Saturday at 5pm I found myself lying in the lab at Central Hospital listening to Mr Chabwera's life story while waiting for the blood, draining ever so slowly from my arm, to fill the one pint plastic bag lying on the stool. Mr Chabwera is a lovely man who does his job with such attention and care you might mistake it for passion, but he told me that his original dream was to be a lawyer. From the looks of it he is probably now in his mid-forties and although he has over ten years of experience working in the lab, has just recently been admitted into a bachelor's program of laboratory science. Off to a late start, he began school at the age of 10. When he was 12 he saw part of a court case and was swept away with awe and admiration for the judge. When he asked his father what he would need to do to become a judge, his poor uneducated father replied, "You keep studying and then you'll find out." At the end of high school his marks were not good enough to gain entrance into the university but he was offered a position in a certificate program for lab technology and that is what he did. He might have made a good lawyer but certainly the way he moves around the lab and the way he talks you can tell his work is infused with the knowledge that people's lives depend on his dedication.
Saturday morning I went to visit a few former patients in Lilongwe, including Doreen and Dalitso, whom I found well but hungry. Doreen depends completely on her 22 year old cousin who already supports herself and two children and whose sole source of income is the rent from three small rooms behind the house (I imagine a total sum of less than US$30/mo.) Dalitso now 4 months, is able to sit by himself and smiles a lot. He's beautiful and chubby, but I think every ounce of fat he gains comes off Doreen's bones. The last several times I visited Doreen told me that she has had nothing to eat. I wrestled with myself a bit over situation, wondering if I would be reinforcing a cycle of dependency if I support her and then silently yelling at myself, "Is there another reasonable option?!" I decided that Doreen is 18 and she is a dependent (both he parents are dead and her other adult guardian died, both her cousin's parents are also dead) and that's okay. She is doing really well with Dalitso, plus she is going to school, and like most people she wants a better life and wants to do better for her son and for herself. These moments make me aware of my own unhealthy maternalistic tendencies. We have to trust people, to believe that if given the resources, they will (in most cases) manage their lives appropriately. It's a problem that stretches from me to our international development policies.
After leaving Doreen, I met up with Deb, and together we went to visit a couple patients at Bottom . . . Ireen who came in the previous day with a Hemoglobin (Hb) of 1.7, and Emily whose eclampsia transformed her from a normal young girl into a shadow, no longer responding to family or voices, only to pain. Ireen had received 2 pints of blood on Friday but each pint only raises the Hb by about 1 point so she really needs 10 pints (spaced out over several days).
Ireen had delivered at Bottom on March 10th and was severely anemic then, to the point where I thought she would surely die soon. But, luckily she survived that crisis. Unfortunately, the cause of her anemia was never corrected so she returned to the village and the deterioration resumed; her milk also began to dry up and so her mother and grandmother supplemented the breastfeedings with water. When she reached the hospital Friday she was barely conscious, only muttering unintelligibly and screaming when I placed the IV. Tarek was not around for most of the day (busy at Central hospital) and I felt myself cursing his absence wanting him to be there to care for this incredibly sick woman (not me). Of course when he did arrive later in the afternoon, after she had received 1/2 a pint (and her Hb was probably 2), she sat up at the sight of him, began talking and joking in Chichewa - startling us and the guardians. If only our presence was enough for these patients.
Saturday, Irene was about the same as she was on Friday, conscious but white as death. Her guardians are both incredibly sweet and since I told them that I would like to visit them in the village and check in on the baby, every time they see Deb and me they ask us if we will come and tell us we must learn Chichewa.
Emily was also slightly improved. Her fever from the previous day resolved and although she still would not respond when I called her name, her guardians said that she responded to them and that she was able the eat the porridge they spoon fed her. Having received no nutrients for 4 days her milk was also drying up and the guardians were supplementing with formula from the nursery. I told them I would like to also visit them and see the baby over time.
