The young African mother had been laboring for quite a long time attempting to deliver her first child. Labor had been sluggish and had been improved only slightly with pitocin. We faced a dilemma that is typical in sub-Saharan Africa; when to transfer?

Although we have a very active maternity unit (up to five deliveries per day), the closest place for surgical intervention is a two-and-a-half-hour drive on a frightful road to a government hospital. Frequently this hospital lacks blood or even sterile gloves, and then the next option is a Catholic mission hospital a further two hours down the road.

Our ambulance was in the shop for repairs. And would this woman tolerate several hours ride in the back of a pickup?

Childbirth is a perilous process here. The statistics in Uganda reveal that for every 150 deliveries, a mother dies in childbirth. The problem is mainly a lack of access to adequate maternal-health facilities and Caesarean sections.

The mother, thankfully, soon delivered the child, but I heard the midwife exclaim, "Omwana taine omwitsyo!" (the baby has no breath). Although the child's heart was strong, there were no spontaneous respirations.

We immediately began CPR and prayers for the survival of this child. The midwife remarked that in her experience male children are sluggish at birth, and with a laugh commented that this sometimes continues later in life.

After a few minutes, the child gasped and began taking a few breaths and opened his eyes for his first look at the world. Later that evening, he was quietly taking nourishment at his mother's breast. Although there was no rest for this mother on her day, she seemed very content.