Theatre of hope: How silent Tana River ward came alive to save lives

The Intercounty Maternal and Perinatal Death Surveillance and Response team, with the Council of Governors Health Secretariat. [Eunice Omollo,  Standard] 

On a humid Thursday evening in Bura, Tana River County, members of the intercounty Maternal and Perinatal Death Surveillance and Response (MPDSR) team huddled outside an operating theatre that had remained silent for years.

The team comprised doctors, nurses, theatre technologists, neonatal specialists and Council of Governors (CoG) secretariat staff drawn from Bungoma, Garissa, Kajiado, Nyeri, Kiambu, Kakamega, Kilifi and Nairobi.

For the first time in years, the theatre at Bura Sub-County Hospital was about to host a Caesarean section.

Director of Health, Ms Khatra Ali, with the county health officials, tours the theatre at the Bura Sub-County, Tana River County. [Eunice Omollo, Standard]

“I am so excited!” exclaimed Khatra Ali, the Director of Health at CoG, as she rallied the team moments before the procedure.

“This is a historic journey. Let us do this for the mothers and babies of Tana River County.”

The team joined hands and chanted in unison: “Every woman, every newborn, everywhere — tunajua, tunaweza, tunarekebisha na ni jukumu letu.”

Then they walked into the theatre. Outside, anxiety gripped 32-year-old Omar Musa.

His wife, Amina Musa, had been in labour for three days at home under the care of a traditional birth attendant before she was finally brought to the hospital.

“She was under the care of a traditional birth attendant who was gracious enough to bring her to the hospital,” said Dr James Amenge, consultant obstetrician-gynaecologist and co-founder of the intercounty MPDSR initiative.
Doctors later diagnosed Amina with Cephalopelvic Disproportion, a childbirth complication where the baby’s head is too large to safely pass through the mother’s pelvis.

“This mismatch prevents the baby from moving through the birth canal,” he explained

For hours, doctors monitored her contractions, checked the baby’s heartbeat and attempted medical interventions to help labour progress. By evening, however, her condition required emergency surgery. At 6 pm, Amina was wheeled into the theatre.

Intercounty Maternal and Perinatal Death Surveillance and Response team works with resident medics to perform an emergency Caesarean section at Bura Sub-County Hospital in Tana River County. [Eunice Omollo, Standard]

“If we did not intervene, the baby would have become distressed and probably would not have survived,” Dr Amenge said.

Yet for Omar, the fear ran deeper than the surgery itself. For years, mothers in Bura needing emergency Caesarean sections had to endure risky referrals to Hola County Referral Hospital or facilities in Garissa and Kilifi counties — journeys stretching for hours across rough terrain.

He feared his wife would become another statistic. Instead, history unfolded before his eyes.

Unknown to him, his firstborn son would become the first baby delivered through a Caesarean section at the revived Bura theatre after nearly a decade of dormancy.

“I was very anxious. She had laboured for too long,” Omar later told The Standard.
“I thank God and the team that ensured my wife and son are alive.”

The revival of the Bura theatre had begun days earlier. Structurally, the theatre existed. It had been equipped years ago under the Managed Equipment Services (MES) programme. However, despite the infrastructure, the unit had remained largely unused for more than six years.

The facility had initially been operational before later shutting down due to multiple challenges, including inadequate human resources, lack of running water, equipment maintenance issues and prolonged underuse, which rendered the theatre unsafe.
One missing component had paralysed the entire facility: an oxygen regulator.
Without it, surgeries could not safely proceed.

Despite having a new oxygen manifold system complete with fitted copper piping directing oxygen throughout the facility, the lack of a regulator stalled operations.

“In emergency obstetric care, oxygen is critical,” explained Dr Amina Mohammed.
“During a Caesarean section, anaesthesia teams continuously monitor oxygen delivery to both mother and baby. Newborns delivered through emergency surgery may also require immediate oxygen support if they struggle to breathe after birth.”

The missing regulator had turned a fully equipped theatre into a silent room.
But the MPDSR initiative arrived determined to change that.

The team was led by Dr James Amenge, consultant obstetrician-gynaecologist at Kenyatta National Hospital, Dr Mary Maina, obstetrician-gynaecologist at Kiambu Level Five Hospital and Khatra Ali from the Council of Governors.

The oxygen hunt

The breakthrough came only hours before surgery. Coordinated efforts led by Khatra saw an oxygen regulator sourced from Garissa Referral Hospital.

By morning, technicians were reconnecting oxygen lines. Finally, the theatre became operational.

Nearby, another team raced against time inside the newborn unit. Beds were assembled. Floors disinfected. Oxygen flow was tested repeatedly.

“We are elated. There is now piped oxygen in the newborn unit,” said Dr Salma Omar, a paediatrician from Kajiado County and part of the team stationed at Bura Sub-County Hospital.

The atmosphere inside the hospital remained tense but hopeful.

Messages flooded a WhatsApp coordination group connecting medics stationed across Hola, Ngao and Bura sub-county hospitals. Blood supplies were mobilised. Additional staff dispatched.

“Hola team, get us blood for the second patient in Bura. Leo hatutalala. This theatre must continue operating,” Khatra posted in the group.

“She has blood group O positive and a haemoglobin level of 7.1, indicating severe anaemia,” she added.

By evening, all eyes shifted to Amina Musa. Inside the theatre, every second mattered.
Pre-operative nurses checked sterile gowns, surgical packs, suction machines and monitors. Anaesthesia was prepared while surgical counts were conducted meticulously.

The operating table was adjusted under bright theatre lights. Once consent was obtained, the team moved swiftly. Spinal anaesthesia was administered. Pre-surgical procedures completed. A surgical drape was raised.

Monitors beeped rhythmically as the operation began.

During a Caesarean section, surgeons carefully make an incision through the abdominal wall and uterus to safely deliver the baby. Throughout the procedure, theatre nurses maintain sterile conditions while anaesthetists continuously monitor blood pressure, oxygen levels and heart rate.

Minutes later, a cry pierced through the theatre. At around 7:30 pm, the baby boy was delivered safely. Soft applause erupted among medics.

“We have had a successful Caesarean section. The mother and baby are both okay,” Khatra later announced.

“Without the support and political goodwill from the county leadership, this could not have been possible,” she added.

The mother who vanished

Among the youngest members of the surgical team was 25-year-old medical pre-intern Dr Patricia Arori, who actively engages young audiences on social media platforms such as TikTok.

For her, the experience was transformative. “Learning from these obstetricians, neonatologists, paediatricians, anaesthetists, theatre nurses and midwives has inspired me to pursue this field,” she said.

Tana River County Executive Committee Member for Health Joshua Jara believes reviving theatres across sub-county hospitals will significantly reduce deaths. “We intend to reduce these deaths to zero. No mother or child should die.”
As darkness settled over Bura that night, exhausted medics finally stepped out of the theatre.

Inside the maternity ward, a newborn slept peacefully beside his recovering mother.
Outside, his father held onto hope not just for his family, but for every mother in Tana River still waiting for a fighting chance at safe delivery.