Before we left Bottom we were told by the postnatal nurses that they had been waiting for blood for four patients all day, including Ireen, but had not yet received anything. So, Deb and I headed to Central and found Mr Chabwera. At the moment the blood bank at Central is a sad sight, just a few lonely pints in the fridge. Three of the patients who needed blood were A+ and one was O+. There were several pints of A+ so Mr Chabwera readily put those aside for us but there was only a single pint of O+ blood left for the entire hospital. The three of us stood over it, staring at it, debating whether to give it to the woman with an Hb of 4 or to save it for Pediatrics (if used for children it could save several lives). Finally we decided to do a swap, we would take the screened pint of O+ and I would leave a pint (I am also O+) which would be screened as soon as someone showed up with the keys to the cupboard that held the reagent needed to do the HIV test.
On the bright side, my goal to organize a blood drive at the Embassy, benefiting Bottom and KCH, is really going to happen. Flyers have been posted at Peace Corps, the Embassy, USAID, CDC, and the British High Commission. The date is set for April 11th. People I talked with have seemed enthusiastic so I hope the turn out will reflect their tone.
Ok, now if you can, wherever you are, go donate blood!
Monday, March 27, 2006
Tuesday, March 21, 2006
Grace
I just went to visit Frank and his baby Grace. He told me everyone has started calling her Joana.
Monday, March 20, 2006
Heart-Warming
During the hand-shaking rounds on my second day at the Embassy, Elizabeth told me that her guard Frank's wife died at Kamuzu Central Hospital the day after giving birth just one week previously. Elizabeth and her partner played an active role in ensuring that the wife received adequate prenatal care and everything seemed to be going well. Frank is 28, his wife Grace was 26. The two of them met, fell-in-love, married and got pregnant within the span of two years. Elizabeth said they were both kind and naturally bright people who should have been doing better in life but were poor because they were born poor and their families were poor. Grace's death was a huge shock to everyone.
About a week later I met Frank at Elizabeth's and together we made our way to his mother-in-law's house where his baby girl was staying. Frank told me more of their story on my second visit. He said that Grace delivered in a health center and everything went well with the birth. After seeing his wife and sharing the thrill of their new daughter, he ran home to gather food and other items they needed. When he got back to the hospital the nurse told him that his wife was incredibly sick and would be transferred to the ICU at KCH. The next day everything seemed to deteriorate. Neither Frank nor his wife knew what was happening, but he said there was a moment when she realized she was dying. She cried about leaving him and the children. (Grace also had a boy, he is six years old now. His dad abandoned Grace as soon as he learned she was pregnant. Frank considers this boy his son and the boy has never known another dad.) They cried together, and she made him promise to take good care of their daughter.
After he finished the story Frank looked at the boy lovingly and as he tearfully shook his head he said, "This one gives me a lot of problems, every night he asks, "Where's mom? Where's mom? And he just cries when I work night shifts and don't come home."
Frank showed me the death certificate; it said "toxemia of pregnancy." Grace died from eclampsia, a little understood disease of pregnancy the end result of which is multi-system organ failure. Although women do become preeclamptic in the developed world they rarely develop eclampsia (the diagnosis is given once a woman seizes) and very rarely die. Here, this is a much more common cause of death for various absurd reasons (I'll leave out speech). Frequently, the diagnosis is not made until there is a seizure, which happens fairly late in the pathological process.
Frank is clearly a special person and adores his little Grace. Although she doesn't live in his house, he lives only 1000 meters away and spends all his off-duty time with her. He asked me to come visit regularly to make sure she is healthy and growing well, and she is. She's sweet and chubby and usually bundled in multiple layers of tenderly knitted outfits (sweating in the African heat), clearly a dearly loved child. I don't do much, just hold her, and reassure Frank, and deliver formula when his supply runs low. He's a great dad.
Last week Elizabeth stopped by to tell me that Frank took Grace for her well-baby check and was told that she was the healthiest baby of all those who visited the clinic that day. Elizabeth said Frank was glowing.
