transfusion. As the blood bank in Renk hospital was closed the woman had to be taken to the nearest hospital in Kusti. Her husband realised he could not afford the transport costs. Some well off relatives sent him money when they heard about her condition. They arrived at Kusti hospital, where she was admitted and transfused on the same day. Unfortunately, an hour and a half later she passed away. The husband and her brother-in-law carried her body back and buried her in their village. (4JMD)