Thursday, August 14, 2008

Last week I (Carla) had to send in a progress report for work, and for one section they asked us to share a story.  So I told the following story that happened around February.  I realized that I have not shared much about my actual work here with MCC, so I thought I’d post it as it kind of shows our daily reality here.  And just some general background info: Kurt and I work for Mennonite Central Committee, and are seconded to a local organization called Community Based Health Promotion Program.  The program does HIV/AIDS education and prevention, voluntary counseling and testing, home-based care for about 500 clientele from 14 surrounding villages, and helps clients with income-generating activities.  It’s really quite an amazing program working in a very difficult environment with little resources.  My job title is “home-based care coordinator,” and I work with 3 Tanzanian full-time staff in the HBC office.  (CBHPP has about 10 or so full-time staff).  Kurt is working to get the offices set up with computers and internet as well as doing general maintenance.  He is also becoming Mugumu’s computer guy so he gets lots of requests to help doctors or pastors or so-and-so’s with their computers.  We like our work although many challenges come along with it.

 

Right now I’m actually on mat leave – technically I have until September off, but will be helping with a 3 week home-based care training seminar that starts next week.  So I will take more mat leave off after the seminar is over.

 

Anyways…to the story…and of course, the promise to try to post pictures sometime soon:

 

We had a client come to the office with her 2 month old child.  The mother, Bhoke, was crippled in one leg but had walked the 13 km from her village to Mugumu center with the help of her aging mother, so that she and her child could get medical assistance.  When I met them they were gettinig ready to leave Mugumu to walk back to their village, but they had not yet arrived at the hospital.  They had decided that it was too late to visit the CTC clinic and needed to start walking home as to arrive back before dark.

We told them that we would drive them to their village if they visited the CTC.  They were able to go and see a doctor, who started the baby on antibiotics for a chest infection.  We started taking them home, stopping at a duka to buy their medicine.  As we were leaving Mugumu, we found out that they had nothing to eat at home.  So we went back to the office and gave them a supply of a mix of ground rice, millet flour and peanuts. As I drove them home I was asking about the health of the baby - he just seemed so small.  And I found out that the mother was only breast-feeding him twice a day, because she was told not to breastfeed him if she was infected with HIV.  So she was trying to give him a small amount of uji at home.  This was disturbing to me, and I encouraged her as best as I could to breastfeed the child when he was hungry.

 

A week later, the baby was admitted to the hospital for malaria and pneumonia.  The mother stayed in the hospital with the baby.  At Mugumu hospital, patients are dependant on family members to buy medications and bring food supplies to them.  However, since they lived 13 km away and had come unprepared to be admitted to the hospital, they had no food with them.  The grandmother left Mugumu to find a source of milk to feed the baby, and the mother stayed in the hospital.  A day after they were admitted, I went to visit them, bringing some bananas, milk, water and millet flour.  The mother and the baby had both not eaten in over 24 hours, and the grandmother still had not returned.

 

I held the baby in my arms and helped Bhoke find the small outdoor shed behind the hospital where there are some firepits.  She built a fire with some twigs.  I gave her an old pot and some utensils, and she cooked up some thin uji mixed with milk for herself and the child.  I tried to educate her about how to know if her baby was hungry, and how to prepare the uji so it was not too thick for the baby to swallow.  I tried to encourage her to know if her baby was getting enough food.  We went back to the ward where she tried to give her baby some food but after a couple of spoonfuls he was unable to take more and she gave up. 

 

Over the course of two or three days I visited them in the hospital several times, asking about her baby's food intake, talking with the nurses and pushing them to weigh the child regularly and monitor his progress.  In two days he went from 2.5 kg to 2.0 kg.  It was very frustrating to feel like people (including the mother) had already given up hope that this baby would survive.

 

Walking home from the hospital after a frustrating encounter in the hospital I was wondering about hope.  Was it reasonable to have hope for this baby?  What kind of life would he have even if he survived - living in a remote village, a crippled mother, an aging grandmother?  Little access to food, and a small chance of obtaining an education.  And then the story of Moses came to me.  We know the end of Moses' story, but what about the beginning - the parts where the Israelite babies are being murdered and the desperation of a mother who gives her baby up to the mercy of a river.  How bad would things have had to have been for a mother to let her child go in such a manner?  And I realized that if God can bring up a person like Moses out of a situation of desperation and despair, that we are certainly called to have hope for each infant, each baby and each child.  It is not up to us to decide what kind of a future a baby might or might not have - it is only up to us to choose to fight for and love each child, and leave it all up to God.

 

One day I went to the hospital to visit them and they had been discharged.  Feeling surprised that they would discharge a baby that was losing weight daily and obviously still sick, I talked with a doctor and got the baby tested for anemia.  He was highly anemic so I got a prescription for iron supplementation.  Then we drove them home with an adequate food supply (the grandmother was able to find a source of milk from the community and we had offered to pay for it).  And an HBC staff person who lived close to their village agreed to follow up with them after a day or two.

 

A week later I learned that the baby had died at home.  And although I knew that this was likely to happen, I still felt overwhelmed with sorrow.  On the one hand, he was in the arms of Jesus, yet on the other hand, it was the poverty, the lack of education, and the lack of adequate health care that led to his death.  How do we work to improve these circumstances so that more infants do not need to die?

 

Later, the same day I learned of his death, another mother came to CBHPP with her 2 year old child.  She had travelled 60 km, getting an expensive ride on the back of a truck, to have her child seen by a doctor.  She had obtained for him a prescription for antibiotics for pneumonia.  She came to our office to get her prescription filled.  But when I asked about his symptoms they did not sound like pneumonia - fever, stomach pain, diarrhea.  I asked if he had been tested for malaria, and she said he had not.  So I walked back to the hospital with her and asked a CTC doctor to test the baby for malaria.  He had a count of 100 (!) and was admitted for IV Quinine over a number of days.  I visited them from time to time and helped them get food and medicines.  After a few days her son was healed from malaria and they were ready to go back to their village.  As she was leaving she told me "If you had not refused to give me the antibiotics until we had tested him for malaria, he surely would have died at home."

 

To me, the stories of these two mothers and their children illustrates the kind of place we work in and the challenges faced.  People living in remote villages with little access to health care and little funds to travel to Mugumu.  Mothers with no health education and little empowerment to make decisions for their children.  Inadequate and incomplete hospital treatment.  Lack of food and lack of funds to buy medications.  Children dying preventable deaths.  The hardships seem overwhelming.   And yet we are still called to have hope for each child, to fight for them, to rejoice in the small victories, and to ask God to give us strength to continue working towards justice so that children do not have to suffer needlessly.

 

4 comments:

Jenn said...

i love you Carla. We will pray for God's grace,wisdom and provision for you each day. Thank you for sharing - i love that you are right where God wants you reaching out to those whom HE loves so much. much love to you and all your handsome boys... Jenn OH

Joshua and Julie Marcum said...

Carla,
I love this insight into your lives - I admire you both so much for doing what you're doing - fighting such insurmountable odds with His power. My prayers are with you today.
Julie

gianna said...

Wow, Carla! Your heart is beautiful! You tangibly display the love of Jesus! Your life alone displays God's love and He has put you in the most perfect place ever to hope and extend hope for HIM!

Anonymous said...

This is amazing, I wish I could be beside you helping. It is a blessing that God is using you for His purpose there. I am blessed and encouraged reading this, thank you for posting. I love you, and pray for ALL of you there. That all your needs are met and that you have joy!