The price of ignorance – A blog by Busi Nkosi


I still think about Millicent.

In 1982 I completed my midwifery training and early in 1983 I was working in a South African clinic’s midwifery department as a qualified midwife. We used to rotate in all the three units i.e. ante-natal care, labour ward and post-natal care. One had an opportunity of following her patient right from ante-natal, through the labour ward to post-natal care, which was fantastic.

Meeting Millicent
Our ante-natal clinic was very exciting. The sessions started with a health talk, followed by singing and dancing as a way of exercise, then individual physical examinations of pregnant ladies in the different cubicles by midwives. Those mothers who were extroverts and could sing and dance would take to the stage and lead the rest during exercises. Millicent was one such mother. She carried her pregnancy beyond 40 weeks which necessitated a referral to the hospital for close monitoring and safe delivery in case complications arose during labour.

Busi as a newly qualified mdiwife

After finishing my term at the ante-natal clinic I was allocated to the post-natal unit and doing home visits for seven days after the child was born. It was here where I met the challenge that would linger in my mind to this day. Unfortunately, until I was introduced to palliative care, I could not talk about it because I thought there was no solution.

Over and above nursing the mothers we delivered at our clinic, we also nursed mothers who had delivered at the hospital. On this particular afternoon, as usual we received the list of mothers to be nursed from the hospital as. The list had Millicent’s name. I prepared my bag and files for the next day, excited that I would see Millicent and her little bundle of joy.

I knocked at the door and heard a faint voice telling me to come in. I struggled to find my way to the bedroom as there was no one to help me. In the bedroom I was greeted by a long face, which I did not expect. My eyes searched for the baby in the room but found none. Perplexed, I asked Millicent where the child was and in a low weak voice she said she lost him. I became confused, did not know what to say or do. For a few seconds I was in a stupor and think she saw that. In a rush to leave the house and relieve myself of this torture, I asked if she was well physically, said sorry and went out.

I was unprepared for the situation
I was a young midwife, hardly a year in practice, who had never come across such a situation. Never trained to deal with such a situation. I was not prepared to go and see Millicent again and transferred her to my older and more experienced colleague. I don’t know what caused the death of her child and I was not ready to go and read her hospital file. I was just traumatised. However, her picture remains in my mind to this day. I can see her leading the exercise classes and laughing with every other mother and nurse.

Now that I have the knowledge, how I wish I could see Millicent again and reverse that whole scenario… it’s too late though. That is the price of ignorance. Perinatal palliative care is an important aspect of midwifery to be learned by all nurses, for you do not know when a situation similar to this may occur.

About the author

Busi Nkosi is the Director of Advocacy for the International Children’s Palliative Care Network. She is a nurse by profession and spent 20 years working in the South African Department of Health. She practiced as a Midwife for 3 years after qualifying. She is also a Primary Health Care Nurse, Nurse Educator, Nurse Manager and Community Health Nurse. Passionate about working with children, she joined the field of children’s palliative care 18 years ago and spent 13 years in a children’s hospice. She started working for the International Children’s Palliative Care Network in 2012. She has advocated for children’s palliative care at global, regional and local levels. She has conducted training courses in children’s palliative care in various African countries. She has also presented papers at various international conferences, advocating for children’s palliative care.



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