by Dr. Archie Achola
Earlier this month, Kibuye Hope Hospital was the site of a quiet miracle—one made possible by the power of preparation, teamwork, and compassion in action.
This moving account comes from Dr. Archie Achola, serving at Kibuye Hope Hospital, a partner hospital of African Mission Healthcare. Dr. Achola was one of the participants in the Mobile Obstetric Simulation Training (MOST) conducted in April 2025 by a team of educators from AIC Kijabe Hospital in Kenya. That training—led by none other than Dr. Greg Sund, recipient of the L’Chaim Prize—equipped local healthcare providers with life-saving skills to manage obstetric emergencies in low-resource settings.
What follows is more than a case report. It is a tribute to how one woman’s life, and the lives of her newborn twins, were spared thanks to a timely, courageous response from a team empowered by training, faith, and love. For Dr. Sund—and for everyone who supports the mission of AMH—this story is a powerful reminder of what your partnership makes possible.
The Pain That Would Not Go Away
On 16th May 2025, in Kivoga, Burundi, Berth Nininahazwe, a 32-year-old woman was going about her normal chores when she felt a sudden, sharp excruciating pain tearing through her abdomen to her lower back . She sat down to catch her breath, waiting for the wave to pass, attributing it to the heavy tasks she was doing. But it got worse, unrelenting.
On a run of the mill day, this would not have caused her distress or panic, and she would have dismissed it as something trivial. It wasn’t. She was pregnant, a twin pregnancy at 38 weeks with two previous scars. Dread and fear overcame her. She knew what it meant to lose a child. Stillbirth is what the doctors had told her it was.
She sent one of her children to call their father from the farm. The daily hustle could wait. On that sunny Friday mid-morning, on the bumpy motorcycle ride through the dusty roads to hospital, Beth’s heart was heavy with fear.
No Longer In The Womb: It’s A Uterine Rapture
An hour later, Berth sat dazed at the waiting area in maternity ward on the queue. The hustle and bustle of the staff, the shuffling feet of visitors, the laughter of women ringing around her. The pain was coming in waves now, on and off, the subsequent episodes more devious than the previous. Her only consolation was that she was not bleeding. Wasn’t that a good sign? Her baby bump looked oddly disfigured. As if the twins were moving away from each other and ascertaining their own space.
Her name was called. Breathing through the contractions, she made her way through the burst of colorful lessons into the examination room.
“Umubare wawe ntahohehe,” the midwife tells her after a vaginal exam.
She did not understand how this could be, yet she was sure, her babies wanted out. It was time.
“Wicare urindire,” the midwife finishes and directs her back to the waiting area.
She sits there stunned. From the pain and the news. 20 minutes pass, an eternity, the pain is unbearable. She waits for a wave to pass and shuffles her way back to the midwife’s desk.
“Ububabare buranrengeje,” she whispers, doubling over the table.
She is whisked back to the examination room and on examination of the abdomen to assess for fetal heart rate, the midwife immediately calls for a doctor.
A Surreal Journey
The events proceeding the doctor’s entrance seemed blurry. Within a few minutes there was a change in pace and rhythm. Gloves were being strapped on both her arms. An injection here, fluids running through her veins, blood being drawn there, catheters being placed, consents being obtained from her husband and herself. A flurry of activities through which she had statements in her dialect like loss of the uterus, death of child, bleeding, transfusion, emergency surgery…. so surreal. “Uterine rupture”, they said. Within an hour, she was in the corridors of theatre.
She remembers being wheeled to a room in theatre. She remembers someone shouting she is bleeding and several people surrounding her bed. Oxygen being placed, fluids being pushed by syringes, cool hands checking her eyes. Busyness. Tension surrounding her. There was no available theatre room.
Few muttered conversations here and a doctor through a translator explained that they are with her, and they will help her and do their best to help her babies. After getting consent there was a quick prayer she was suddenly on her side, something wet, something rubbing her lower back, a pinch, a bit of pressure. It was all over so quick.
