THE FOREIGN SERVICE JOURNAL | SEPTEMBER-OCTOBER 2025 53 strong IV antibiotics, a blood transfusion, and we’d go on with our day. But this is Cameroon. I can’t say that for sure. At the end of my visit, we stop in to see the girl—still unconscious—and then walk out, down corridors smelling of Dettol and urine, emerging from the building into scents of roasting seafood and plantains. I give thanks for the matron’s quick thinking, skill, and dedication, and say a little prayer that the girl will survive. And we go on with our day. IBANDA, UGANDA I am in a level 2 health center with the 22-year-old midwife who asks if I have ever lost a woman to postpartum hemorrhage. She lost a woman last week, and it haunts her. As a skilled midwife, she knew what to do. She knew she needed to give oxytocin. But there was none in the health center. She knew the woman needed to go to a hospital, so she called the ambulance. But nobody answered the phone. She needed a senior clinician to help manage the situation, so she called her facility director. But he was away on leave. In the end, she was left alone, at night, in the dark, with a woman who didn’t need to die. Holding her phone in her mouth for light, she performed a bimanual compression, one fist deep in the woman’s uterus and the other pushing on her abdomen from above—trying to exert enough pressure to staunch the bleeding. She sat with that woman through agonizing minutes, with blood pouring down her arm and tears running down her cheeks. I sit with her as she weeps and tells me this story. I clasp her hand and hold her gaze as I bear witness to this tragic story. The world’s trajectory is not altered for any one of us having been in it. But our impact on the world comes from the people we have known, we have seen, we have witnessed. The people of this world repeat in infinite hues coloring similar themes. I have known people. —Robyn Churchill USAID Maternal Health Lead until July 1, 2025 n
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