Yesterday Frank called to tell me that he had something to tell me and he would come to the Embassy today to see me. ? ? ?
This morning I found Frank waiting for me at the entrace of the Embassy and he said that he decided to volunteer at the Crisis Nursery one day every week, "as a way to thank you people for everything you've done for me." I felt like laughing and crying all at once. This is someone who works six days a week and earns about US$30 a month, has lost his wife, is raising two children and still has a surplus of love to share with orphans. Frank just laughed at my reaction, said "Thank you" and "When are you coming?"
"Tuesday, I'll see you and Grace Tuesday."
About a week later I met Frank at Elizabeth's and together we made our way to his mother-in-law's house where his baby girl was staying. Frank told me more of their story on my second visit. He said that Grace delivered in a health center and everything went well with the birth. After seeing his wife and sharing the thrill of their new daughter, he ran home to gather food and other items they needed. When he got back to the hospital the nurse told him that his wife was incredibly sick and would be transferred to the ICU at KCH. The next day everything seemed to deteriorate. Neither Frank nor his wife knew what was happening, but he said there was a moment when she realized she was dying. She cried about leaving him and the children. (Grace also had a boy, he is six years old now. His dad abandoned Grace as soon as he learned she was pregnant. Frank considers this boy his son and the boy has never known another dad.) They cried together, and she made him promise to take good care of their daughter.
After he finished the story Frank looked at the boy lovingly and as he tearfully shook his head he said, "This one gives me a lot of problems, every night he asks, "Where's mom? Where's mom? And he just cries when I work night shifts and don't come home."
Frank showed me the death certificate; it said "toxemia of pregnancy." Grace died from eclampsia, a little understood disease of pregnancy the end result of which is multi-system organ failure. Although women do become preeclamptic in the developed world they rarely develop eclampsia (the diagnosis is given once a woman seizes) and very rarely die. Here, this is a much more common cause of death for various absurd reasons (I'll leave out speech). Frequently, the diagnosis is not made until there is a seizure, which happens fairly late in the pathological process.
Frank is clearly a special person and adores his little Grace. Although she doesn't live in his house, he lives only 1000 meters away and spends all his off-duty time with her. He asked me to come visit regularly to make sure she is healthy and growing well, and she is. She's sweet and chubby and usually bundled in multiple layers of tenderly knitted outfits (sweating in the African heat), clearly a dearly loved child. I don't do much, just hold her, and reassure Frank, and deliver formula when his supply runs low. He's a great dad.
Last week Elizabeth stopped by to tell me that Frank took Grace for her well-baby check and was told that she was the healthiest baby of all those who visited the clinic that day. Elizabeth said Frank was glowing.
Yesterday Frank called to tell me that he had something to tell me and he would come to the Embassy today to see me. ? ? ?
This morning I found Frank waiting for me at the entrace of the Embassy and he said that he decided to volunteer at the Crisis Nursery one day every week, "as a way to thank you people for everything you've done for me." I felt like laughing and crying all at once. This is someone who works six days a week and earns about US$30 a month, has lost his wife, is raising two children and still has a surplus of love to share with orphans. Frank just laughed at my reaction, said "Thank you" and "When are you coming?"
"Tuesday, I'll see you and Grace Tuesday."
Sunday, March 12, 2006
Simple Joy
The world is an incredible place to be in . . . I feel alive and happy, so I decided this would be a good moment to write an entry. Clement and I just returned from our friends' house in Natenji, a green 20km South of Lilongwe. Malawi is stunningly beautiful at the moment. The hills and distant mountains transformed from barren brown to lush green with the attentive care of the rains. The maize grows thick and tall in the fields and they say this year there will be a record harvest, maybe enough to feed the entire population (usually in a good year 25% of the population faces food insecurity, this year it was closer to 80%).
