Using the non-pneumatic anti-shock garment to save women's lives in Timor-Leste

Oecusse Referral Hospital’s Dr. Humberto and Francisca the midwife, unfolding the non-pneumatic anti-shock garment (NASG) that was used to stabilize Joana. Photo: Tarcisio Amaral
Joana is a healthy 19-year-old woman who strictly follows health provider advice. Unfortunately advice cannot prevent uterine atony, which Joana experienced on November 23, just minutes after she delivered at Oecusse Referral Hospital in Timor-Leste. Luckliy for Joana, staff at that hospial have benefitted from the JSI-led Timor-Leste Health Improvement Project (HIP), which gives training and equipment to maternal and child health care providers. 

Joana had been waiting in the maternity for a few hours. When contractions became more frequent, she was moved to the labor ward and delivered her second son, assisted by Francisca, a hospital midwife. Suddenly Joana started to bleed heavily. The midwife quickly diagnosed uterine atony and commenced uterine massage to help stop the bleeding while her colleague called Dr. Humberto, the hospital’s obstetrician.

“Uterine atony is the most common cause of postpartum hemorrhage, and also the most serious one. Within a short period of time, a woman with this condition can bleed to death. When I arrived, despite intensive uterine massage by the midwife, the patient had already lost a lot of blood and was becoming unconscious. Only the NASG could reverse this situation,” Dr. Humberto explained a few days later. 

NASG is a “non-pneumatic anti-shock garment”, a low-technology device that can slow excessive bleeding and stabilize a mother with postpartum hemorrhage until she reaches a health facility or, if she is already at the hospital, until appropriate treatment is available. It provides compression on the lower part of the body so that blood can circulate in the vital organs.

Joana and her son, both healthy, Photo: Tarcisio Amaral
A few minutes after Dr. Humberto and Francisca applied the NASG on Joana, the bleeding stopped and her vital signs returned to normal. She was discharged from the hospital a couple of days later.

Today, Joana is very thankful to the hospital personnel, especially Dr. Humberto and Francisca, who did not hesitate to use the NASG. As Joana recalls, “All I remember right after my son was born was an emergency situation around me, then my vision became blurred and I thought I was dying. I woke up inside the NASG and felt secure. I felt I was in good hand and close to my baby.”