He Gives and Takes Away

I would like to preface this blog post with this: This is not just another travel experience, like my first boda ride or a trip to the falls; this is a story of life and death and I share it not only that you might be aware of what I have been experiencing here in Africa, but that you might have a greater appreciation for the fragility of life and what the girls here are up against. Though written as a story, it was as real and heart-breaking as anyone might imagine and something that will stick with me for as long as I live…

Thursday evening, shortly before yet another power outage, Nam went into labour and was rushed to the local hospital while the volunteers eagerly awaited word back home. Early Friday morning she had not yet had her baby, but I rolled out of bed and stepped outside our room to find Emily H leaning over 6 year old, 15lb Selina (http://ekisainternational.blogspot.com/2011/06/selina-needs-surgery.html) as she lay in the arms of one of the mommas, They had found her that morning looking horribly unwell and given how malnourished she was, the issues we’ve had with her g-tube and the few scares she’s given us since I’ve been here, she had Emily and the mommas very concerned. As the local hospitals are dodgy and have been very unhelpful with her in the past and a trip to Kampala was out of the question due to the length of time it would take to get there, Emily decided it was best to take her instead to their friend, Renee’s. She has been in Jinja full time for the last few years running a malnutrition rehabilitation centre just 20 minutes from our home (10 when you drive as though a child’s life depends on it) and is much more capable and equipped to handle such a situation. I offered to accompany Emily, threw on some jeans and was out the door with Selina in my arms before I’d wiped the sleep out of my eyes. The whole way, I had my hand on her neck feeling what I could of her pulse and watched her stomach rise and fall, praying that this little girl would not stop breathing in my arms. We arrived at Renee’s, abandoned the car at the gate, rushed in through a small metal door just beside the gate and into the house where Renee was waiting and immediately assessed her; she was nearly hypothermic with a temperature of 93° and severely dehydrated. After several failed attempts at an IV due to the scarceness of her veins (both feet, her hands, her head…) Renee was successful and after an hour or so of a steady flow of nutrient rich fluids to hydrate her and the help of a few water bottles to bring up her temperature, she was looking a 100% better and had perked up enough to start moving around enough that the oxygen tube had to be taped to her bald little head. We were feeling immensely relieved and optimistic.

At this same time, we were getting regular updates from Emily W from the hospital regarding Nam. She wasn’t progressing fast enough for the doctors and after about 17 hours of contractions, was still only 2 cm dilated; so around the time of Selina’s improvement, we got word that the doctors were beginning to consider a C-section.

Once Selina had received the amount of fluids she could handle at one time and her temperature was up to a much safer 97°, we decided to take her home. We packed up some supplies, listened to a few instructions from Renee and bundled her up for the drive but it was no more then 2 minutes from the house when I stopped Emily as Selina’s breathing had suddenly become strange and laboured. We rushed her back to a rather startled Renee who called in the nurse that she employs and the two of them took over, standing over her administering oxygen and then bagging her while Emily and I stood a few feet back not knowing what was actually going on and not knowing what to do besides pray. It wasn’t 5 minutes later when Renee turned around and said simply, “She’s gone, I’m sorry.” I thought I heard her wrong at first but as they put away the oxygen and supplies and backed away, I began to fully understand what had just happened. I just stood there shocked as emotion began to take over but I did everything I could to keep myself from breaking down as I felt that all there was for me to do then was be there for Emily. As she stood over Selina, I made the call to the girls at the hospital with Nam and told them the news they least wanted to hear and came back to find Emily cradling Selina in her arms, rocking and kissing her forehead…such a pillar of strength. It was when she went out to begin making some arrangements that I went and stood over Selina’s body trying to process what had I had just witnessed. I held her hand, stroked her leg and kissed her forehead all the while trying to make myself understand that this was just her flesh; that she was at that moment at home in the arms of Jesus; something that has been immensely comforting to all of us as well as the fact that for the last 6 months of her life, Selina was in a home where she was cuddled and loved and cared for to the best of everyone’s ability.