Our friends are lovely. I am constantly in awe of and grateful for the people who color my life. Patricio is Chilean and works on wildlife conservation projects. Dominique, his Belgian/Congolese wife, is a nurse who now works with health outreach projects. They are a beautiful couple on multiple levels. Dominique is 7 months pregnant and they have asked me to attend their birth. It is a huge honor and will be the first birth of a friend that I will attend as a midwife.
We spent the afternoon leisurely eating a delicious meal and discussing the pieces of Malawi we love. Here is a smattering from our list: the calmness of the people, the peacefulness of the country, the beauty of the land, the beautiful women and adorable kids. Dominique and Patricio live near a village and they talked about the laughter and song of the women lilting into their yard. Patricio said, "the women here are incredible, they get up at 4am, cook, carry water, work in the fields, clean, tend their families, and then in the evening they sing. Sometimes I just want to shake them and tell them to please rest." Dominique talked about the dancing, how health messages are learned as songs and dances, and then shared by women volunteers with people in their communities. She noted that everyone, young and old, is happy to participate; everyone is equally willing to get up in front of a group and dance with the simple joy of movement and without a grain of self-consciousness.
Of course for me, many of the good moments are also birth related. I had a couple sweet birth moments recently. . .
(1) About a week ago there was one woman who was having a particularly difficult birth. Birth is painful for most women but a few women truly suffer with their labor beyond what others experience. This woman cried for hours, often calling for the nurses who could do little to comfort her; incessantly changing positions to try and find relief. I was with her when she finally delivered. At the first cry of the baby, the laboring women occupying the bed next to her let out a laugh of pure glee and began clapping.
I cleaned the woman, told her she had a boy, and arranged her and her little boy in the bed. A few minutes later the maid shouted her name from the doorway. (The patients' caretakers wait outside and will occasionally ask the maids to find out if their relative has delivered.)
She responded, "INE!" (I am).
"MWACHIRA?" (Have you delivered?)
"EI!" (Yes)
"WACHIANI?" (what is it?)
She clutched her baby happily but looked at me, completely exhausted and confused "Wachiani?"
Her neighbor, who witnessed the whole thing, laughed again between her own contractions.
"Mwamuna," I said.
"MWAMUNA!"
(2) There was a really sweet girl who came into the labor ward at the beginning of my night shift last week. She said she was 20 but looked closer to 16. Her expression was intense, focused, innocent, and fearful. Looking at her still, she looked like a normal young girl, but movement made her jerky and a bit imbalanced, maybe polio? maybe muscular dystrophy? She came first in early labor and was sent out but her contractions continued so was eventually settled into a bed in the ward. I kept an eye on her, just noticing her, and feeling a bit protective.
Another nurse attended her delivery in the early morning hours but the ward was almost empty so I stood maybe 15 feet away and watched. This particular nurse is a very sweet woman but sometimes assumes the persona of a little soldier, shouting directions and orders at the laboring women as she walks between the beds. And so she stood, shouting directions on how to push as the girl grabbed her knees, shut her eyes tightly, and pushed with all her might. Every now and then she would open her big fearful eyes, look briefly at the nurse, and then snap them shut to push again tensely and intensely.
The girl did a beautiful job. The baby was born and I watched the nurse lay it on the girl's belly, wipe it and cut the cord. But I also noticed the still blue legs remained still. At that point I retrieved the baby from the mom, gave her a few breaths until she became pink and cried. When I took her back to her young mom, the girl held out her arms with fingers spread wide, craning her neck, as though she was reaching with all her will for the most precious thing. As she took the baby from me and brought her gingerly to her chest, everything softened; her limbs and expression taking on peace. "Wamkazi," (Girl) I said. She opened her eyes - now big, soft, and warm - met my gaze and then closed them again. She was holding the most precious thing.
Our friends are lovely. I am constantly in awe of and grateful for the people who color my life. Patricio is Chilean and works on wildlife conservation projects. Dominique, his Belgian/Congolese wife, is a nurse who now works with health outreach projects. They are a beautiful couple on multiple levels. Dominique is 7 months pregnant and they have asked me to attend their birth. It is a huge honor and will be the first birth of a friend that I will attend as a midwife.
