Life/Death

Death is here. No matter how I may try to avoid it, to run or hide from it, death is in this village. It’s amongst the children, which for some reason feels like the biggest injustice of all. You can smell it, the sickness, and in contrast the health amongst them. One of the children moans in a decibel that reminds me of a kitten. When I heard him in the infirmary the other day I thought the woman in maternity had given birth, but when I glanced in and saw her still full belly I checked the other room.

His mother had been cradling him, and my mind struggled to slowly register the contradiction between what I was hearing and seeing. While I heard the shallow cries of a newborn, I saw that the limbs of this child were too long to be a newborn. When I got closer and saw his skeletal mouth full of teeth and head full of the fuzz of a newborn I knew something was incredibly wrong.

I checked his chart and sure enough he was nearly a year and a half old. I glanced at his growth chart, which had progressed for a short period and then plummeted towards the bottom of the chart. Prior to this I’d never thought of that line as what it is, an indicator of growth in relation to averages, of expectations, something that measures health in relation to the space that one takes on the planet, one’s height and weight, a record of growth, of progress. What this line appeared to me as that day was an indication of the decreasing space this child required on the planet, likely soon to be no space.

The nurse standing next to me noticed the change in my demeanor as I reviewed the chart. Failure to thrive was written nowhere but rather implied. The multiple HIV blood tests taken from the baby’s foot had not been returned from the lab in Gaborone, but there was no doubt that HIV was the culprit. Tears welled in my eyes and I looked away. I quietly asked the nurse in English if the baby would live through the night.

“You feel for the kid, huh?” he said sympathetically. “He’ll be fine, he’s a fighter, look how many times he’s been to the clinic and he’s still fighting!” his enthusiasm rang with the hollowness of we both knew was the reality of the situation. I went to find the child a rattle that was left over from the breast feeding promotion we had. I was trying to distract him from the agony of the nurses probing every tiny vein in his emaciated body in a valiant attempt to revive and rehydrate him. I grimaced when he went to put his left thumb in his mouth, he had used this particular method to comfort himself so frequently that he had sucked off much of the skin, and refused to use his right thumb. He also refused the offer of the rattle, the pain in his watery eyes accusatory; it was as though he was insulted by my feeble attempt to comfort him with a bloody rattle.

I walked out of the infirmary, helpless, hopeless.

The next morning I arrived at the clinic to find the child had indeed survived the night, and sent up some gratitude to the universe. The patients and I made our way down to the boat to travel across the river to the hospital in Gumare.

On that journey, somewhere between Seronga and Sepopa another child, a brand new baby, has died. The last breath has escaped her lips and there’s nothing any of us can do about it, least not me. On the shore at Sepopa the women call me over in English, which is how I am first alerted to the problem. The people in my village and all the surrounding villages have decided that I will learn Setswana by immersion if nothing else, or perhaps they’re just more comfortable speaking in their native tongue and hoping I understand through some magic Rosetta stone of the universe. But when I hear them speaking to me in careful English I can sense the urgency in the situation. I know that obviously there are sick people on the boat, it is the water ambulance after all, and so most people are being transported to hospital, but I hadn’t taken the time to consider the ratio of women to sick children until now. So I approach them, and they open the circle from which they were originally huddling around the silent bundle in one woman’s arms.

“Is this baby alive, Lorato?” I hesitate to look but know I must. I see the baby’s purple face, lips still wet with her first tastes of life and although I know the inevitable answer, I search her motionless, still warm body for signs of life. I lift her arm, still covered in the waxy coating of birth, and search for a pulse, my thumb big and awkward and nearly the size of her tiny wrist. I fumble around before realizing that one’s thumb has a pulse of its own, and thus I must use one of my fingers, but I find they’ve also developed a pulse of their own.

I feel my own heart begin to race as I search for life in this child, it’s a cross between taunting me with the strength of its pounding and my own desperation to give this mother another answer than what is now the truth. I begin to feel frantic and panicky, as though there is some cosmic move I can make to bring this child back from the other side, if I only knew it, if only. The women somberly look over me, patiently waiting to see if my white skin does indeed have the special powers of which they’ve only heard.

It’s like not knowing the answers on exam day, or every bad dream I’ve ever had where I cannot control the course of events in any way, like the other night when I woke up crying. I look around in a state of anxiety and insecurity, I want someone else to take this burden, I don’t know what to do, and I’m not the doctor. I want to scream it; I want to run away, I want to know how to handle this situation.

There is no way. I’m the only one who hasn’t accepted the inevitability of the situation. Life and death come every day to Seronga, and everyone seems to know the score but me.

Just when I think that my heart is finished, that it has shriveled and hardened into a little palm nut, covered in a hard, protective shell, it is broken again. A tender piece of flesh exposed, to the wind, to the world, to the hurt and it bleeds anew. A little river of pain flows through and I know I can still feel, and this feeling is sadness. And it is sprinkled with despair, and laced with hopelessness, and I can taste the pain, it springs bitter onto the tip of my tongue and it mixes with the bile of the rage which has risen in my throat, the indignation and confusion that although this matters, it doesn’t seem to matter.

I want to scream primally, I want to howl, I want to shake my fist at the heavens and demand that this child’s spirit and her life be returned to its rightful place here on Earth. But how can I do any of these things when the child’s own mother sits stoically next to the woman who holds her now lifeless child, the body of which sprung from her own body less than 12 hours previous. The tears stream silently down my own face, defying the dehydration that is my normal state of being to protest this awful situation.

What do you do? There’s nothing. I don’t mean to sound like a “save the children” ad here, and to be honest it frustrates me to describe the problem in any depth as I know from living here that there is certainly not an easy, and possibly not even a difficult implimentable solution to this problem, which surely will not be solved any time soon.

Why should I even write about it, to make all of you reading this have an idea of the shittiness if there’s nothing to be done about it? I guess I do it to get rid of some of the rage and sadness that lives inside me as a result of this experience. Parts of me are becoming hardened to this constant human suffering, but am I so different from people who work anywhere else doing this type of work? What about nurses and doctors in Emergency Rooms anywhere on Earth, or homicide detectives, or even teachers in some areas?

What obligation can I possibly have to each of these children? What can I do? I swear I would move mountains if I thought it would help…

I have no answers. This upsets me. I go on with life, not able to forget, but slightly becoming numb to the pain.

This day comes, as all do, to an end. Later, in the darkness of night I hear the rain begin to fall on the corrugated iron roof. I run outside, desperate to feel the rain on my skin, to cleanse me of this day. I look to the sky for answers and find my hot tears mixing with the cold rain. I yearn to have the lightning illuminate the world, and make it clear again, if only for a moment.