Just got back from a visit to Bante, a village about 200 km North-Northwest of Porto Novo (250 km drive, though, due to having to take a major detour south through Cotonou because it is really the only highway in Benin). Four of us from the RCH program headed up there on Wednesday morning and returned Saturday afternoon. We visited a volunteer in her 50’s who does RCH work up there in conjunction with the local health center. As part of the “technical” aspect of our technical visit we zemmed out to a nearby village, Banon, and observed/helped with a baby weighing and immunization session there.
This was my first taste of true village life in rural Africa. Upon arriving (I was first), I was offered a chair and there I sat while the worker from the health center went to find his counterpart in village. Children, adults, animals even, gathered in a large circle with myself perched in its radius repeating “bonjour” as I made eye contact or, rather, tried. It seems the children are shyer than elsewhere and uncomfortable with being singled out like that so I put on my sunglasses and sat for almost twenty minutes, a one woman show with no lines and an unlimited supply of self-conscious smiles. At one point a scraggy dog approached me, sniffing the ground near my feet, to which a woman promptly responded with a painful war cry, kicking off her sandal in a blur and walloping the dog on the hindquarter before I had even a thought of acting to prevent it. I mumbled “that’s uncomfortable” to myself as a meager attempt at humor/consolation but nothing doing. I failed to comprehend her reasons for beating a half-starved mange-ridden dog because I remain a culturally insensitive American with one month‘s history in Benin to work with. The difficulty, now, lies in attempting to reconcile my (painfully) deeply ingrained beliefs about the treatment of animals and children with the often seemingly opposite beliefs about said treatment held by the Beninese. I am going to have to understand and accept that there are everyday occurrences over which I have no control, but acceptance in Banon became much harder as my visit to unfolded.
We began to weigh babies when all of the paperwork was in order and the mothers were gathered round, waiting. A couple of hours into it, during the immunizing, I looked over and saw a girl of maybe seven or eight holding the tiniest, frailest baby I have ever seen. I said to my friend that the baby looked severely malnourished, but he replied “Its head is cone shaped from being born. It’s still less than three weeks old.”
“Nah, something about her proportions just looks intuitively wrong,“ I replied unconvincingly. True, her overall size would have indicated a newborn, but her face. She had but a tiny patch of hair on her head, a soft black triangle at the tip of her forehead, and the skin of her scalp and face was loose. Her eyes were wide open, big, round and shiny and looking everywhere with intent, not the way the puffy new lids of a three week-old house straying, wandering new eyes. She knew how to use her eyes, had had plenty of practice. They were sunken though, and as seemed to be common practice in Banon, ash or some other form of eye makeup had been applied around her lids, adding to the effect not of vitality but of sickness, weakness. My eyes moved from the wrinkles on her face and scalp to her limbs. Her arms were thin and limp. She laced and unlaced her fingers in tactile exploration over her puffy, swollen tummy. Her little legs appeared bowed from shin to ankle, either due to a vitamin deficiency or from not having enough meat on her bones. Her feet were crossed. The girl holding her looked at her lovingly and bounced her as though she were a Cabbage Patch doll, then smiled at me, no doubt having taken interest in my unwavering gaze at the little life in her arms. We were both fascinated by the baby girl, each for entirely different reasons.
I learned shortly that the baby girl is five months old. She weighs three kilos, or 6.6 lbs. We have learned in classes that it is highly unlikely that a baby this malnourished can be saved, . I plotted her growth on the chart: indeed, very deep into the “red.” Soon, she will die. I was in Banon Friday morning; she may even be dead now. I do not know, and never will.
Why, right? Why why why why why. Ask it as many times as you like and I’ll give you the same answer: money. Her mother is neither wicked nor evil (I realize in hindsight; picturing her as villainess provided me an outlet for my outrage and helplessness while in Banon). She has another baby and several other children to care for. I learn through translation, for she does not speak French but only Cha, the local language, that the baby will nurse but will not gain weight. This means she is most likely infected with a parasite or other disease preventing her from growing properly, and her mother states she does not have the money to travel the 10km to Bante (which costs about 500CFA, or $1 USD) and have her baby seen at hospital, which would cost more. I want to tell her that a funeral is going to cost more, but I know the baby cannot be saved by me, and I don’t have the words or power within me to change this situation.