We spent the afternoon leisurely eating a delicious meal and discussing the pieces of Malawi we love. Here is a smattering from our list: the calmness of the people, the peacefulness of the country, the beauty of the land, the beautiful women and adorable kids. Dominique and Patricio live near a village and they talked about the laughter and song of the women lilting into their yard. Patricio said, "the women here are incredible, they get up at 4am, cook, carry water, work in the fields, clean, tend their families, and then in the evening they sing. Sometimes I just want to shake them and tell them to please rest." Dominique talked about the dancing, how health messages are learned as songs and dances, and then shared by women volunteers with people in their communities. She noted that everyone, young and old, is happy to participate; everyone is equally willing to get up in front of a group and dance with the simple joy of movement and without a grain of self-consciousness.
Of course for me, many of the good moments are also birth related. I had a couple sweet birth moments recently. . .
(1) About a week ago there was one woman who was having a particularly difficult birth. Birth is painful for most women but a few women truly suffer with their labor beyond what others experience. This woman cried for hours, often calling for the nurses who could do little to comfort her; incessantly changing positions to try and find relief. I was with her when she finally delivered. At the first cry of the baby, the laboring women occupying the bed next to her let out a laugh of pure glee and began clapping.
I cleaned the woman, told her she had a boy, and arranged her and her little boy in the bed. A few minutes later the maid shouted her name from the doorway. (The patients' caretakers wait outside and will occasionally ask the maids to find out if their relative has delivered.)
She responded, "INE!" (I am).
"MWACHIRA?" (Have you delivered?)
"EI!" (Yes)
"WACHIANI?" (what is it?)
She clutched her baby happily but looked at me, completely exhausted and confused "Wachiani?"
Her neighbor, who witnessed the whole thing, laughed again between her own contractions.
"Mwamuna," I said.
"MWAMUNA!"
(2) There was a really sweet girl who came into the labor ward at the beginning of my night shift last week. She said she was 20 but looked closer to 16. Her expression was intense, focused, innocent, and fearful. Looking at her still, she looked like a normal young girl, but movement made her jerky and a bit imbalanced, maybe polio? maybe muscular dystrophy? She came first in early labor and was sent out but her contractions continued so was eventually settled into a bed in the ward. I kept an eye on her, just noticing her, and feeling a bit protective.
Another nurse attended her delivery in the early morning hours but the ward was almost empty so I stood maybe 15 feet away and watched. This particular nurse is a very sweet woman but sometimes assumes the persona of a little soldier, shouting directions and orders at the laboring women as she walks between the beds. And so she stood, shouting directions on how to push as the girl grabbed her knees, shut her eyes tightly, and pushed with all her might. Every now and then she would open her big fearful eyes, look briefly at the nurse, and then snap them shut to push again tensely and intensely.
The girl did a beautiful job. The baby was born and I watched the nurse lay it on the girl's belly, wipe it and cut the cord. But I also noticed the still blue legs remained still. At that point I retrieved the baby from the mom, gave her a few breaths until she became pink and cried. When I took her back to her young mom, the girl held out her arms with fingers spread wide, craning her neck, as though she was reaching with all her will for the most precious thing. As she took the baby from me and brought her gingerly to her chest, everything softened; her limbs and expression taking on peace. "Wamkazi," (Girl) I said. She opened her eyes - now big, soft, and warm - met my gaze and then closed them again. She was holding the most precious thing.
Thank You
Thank you for your empathetic responses, your comments, emails, and telephone calls. Thank you for reading, for acknowledging, for feeling, for sharing this with me. Thank you for being here. Whether I know of your presence or not, I am deeply appreciative.