She couldn’t feel her legs anymore. Her babies seemed to have gone numb too. The familiar kicks were long gone.
The pain was no more. She was now unaware of time.
“Abana Banje Barakomeye?” (Why Are They Not Crying?)
She now lay on a plastic tarp on a theatre table, a burst of light above her, blinding her, endless wires around her, warm liquid flowing around her abdomen. She did not feel the slice of the surgeon’s knife on her skin. A bit of tugging, pulling and muffled sounds. A few moments later, she got a glimpse of her first twin, pale, floppy, arms dangling around her limp torso. The silence thick and deafening. A few seconds later, her sister’s lifeless body followed.
Grief presents itself it various forms. For Berth it was silent tears. Just like her babies, her life had been sucked out of her. A frenzy of activity around her babies ensued. She remembers a lot of counting and a lot of pushing on the babies’ chests. She turned away.
She must have slept, because in her dream, a baby cried, her baby. The celebration that erupted throughout the room made her turn her head back. One of the twins was crying, a loud determined joyful song as if to say, I fought, I am here! Something contagious it seemed because a few people cried along. She was whisked away. To NICU, she was later informed.
Through the joy and ululations, she noticed that counting and pressing was still ongoing over her second twin. With that her grief gave way to surrender and she started praying. They told her it took 12 minutes, and in what seemed like an eternity, she heard her baby cry. What joy in that theatre room that afternoon! The high fives and the hallelujahs and amens were a testimony of God’s grace and the compassion that everyone felt for her and her babies. It was, indeed, a miracle, God’s hand.
Compassionate Care Through MOST
Sitting back and thinking about Berth’s story brings a huge debilitating burden to light. This year alone in Kibuye Mission Hospital, by April 2025, we had already lost nine mothers due to peripartum complications coupled with newborn mortalities and morbidities. Deaths which were preventable through early recognition and management. The death of a mother is the death of a community.
Berth’s story is just a grain in the sand. Similar presentations occur in various facilities around us with poor outcomes in most settings as health care providers are not well equipped with the knowledge and skills to handle obstetric emergencies and poor neonatal outcomes
Within this month that I’ve been here we have encountered multiple obstetric emergencies with up to three emergency caesarean sections per day, due to a wide range of complications like uterine rupture, post-partum hemorrhage, fetal distress, obstructed labor and high spinal anesthesia and I’m happy to report very good outcomes, I believe in large part due to Mobile Obstetric Simulation Training (MOST) held at the beginning of the month by a teach of simulation educators from AIC Kijabe Hospital in Kenya.
At the end April 2025, we had the privilege of having a group of health care providers spanning all cadres take part in the MOST training and simulations including training of trainers (TOTs) to take up the mantle.
Despite some system limitations, I believe from the depths of my heart that this training has made a significant impact towards saving the lives of mothers and babies. From the amazing teamwork to effective communication between different cadres and departments, to recognition of emergencies and early interventions with intrauterine resuscitation of the baby, down to following the correct protocol in resuscitation.
It hasn’t stopped there. The TOTs are doing a great job to in facilitating weekly simulations with the zeal to improve neonatal and maternal outcomes. It’s a great joy to witness what the power of knowledge and simulation can do to change the life of a community. With this trajectory, Berth’s story will be just a grain in the sand of all the good outcomes this journey will yield.
You Are The Light Of The World: To God’s Glory
It’s a bright Sunday afternoon on May 25, 2025. Berth is elated. She is packing her things preparing to head back home. Her twins are doing great. Off support, off oxygen, breastfeeding well. She is excited to go back home, to her three children, including another pair of twins! News from her husband is that the clan is eagerly waiting her return. The story of how the twins came back from the dead went before her.
Through my colleague, I ask how she plans to get home on a motorbike with two babies in tow and luggage, she laughs. I ask her if she is okay giving me her number to check in on them. She gladly does. She showers us with blessings in Kirundi and we say our goodbyes. Bittersweet. A miracle.