Mohamed is the local Community Health Officer. He has 3 years of training after high school. With this professional background he stitches wounds, performs minor surgeries, and treats malaria. Today I rode with Mohamed on his motorbike to his health centre in Mombajo.
His first patient was a young 20 year old woman who was a few hours post-partum and continuing to bleed. She lay on a plinth, naked, blood dripping to the floor. She was awake but didn’t make a sound. Mohamed was clearly worried–neither he nor the traditional childbirth attendants could locate the source of the bleeding. Eventually he called the hospital in Bo and asked for an ambulance. They said they had an ambulance but no fuel—would he pay for the fuel if they sent the ambulance? Over the course of the next hour there were several calls between Mohamed and the authorities in Bo–“get me an ambulance” he pleaded, “there is no fuel” they insisted. 
Meanwhile a farmer came in with a mangled foot—he had hit it with an axe. The wound was grotesque. Mohamed drew some anesthetic and stitched the wound. Two moms brought in their very sick babies—the children looked close to death. Mohamed diagnosed malaria and treated them. All in an hour.
As Mohamed drove me back to Sumbuya his phone rang. The bleeding mother died soon after we left.
No fuel for the ambulance.
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