Thursday, November 19, 2015

The first time I met Mrs X - Oliver's mother

We had barely gotten the few things we brought to open the new birth center unpacked.    We arranged the birth room and prenatal room.   We knew where emergency kits were and had set up a birth bed and table but we were not yet officially opened.

We arrived Sunday afternoon and by Monday had a full day of prenatal care and machete wounds.   Machete wounds are neat and straight, if you get to them right away.  If you allow them to sit untreated they become an infected mass of puss and scaring.   I had not known this but came to see this but I was new there and this was the day of my first machete wound.  I poured betadine over the wound again and again and put triple antibiotic cream on it. It was too late for stitches and besides I was use to stitching vaginas; not machete wounds.  Later I would put in a few stitches.   Later when I saw how infected they could get and how the children starved if no one went to the farm.   Later when I could no longer see the lines between a birth outcome and the man's ability to farm.

But on that day, looking up from the machete wound, I saw a woman with her husband making her way towards us.  She could barely walk.

The new birth center in Cabestore at dawn with mist still clinging to the mountains

I finished the pouring of the water and tried to get the translator ( a different translator) to help me.   He was restless and did not hold still.  He was from the city and it soon became clear he did not have such a favorable opinion of the  "peasant" community.   It was not what a young, urban, English speaker aspired to.   But he knew the line was not so clearly drawn and the fear of dropping over the edge into such poverty was a day to day struggle of wit and will.

I got that she had diarrhea and it was bad. I rooted through a blue bag where I knew I had packed re-hydration salts.   We used them all the time but this was the first.  I found a bottle and clean water and had her drink some.  She threw up over and over again.  She was lying on the ground in front of the new pink birth center and was having fluids pour out of her.   I gave her anxious husband more packs of de-hydration fluids and told them to go to the hospital.  I said this through a translator who was not paying attention.   Later I would remember this.  Me trying to make sure they knew to go the the hospital, showing them the re-hydration mix and bottle.   The translator walking away and me hauling him back again.

"Are you sure she is going to the hospital? "

"Yes, yes."

But I am never sure.  In the weeks that follow he translates so many things without paying attention and so I am never sure.   It feels too cruel to ask, "Are you sure you told her to go the hospital?"  I ran upstairs and got her a diarrhea pill just to hold her till she got to LasCahabas.

We arrived Sunday and it was only Monday.

Later I would learn to walk upstairs and get 100 gouds and put the sick person on the moto - no going home- no nothing - just go now!

I never saw her again.   The next thing I knew we were walking up the path to her funeral and wondering what to do with the baby.

I had put together some emergency kits to prevent maternal and newborn deaths but there I was with a mother newly dead and a baby with slim chances of survival.

I walked that path many times and as I walked I asked, "Why did she die?"   She had gotten prenatal care at the mobile clinic.  She had not died in childbirth but she had died of an undiagnosed cause and the baby might die too.   In this way, I began to collect clues and conduct an investigation.

In the belief system of many people, a person can put a curse on you.  The translator says the person can send an actual virus or bacteria so it looks like an illness but it was sent by someone.   "Buy who? I ask.

"Sometimes you never know."   He does not have much patience for my questions.   It is just how it is.  He plays music all night long. Between his music and the dogs, it is hard to sleep.   The music keeps the bad spirits away.   I wonder out loud.  Maybe the bad spirit is things people worry about or a past argument or a loss of a good friend or fear.

"More than just that."    he does army calisthenics each morning with the midwives.   The young women at the water pump laugh so hard they can barely stand.  I take it all in - the baby without a mother, the calisthenics and the water pump.

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