This question refers to a poem by Finuala Dowling, a contemporary award-winning South African poet and writer.  Understanding her time and place helps put the poem in the right context for analysis.  This poem describes a scene that could be happening today.

Your question about the repetition of the word 'and' highlights a very powerful literary technique.  Whenever a poet repeats a word, particularly a seemingly mundane word like 'and,' we have to consider the rationale. 

Looking carefully at the structure of this poem, we can see that there is very little punctuation, but there is some.  The entire poem consists of three sentences.  The first sentence comprises the first 21 lines of the poem; the second sentence is the next three lines; and the final sentence is the final single line.  There is a frenetic quality about the first, overly long sentence.  If you wrote something like this yourself, outside of the context of a poem, you would likely be criticized and would be encouraged to chop it into shorter sentences.  But by keeping the single very long sentence of independent clauses joined by "and... and... and... and," Dowling makes the reader feel the anxiety and also highlights how much the doctor is doing.  The doctor staunched the blood AND administered an opiate AND called for more blood AND stitched the wound, etc.  When you read this poem aloud, those "and"s take a place of prominence and emphasize the doctor's actions.  Finally, eventually, the first sentence comes to a close and ends with a period.  The next sentence then begins with "And."  Normally, it would be considered grammatically incorrect to start a sentence with a conjunction.  In this case, however, the pause of the period gives the reader a rest, just as the family in the poem can finally rest once the surgery is over.  The "And" this time connects the thoughts, but the punctuation creates a sense of relief.  The absence of an "and" in the final line completely separates it from the first part of the poem, and the reader gets the sense that the family can now really get some rest and some sleep.

This ending is reminiscent of the closing of Robert Frost's "Stopping By Woods on a Snowy Evening."  The two poems are very different in style and theme, but the final two lines of "Stopping By Woods" present a similar feeling with, "And miles to go before I sleep, And miles to go before I sleep."  Many essays have been written about the repetition in those two lines.

Why is the repetition of "and" effective in Dowling's poem "To The Doctor Who Treated The Raped Baby"?

When conjunctions are repeated for effect in prose or poetry, the writer is using the literary or stylistic device called polysyndeton.

In this poem, the word "and" is repeated at the beginning of eight different lines. In these lines, the repetition of "and" is linked to the actions the doctor takes to save the life of the brutalized infant. The repetition lends a certain rhythm to the reading of the lines. It highlights the laborious and tenacious efforts of the doctor to save the patient.

The stylistic device of polysyndeton is effective because it emphasizes emotion and effort in this poem. It draws our attention to the horrific crime against the defenseless infant and the unspeakable injuries it must have suffered at the hands of the perpetrator. Also, since the conjunction "and" is repeated at the beginning of the sentences in question, we can even say that the poet is using the stylistic device of anaphora. Again, as with both of these stylistic devices, authors and poets use them to evoke deep emotion in their audience and to emphasize specific points. In this poem, the poet wants to highlight the heinousness of the sexual crime.

The repetition of the word "and" is also effective because the poet links it to images of the aberrant and juxtaposes these against images of the mundane. This clever literary dissonance renders the image of the brutalized infant starker and more immediate to the reader. We are left horrified that such crimes can happen amid the normalcy of everyday life.

Why is the repetition of "and" in Dowling's poem effective?

Finuala Dowling utilizes the repetition of the word 'and' at the beginning of many lines in her poem "To the Doctor Who Treated the Raped Baby and Who Felt Such Despair." The name for overusing a conjunction like 'and' is polysyndeton, and the effect is to increase the pace of the poem and to create emphasis.  Beginning lines with the same word multiple times is known as anaphora and is also used for emphasis and juxtaposing ideas.

As we examine the poem, we see that this particular repetition is used to juxtapose the horrific injuries the doctor must attempt to correct with a more tranquil episode the speaker claims is occurring elsewhere.  

This technique is effective for two reasons.  First, the increased pace mimics the movements of the operating room team as they race to save the baby. The reader feels the intensity as he, himself, does not experience pauses in the reading.  Second, the reader sees the connections between the two ideas the word 'and' links.  The first is a the soul-crushing plight of the doctor, as in "and when the bleeding baby was admitted to your care," while the next is a reassurance that the whole world is not vile, as in "faraway a Karoo shepherd crooned a ramkietjie lullaby in the veld."

With each action the doctor takes, he realizes the despicable nature of the world.  The word 'and' links his experience with another example pointing to a positive side of humanity.

In Dowling's poem, what effect does the repetition of "and" have?