Frustration? Doesn’t come close. Helplessness? Closer. Utter exasperation at the system and terror of the insignificance of my role within it? Closer still. I don’t speak French yet. I can get around and survive, but I’m not about to enter into an argument with a mother I don’t know about her economic circumstances and the impact on her family’s health, even is she did understand French. The conflict in me… SAY SOMETHING! THIS BABY IS GOING TO DIE IF YOU DON’T! Beaten out by It wouldn’t matter if you spoke Cha. It wouldn’t matter if you handed her the cash to have her baby treated. The girl would most likely die anyway, I can’t make it right. I can’t fix this. And it isn’t my job to. I am here to teach mothers about the importance of breastfeeding and slow weaning, proper nutrition for themselves while they are pregnant and breastfeeding, utilizing a variety of foods for a well-rounded family diet, hygiene and sanitation, etc. Prevention. Yes, I will catch babies who may be slipping toward the dreaded yellow line on the growth chart, will discuss with their mothers how to bring them back up to the center of the green “safe” zone, but No. I am not a miracle worker and I can’t save a dying baby. If I can accept this, I will have more success in ensuring the health and safety of babies and mothers at my post and the surrounding communities, but if I assume personal responsibility for each of them, I will become overwhelmed and fail. All I can do is provide education, tools and resources to help people take care of themselves. I cannot do it for them and I must promise myself I will not chase the impossible, lofty goals so many of us imagine upon signing on to a job like this.
I am focusing on the fact that my witnessing a phenomenon doesn’t cause it to happen. It is a reality external of my observation of it. I take, if not solace, than a degree of relief in this knowledge. What I haven’t figured out yet is the extent to which my observation obliges me to act. I am drawn into to everything I see, but isn’t it almost egomaniacal to think that I must be a part of it? The ethics of my position here continue to evade me, but I have plenty of time to figure out and really could go on forever in knots. Maybe Shane can help me untie them when next I see him.
The rest of our visit to Bante was nice. I learned what has been causing my diarrhea: Dr. Lomo called from the PCMO office to say there was Giardia in my stool sample. Went to pharmacy and she prescribed Tinidazole over the phone. Took 4 tabs that night, and with the one-dose blast to the system, I am pleased to report that the Giardians have either died or moved on, no longer finding my upper bowel a cozy habitat for their swimming, leaping and churning. I don’t miss them, but nonetheless I have a notion that if they fail to visit in the near future, one of their close cousins will come to call.
In the meantime, I continue to sort out Life In Africa. It’s new to me, you know.
This was my first taste of true village life in rural Africa. Upon arriving (I was first), I was offered a chair and there I sat while the worker from the health center went to find his counterpart in village. Children, adults, animals even, gathered in a large circle with myself perched in its radius repeating “bonjour” as I made eye contact or, rather, tried. It seems the children are shyer than elsewhere and uncomfortable with being singled out like that so I put on my sunglasses and sat for almost twenty minutes, a one woman show with no lines and an unlimited supply of self-conscious smiles. At one point a scraggy dog approached me, sniffing the ground near my feet, to which a woman promptly responded with a painful war cry, kicking off her sandal in a blur and walloping the dog on the hindquarter before I had even a thought of acting to prevent it. I mumbled “that’s uncomfortable” to myself as a meager attempt at humor/consolation but nothing doing. I failed to comprehend her reasons for beating a half-starved mange-ridden dog because I remain a culturally insensitive American with one month‘s history in Benin to work with. The difficulty, now, lies in attempting to reconcile my (painfully) deeply ingrained beliefs about the treatment of animals and children with the often seemingly opposite beliefs about said treatment held by the Beninese. I am going to have to understand and accept that there are everyday occurrences over which I have no control, but acceptance in Banon became much harder as my visit to unfolded.
We began to weigh babies when all of the paperwork was in order and the mothers were gathered round, waiting. A couple of hours into it, during the immunizing, I looked over and saw a girl of maybe seven or eight holding the tiniest, frailest baby I have ever seen. I said to my friend that the baby looked severely malnourished, but he replied “Its head is cone shaped from being born. It’s still less than three weeks old.”