A few people have asked me for my updated contact information, so here it is:
Joanne Jorissen
PO Box 30543
Lilongwe, Malawi
AFRICA
tel: 011-265-8-525-951 (as directly dialled from the States)
time difference: Malawi is 6 hours ahead of the East Coast and 9 hours ahead of the West Coast.
calling cards: you can find cheap calling cards $.02/min - check the link on this site "call Malawi"
e: joanne_jorissen@yahoo.com
A few people have asked me for my updated contact information, so here it is:
Joanne Jorissen
PO Box 30543
Lilongwe, Malawi
AFRICA
tel: 011-265-8-525-951 (as directly dialled from the States)
time difference: Malawi is 6 hours ahead of the East Coast and 9 hours ahead of the West Coast.
calling cards: you can find cheap calling cards $.02/min - check the link on this site "call Malawi"
e: joanne_jorissen@yahoo.com
Thursday, March 09, 2006
Gabriel
Gabriel. I don't think I mentioned that his name was Gabriel. The second time I went to the village to collect him along with grandma, Anije (who actually turned out to be his great-aunt, but that will come later in the telling), I asked her his name. She just shook her head. Thirty minutes later when the admitting nurse at the hospital asked her she said, "Gabriel." And so, just like that he became someone. From the time of my last entry until this Monday grandma and Gabriel were regulars on the malnutrition ward. I stopped by every few days to check-in on the two of them, and usually found grandma roaming around with peanut strapped to her back. He was so tiny, sometimes you had to consciously look at the form of her chitingi to see his small bulge.
On the ward his health improved significantly; his little bum healed, the thrush sores in his mouth healed, his little cheeks started filling out a bit, and my fantasies of seeing him as a chubby little kid took flight. The stay was clearly doing much good for Gabriel but it was a strain on Anije. Everytime grandma saw me or Clement or Lisa, the pediatrician, she always asked brightly when they could leave. About two weeks ago I called a social worker Friday evening to see if I could get the baby placed at a nursery in town. The nursery, "Crisis Nursery" is run out of a home, and staffed by a mix of paid Malawians and many volunteers. It's clean and the babies get plenty of attention and good care. The social worker met me at the hospital Saturday morning and interviewed Anije, me, and the nurse after which she decided that the baby would not survive in the village until it was at least six months old. She made a deal with grandma - they would stay in the ward until the baby weighed 3.2kgs (at that time he weighed 2.9kg) and then we would take him to the nursery and I would pick grandma regularly from the village to come and visit until he was 6 months to 1 year old. The social worker called the nursery and the director said she would come and visit baby and granny the next day. I was so thrilled and impressed by the speed of the process - that would never have happened so quickly and smoothly in the States.
From that point, the program continued . . . my visits, grandma clearly loving but eager to leave, and the little one, improving but failing to gain weight. He hovered around 2.9 for at least a week, reaching 3 on some heavy days but always returning to 2.9. Monday night Clement told me that grandma left without being discharged. She sought him out so he could convey the message to me that her son-in-law was very sick at a hospital in Likuni and she had to go see him and her daughter, and that I should find her there to take little Gabriel. I had to laugh when I realized that she was probably stashing away the money I was giving her for food to fund her escape - without that I was her only way out.
Yesterday, I called the director of Crisis Nursery and she said she had come to meet them previously but couldn't find them. She found another abandoned baby instead who she gathered up and took with her to the nursery. She said she would meet me Thursday to go to Likuni together and collect Gabriel. I wanted to make sure they were at the hospital so yesterday afternoon I went to Likuni and combed every corner of the grounds with the help of a few nurses and maid but did not find them. I thought about going to the village but thought again and decided to go this morning.
Today was not a good day. On my way out of town I dented my car at a gas station (they have these big cement blocks that are low to the ground, too low to be seen, but high enough to do damage) and that was the beginning.
About a kilometer from the turn off of the main road towards the village I met grandma walking with a group of women with no little bulge on her back. I stopped and she told me so many things with incredible emotion but I only picked out that Gabriel died Wednesday. Thankfully her daughter-in-law who was present, spoke English and filled in the details. Apparently she went to see her son-in-law at Likuni but he died shortly thereafter and so she returned to the village to help with preparations for the funeral. The seven women were on their way to Lilongwe for the funeral when I met them. Wednesday, Gabriel began coughing and as they were heading back to the hospital, he died. Anije said we should go together to the house to see the body and then I could give them a lift back to Lilongwe.