We needed to take her home but felt that it would be too distressing for the mommas and everyone involved to simply carry her body into the house so Renee made the call to have a casket delivered to her home. About an hour and a half later, during which time we received news that Nam was going in for an emergency C-section, the boda driver and a pastor-friend of theirs arrived carrying a freshly lacquered wooden casket built to her size with a simple wooden cross hammered onto the lid. I think the most heartbreaking and horribly morbid part of that whole morning was watching Emily and the pastor lift her body, place it in the casket with her Dora blanket and close the lid. After a quick prayer, they lifted the casket, I gathered our things, and we placed her in the back of the SUV and headed home; now praying no longer for Selina but for the safety of Nam and her baby.

Arriving home, we were expected, and arrangements were made to place her on the patio so the mommas had a chance to pay their respects. Instructions were given that the kids were to remain in their rooms once they’d awakened from their naps and the mommas would take their turns coming out. Most of them already knew but it was the time of day where the shift changes and there were some that arrived in that moment not knowing what had happened until they stepped onto the patio faced with the open casket and a small crowd of crying women. It broke my heart to see them fall to the ground in a sweep of emotion and it touched me deeply to witness the love and the compassion that these amazing women have for the children they care for.

Not even an hour after we returned home, we received word that Nam had delivered a healthy baby boy.

After everyone had a chance to say goodbye and the mommas had taken the time to wash and prepare her body, her casket was put back in the vehicle and the Emily’s made a quick stop at the hospital to meet baby before carrying on to the village where Selina was born to deliver her there, as is customary, and make arrangements to return the following day for her burial. While they were away, I received a call from Emily asking if I would be willing to take the first night shift at the hospital to monitor Nam and baby with another volunteer and one of the mommas, which of course I agreed to. So that evening, we packed up some things and got a ride to Al-Shafa Medical Center and settled in for the long night ahead.

This was a day I will never forget as long as I live. Whereas my morning was overwhelmed with the reality of death, my night was spent holding in my arms a baby that had been in this world for less than a day, still smelling of birth; the ultimate representation of new life.

The memorial the following day didn’t feel real. The village was a 40 minute precarious drive a bit off the main road and the scene was oppressive, due not only to the weather, but the surroundings, the wailing and grieving of the women…Jessica said it right when she said it felt like we were in a movie. Only the men are allowed around the grave when they actually bury a body, but as they began to recede back towards us, we took the opportunity to circle around the freshly dug mound of dirt to have a small service of our own. The pastor prayed, the four of us girls (The Emily’s, Jessica and I) huddled together and prayed and a bit of time was spent connecting with Selina’s biological family unearthing some hidden truths before a sudden downpour forced us back into our vehicles for the drive home.

To be honest, I think I am still trying to make sense of everything that has happened. As horrible as it was, it did not make me want to leave Africa; on the contrary. It may have contributed significantly towards how settled I’ve been feeling lately due to the fact that I somehow feel tied to this place because of what I went through and somehow more bonded to those I went through it with. It’s as though in order to truly relate to those that have been here for a significant length of time, you have to experience something like this; you must have experienced something of Africa that leaves you choked by injustice, sad and angry. I still cry sometimes when I think about it and there are constant reminders that life here is never without it’s struggles (the skin and bones, extremely malnourished little girl with CP that has just come to stay with us for a while; the fact that there’s a malaria epidemic in our house right now), but the last few days have been filled with such joy also. The laughter between us, baby Grace and Nam coming home, a candlelit dinner we all prepared and ate together last night in celebration of the new stove that Jessica’s dad bought for us, a chocolate croissant from a bakery in Kampala.

We are having a small memorial at the house this afternoon for Selina and Shamim, the little girl that I never met, but passed away a day or so after I got here. There will be singing, there will be prayer, and we will be planting two trees in their honor…it will be a celebration of their lives. Maybe feeling at home in Africa isn’t about time, but simply happens when you reach a place where you can accept that there will be tragedy and hardship and in the midst of it appreciate life in a way you hadn’t quite done before. If that is the case, then I can say with certainty that, for now, Africa is my home.

Soon after meeting baby Grace

The room at Al-Shafa

Dear Selina, now in the arms of Jesus