“Nah, something about her proportions just looks intuitively wrong,“ I replied unconvincingly. True, her overall size would have indicated a newborn, but her face. She had but a tiny patch of hair on her head, a soft black triangle at the tip of her forehead, and the skin of her scalp and face was loose. Her eyes were wide open, big, round and shiny and looking everywhere with intent, not the way the puffy new lids of a three week-old house straying, wandering new eyes. She knew how to use her eyes, had had plenty of practice. They were sunken though, and as seemed to be common practice in Banon, ash or some other form of eye makeup had been applied around her lids, adding to the effect not of vitality but of sickness, weakness. My eyes moved from the wrinkles on her face and scalp to her limbs. Her arms were thin and limp. She laced and unlaced her fingers in tactile exploration over her puffy, swollen tummy. Her little legs appeared bowed from shin to ankle, either due to a vitamin deficiency or from not having enough meat on her bones. Her feet were crossed. The girl holding her looked at her lovingly and bounced her as though she were a Cabbage Patch doll, then smiled at me, no doubt having taken interest in my unwavering gaze at the little life in her arms. We were both fascinated by the baby girl, each for entirely different reasons.
I learned shortly that the baby girl is five months old. She weighs three kilos, or 6.6 lbs. We have learned in classes that it is highly unlikely that a baby this malnourished can be saved, . I plotted her growth on the chart: indeed, very deep into the “red.” Soon, she will die. I was in Banon Friday morning; she may even be dead now. I do not know, and never will.
Why, right? Why why why why why. Ask it as many times as you like and I’ll give you the same answer: money. Her mother is neither wicked nor evil (I realize in hindsight; picturing her as villainess provided me an outlet for my outrage and helplessness while in Banon). She has another baby and several other children to care for. I learn through translation, for she does not speak French but only Cha, the local language, that the baby will nurse but will not gain weight. This means she is most likely infected with a parasite or other disease preventing her from growing properly, and her mother states she does not have the money to travel the 10km to Bante (which costs about 500CFA, or $1 USD) and have her baby seen at hospital, which would cost more. I want to tell her that a funeral is going to cost more, but I know the baby cannot be saved by me, and I don’t have the words or power within me to change this situation.
Frustration? Doesn’t come close. Helplessness? Closer. Utter exasperation at the system and terror of the insignificance of my role within it? Closer still. I don’t speak French yet. I can get around and survive, but I’m not about to enter into an argument with a mother I don’t know about her economic circumstances and the impact on her family’s health, even is she did understand French. The conflict in me… SAY SOMETHING! THIS BABY IS GOING TO DIE IF YOU DON’T! Beaten out by It wouldn’t matter if you spoke Cha. It wouldn’t matter if you handed her the cash to have her baby treated. The girl would most likely die anyway, I can’t make it right. I can’t fix this. And it isn’t my job to. I am here to teach mothers about the importance of breastfeeding and slow weaning, proper nutrition for themselves while they are pregnant and breastfeeding, utilizing a variety of foods for a well-rounded family diet, hygiene and sanitation, etc. Prevention. Yes, I will catch babies who may be slipping toward the dreaded yellow line on the growth chart, will discuss with their mothers how to bring them back up to the center of the green “safe” zone, but No. I am not a miracle worker and I can’t save a dying baby. If I can accept this, I will have more success in ensuring the health and safety of babies and mothers at my post and the surrounding communities, but if I assume personal responsibility for each of them, I will become overwhelmed and fail. All I can do is provide education, tools and resources to help people take care of themselves. I cannot do it for them and I must promise myself I will not chase the impossible, lofty goals so many of us imagine upon signing on to a job like this.
I am focusing on the fact that my witnessing a phenomenon doesn’t cause it to happen. It is a reality external of my observation of it. I take, if not solace, than a degree of relief in this knowledge. What I haven’t figured out yet is the extent to which my observation obliges me to act. I am drawn into to everything I see, but isn’t it almost egomaniacal to think that I must be a part of it? The ethics of my position here continue to evade me, but I have plenty of time to figure out and really could go on forever in knots. Maybe Shane can help me untie them when next I see him.
The rest of our visit to Bante was nice. I learned what has been causing my diarrhea: Dr. Lomo called from the PCMO office to say there was Giardia in my stool sample. Went to pharmacy and she prescribed Tinidazole over the phone. Took 4 tabs that night, and with the one-dose blast to the system, I am pleased to report that the Giardians have either died or moved on, no longer finding my upper bowel a cozy habitat for their swimming, leaping and churning. I don’t miss them, but nonetheless I have a notion that if they fail to visit in the near future, one of their close cousins will come to call.
In the meantime, I continue to sort out Life In Africa. It’s new to me, you know.
KC,
ReplyDeleteLet me know when a good time to meet on skype is.
S
D'accord.
ReplyDelete