As soon as I heard he died tears starting spilling on to my cheeks. We drove the 600 meters back towards the house, parked the car and then walked the last 500. There were so many women the whole way, lining the path to the house, silent, watching. Anije led us, moaning and crying with each step, her daughter-in-law took my hand in hers and we cried together silently. When we approached the house an older woman I didn't know took my other hand and the two of them led me inside behind Anije. The small dark room was filled with women and in the middle on a single thatch mat was the little wrapped body. A path opened for me, someone pulled the cloth down to reveal his face, and instantly the room filled with wailing and sobbing. . The scene was heartbreaking but I also felt so much love and support in that small room, in a way I have never previously experienced.
I just sobbed, loudly, messily; the women around me, touching my arms, crying with such love and pain. What really broked me was when one by one, all the women got up, came to me, looked me in the eyes, and silently shook my hand. Their immense gratitude surprised and overwhelmed me. I felt I had failed them and failed Gabriel, but at that moment I also felt, that I would never leave this world whether it's Malawi or somewhere similar. I will give them anything. I will give myself. We stayed only thirty minutes or so before we headed back to the car. Along the way Anije's husband and Gabriel's grandfather intercepted us. They each shook my hand and said thank you and sorry. Gabriel's grandfather said, "He has died, but he has really been loved. Don't worry." (I'm a slobbering mess again as I'm typing this in the internet cafe.)
From there, seven women piled into my 5-seater sedan and we drove to Lilongwe. Along the way Eliza, Anije's daughter-in-law told me that Anije was the aunt of the girl who died and the woman, who I thought was the 17-year-old's older sister was actually her mother and Anije's sister. Discerning blood relationships is difficult because the bottom line is that many women care for the children around them as their own. In the end, blood in only one of many lines of love and connection.
I dropped the women outside another house of mourning. Anije said thank you and that I should continue to visit the village. Eliza said there was so way to thank me. I said, "I wish I could have done more, I'm sorry." And I do, I know I shouldn't go down this path of thinking but it's difficult not to, what if I had gone to the village Wednesday afternoon or Tuesday morning to Likuni hospital???
* * *
My mom told me that all my entries are too sad and that I need to write about the good moments and the beauty of Malawi. Several friends have also told me that the stopped reading because it is too depressing. I promise I was planning to write a happy entry and I will but I appreciate your presence and compassion through this most recent heartbreak.
On the ward his health improved significantly; his little bum healed, the thrush sores in his mouth healed, his little cheeks started filling out a bit, and my fantasies of seeing him as a chubby little kid took flight. The stay was clearly doing much good for Gabriel but it was a strain on Anije. Everytime grandma saw me or Clement or Lisa, the pediatrician, she always asked brightly when they could leave. About two weeks ago I called a social worker Friday evening to see if I could get the baby placed at a nursery in town. The nursery, "Crisis Nursery" is run out of a home, and staffed by a mix of paid Malawians and many volunteers. It's clean and the babies get plenty of attention and good care. The social worker met me at the hospital Saturday morning and interviewed Anije, me, and the nurse after which she decided that the baby would not survive in the village until it was at least six months old. She made a deal with grandma - they would stay in the ward until the baby weighed 3.2kgs (at that time he weighed 2.9kg) and then we would take him to the nursery and I would pick grandma regularly from the village to come and visit until he was 6 months to 1 year old. The social worker called the nursery and the director said she would come and visit baby and granny the next day. I was so thrilled and impressed by the speed of the process - that would never have happened so quickly and smoothly in the States.
