encephalocele ethics

Hey there you current PICU warriors! I'm sitting here on my boat in Liberia and wondering if anyone can help me out a bit.

We did an encephalocele repair yesterday. 2 month old baby, 3 kilos. Her CT had shown agenesis of the corpus callosum and a Chiari I malformation along with the encephaocele, which was an extensive one (extending into both orbits). She seems a bit microcephalic too, just to add insult to injury.

Given the fact that we're in an environment where intensive monitoring isn't really possible and where she's coming back to a ward with 15 or so other patients, all in various stages of illness and infection, it seems to me like this wasn't really an ethically okay move. This is a family from up country who trust "white people" implicitly. I just question whether informed consent was ever properly obtained, since we had an aunty translating into the tribal language for us, and we have no idea what she was really saying. It's hard to tell whether or not the mum understood the implications of the baby's CT even preop. I don't know. I struggle with this stuff.