In this poem, the word "and" precedes all statements relating to the actual treatment the doctor gives the raped baby. These statements start with the fifth line, "and when the bleeding baby was admitted to your care," repeats in the seventh line, "and while you staunched,"  and then again in the tenth line, "and when you administered an infant-sized opiate." The repetition continues throughout the poem in this fashion.

These "and" lines are grim and reinforce the despair referenced in the title of the poem. However, each "and" line is followed by a line illustrating a positive element of child-rearing. For example, lines 15-19 read, "and while you stitched/ there was another chapter of a favourite story/ and while you cleaned/ a grandpa's thin legs walked up and down for a colicky crier." The contrast between the depressing imagery of the "and" lines and the hopeful imagery of the lines which follow give the reader - and the doctor - reasons to feel optimistic in the face of such a horrific event. The author especially wants the doctor to remain hopeful and optimistic because we (the readers, the author, people in general) need doctors to heal the sickness in the world.

What is the purpose of repeating "and" in the poem "To the Doctor Who Treated the Raped Baby and Who Felt Such Despair"?

First, I would point you to this answer elsewhere on eNotes, which discusses the double nature of the poem -- part of the poem describes the horrific trauma of the raped baby, while another part provides images of children safe in loving homes. Take, for example, the following passage:

and when the bleeding baby was admitted to your care
faraway a Karoo shepherd crooned a ramkietjie lullaby in the veld and while you staunched
there was space on a mother-warmed sheet
for a night walker
and when you administered an infant-sized opiate
there were luxuriant dark nipples
for fist clenching babes

The "and" has a double purpose. First, it serves as an additive -- it immediately preceeds each action of the doctor, and the effect is one of documenting the lengths to which the doctor must go to save the child. In another sense, the "and" has an almost accusatory effect, its repetition serving as a kind of recurring sound, almost like a tolling bell, calling attention to the horrible nature of the crime. The doctor's final question, "Where is God?" contains in it the double mood of the poem -- in one sense, we understand it to mean, "How could God allow this," but in another sense it is a little ironic, because clearly God is in the hands and caring heart of the doctor.

What is the speaker's intention in the poem "To the Doctor who Treated the Raped Baby"?

In Finuala Dowling's poem, "To the Doctor who Treated the Raped Baby and Who Felt Such Despair," the speaker attempts to reassure the doctor who is given the horrible task of treating an infant rape victim.  Of course the doctor is in a state of shock and agony at the evil he is having to fix, even to the point where he asks "Where is God?"

However, the speaker gives the doctor, and the reader, the calming knowledge that for every one evil example of man's inhumanity, other people in the world are putting themselves last in order to care for and nurture others.

For example, "when the bleeding baby was admitted to your care faraway a Karoo shepherd crooned a ramkietjie lullaby in the veld" shows the reader that far away from the operating room, another baby was being cared for and sung to.  As the baby is being "stitched," in a safe bed in a safe home, another baby is being read "another chapter of a favourite story."

The poem is an appeal to the doctor not to give up hope.  Additionally, it supports the overall idea that humanity is generally kind and compassionate and that one horrible crime against a child is not indicative of the whole world.  

Why is the repetition of "and" effective in "To the doctor who treated the raped baby and who felt such despair"?

“To the doctor who treated the raped baby and who felt such despair” is a poem written by South African poet Finuala Dowling.

First, let’s start with a brief summary. As the title suggests, the poem is written to a doctor who’s treating a baby who has been raped. The poem contrasts lines (these are the ones that start with “and”) about the doctor’s actions with lines about normal nighttime activities in normal families, where parents care for their children. This contrast highlights the cruelty of the child’s assault, placing kind, normal actions next to tragedy.

As I mentioned, the lines about the doctor’s actions all begin with the word “and.” There are a couple ways to interpret this use. On a structural level, any time “and” is used repeatedly at the beginning of a line in a poem, it usually builds momentum and flow. Think about it this way – when we talk, we often use “and” to link our sentences rather than creating neat, complete ones. For example, “I was talking to her and she said hi and we talked for a while and then I left” sounds more natural than “I was talking to her. She said hi. We talked for a while. I left.” So on one level, the repeated use of “and” structurally ties the poem together, building momentum and making the poem read in one breath rather than distinct sentences. It’s a “real” voice, rather than a performative one.

In terms of content, the use of “and” reinforces the distinction between the doctor’s work and normalcy. Dowling writes, “and when you called for more blood / a bleary-eyed uncle got up to make a feed / and while you stitched / there was another chapter of a favourite story.” Dowling repeatedly lets her reader out of the tragedy, showing them a quiet scene, showing them a child who is well, then uses “and” to pull the reader back to the baby who is hurt, back into a scene that should not have happened.

An analysis done for a related question about this poem can be found at the link below.