From that point, the program continued . . . my visits, grandma clearly loving but eager to leave, and the little one, improving but failing to gain weight. He hovered around 2.9 for at least a week, reaching 3 on some heavy days but always returning to 2.9. Monday night Clement told me that grandma left without being discharged. She sought him out so he could convey the message to me that her son-in-law was very sick at a hospital in Likuni and she had to go see him and her daughter, and that I should find her there to take little Gabriel. I had to laugh when I realized that she was probably stashing away the money I was giving her for food to fund her escape - without that I was her only way out.
Yesterday, I called the director of Crisis Nursery and she said she had come to meet them previously but couldn't find them. She found another abandoned baby instead who she gathered up and took with her to the nursery. She said she would meet me Thursday to go to Likuni together and collect Gabriel. I wanted to make sure they were at the hospital so yesterday afternoon I went to Likuni and combed every corner of the grounds with the help of a few nurses and maid but did not find them. I thought about going to the village but thought again and decided to go this morning.
Today was not a good day. On my way out of town I dented my car at a gas station (they have these big cement blocks that are low to the ground, too low to be seen, but high enough to do damage) and that was the beginning.
About a kilometer from the turn off of the main road towards the village I met grandma walking with a group of women with no little bulge on her back. I stopped and she told me so many things with incredible emotion but I only picked out that Gabriel died Wednesday. Thankfully her daughter-in-law who was present, spoke English and filled in the details. Apparently she went to see her son-in-law at Likuni but he died shortly thereafter and so she returned to the village to help with preparations for the funeral. The seven women were on their way to Lilongwe for the funeral when I met them. Wednesday, Gabriel began coughing and as they were heading back to the hospital, he died. Anije said we should go together to the house to see the body and then I could give them a lift back to Lilongwe.
As soon as I heard he died tears starting spilling on to my cheeks. We drove the 600 meters back towards the house, parked the car and then walked the last 500. There were so many women the whole way, lining the path to the house, silent, watching. Anije led us, moaning and crying with each step, her daughter-in-law took my hand in hers and we cried together silently. When we approached the house an older woman I didn't know took my other hand and the two of them led me inside behind Anije. The small dark room was filled with women and in the middle on a single thatch mat was the little wrapped body. A path opened for me, someone pulled the cloth down to reveal his face, and instantly the room filled with wailing and sobbing. . The scene was heartbreaking but I also felt so much love and support in that small room, in a way I have never previously experienced.
I just sobbed, loudly, messily; the women around me, touching my arms, crying with such love and pain. What really broked me was when one by one, all the women got up, came to me, looked me in the eyes, and silently shook my hand. Their immense gratitude surprised and overwhelmed me. I felt I had failed them and failed Gabriel, but at that moment I also felt, that I would never leave this world whether it's Malawi or somewhere similar. I will give them anything. I will give myself. We stayed only thirty minutes or so before we headed back to the car. Along the way Anije's husband and Gabriel's grandfather intercepted us. They each shook my hand and said thank you and sorry. Gabriel's grandfather said, "He has died, but he has really been loved. Don't worry." (I'm a slobbering mess again as I'm typing this in the internet cafe.)
From there, seven women piled into my 5-seater sedan and we drove to Lilongwe. Along the way Eliza, Anije's daughter-in-law told me that Anije was the aunt of the girl who died and the woman, who I thought was the 17-year-old's older sister was actually her mother and Anije's sister. Discerning blood relationships is difficult because the bottom line is that many women care for the children around them as their own. In the end, blood in only one of many lines of love and connection.
I dropped the women outside another house of mourning. Anije said thank you and that I should continue to visit the village. Eliza said there was so way to thank me. I said, "I wish I could have done more, I'm sorry." And I do, I know I shouldn't go down this path of thinking but it's difficult not to, what if I had gone to the village Wednesday afternoon or Tuesday morning to Likuni hospital???
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My mom told me that all my entries are too sad and that I need to write about the good moments and the beauty of Malawi. Several friends have also told me that the stopped reading because it is too depressing. I promise I was planning to write a happy entry and I will but I appreciate your presence and compassion through this most recent heartbreak.
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