She was twenty-seven, and had a son, he must have been about eight or nine. It’s always hard to tell in rural Tanzania, life is hard on even the young here. She had four diagnoses. Of her four diagnoses, if she had had just one, she would still be a very sick individual. Malaria, Typhoid fever, Syphilis, and AIDS, in Tanzania all of these are killers. Yet here she was fighting for life. As I watched her struggle for breath all I could feel was angry. This was not helped when one of the nurses came with a respirator. As there was no oxygen in the entire hospital this was the only thing that they could use when a patient was experiencing respiratory distress. I was even less encouraged when I noted the part used to seal in air was broken. And I was even more angry when I watched the nurse begin to ferociously start pumping air at a rate that would kill someone if indeed the machine was operable. I guess that in itself was a blessing. The nurse grew tired and to feel like I was doing something I took over. As I sat there pumping, watching her struggle for life, I felt overwhelmingly sad and frustrated by the inability to do anything at all and most particularly by the unfairness of it all. What made this woman’s life less valuable than mine, or any of my patients in Canada. If anything it was more valuable as she had lived far fewer years than the general populace of the patients I have had the privilege of serving in Canada. And yet if one of those patients were experiencing the respiratory distress that this young Tanzanian was, they would be surrounded by doctors within seconds, have any known medication that could possibly be effective shoved into their system, and had an oxygen bar hooked up within seconds. Here I sat, pumping a useless piece of shit, and watching a sick patient slip into the afterlife. There were no medicines that would kick start her breathing again, the one doctor had left on a much needed errand, and even if any of the nurses knew CPR, it wouldn’t do any good as none of them would perform it, not on an HIV positive individual.
After about an hour or so, I was relieved of my duty and the last rights were performed. My anger was little assuaged as another patient’s call phone rang, and was answered. I was then forced to go take dinner. Guests in Tanzania are not allowed to work too hard. In fact no one is. I obliged, knowing I didn’t really have a choice if I wanted to maintain any sort of cultural respect. I went to bed that night angry, frustrated and sad.
I was awoken the next morning to the sound of my phone ringing. As my primary goal for being at this centre was to learn about maternity care in Tanzania, I had left instructions with the nun in charge to call me if any mamas-to-be came in. Greeted, and told, from what I could piece together using my limited Swahili, that there was a mama, four cm dilated and I had better come quickly. I obliged here and was at the hospital in minutes. Everything went smoothly and within a half hour a healthy baby boy entered the world. Despite the events of the last twelve hours I couldn’t help but feel proud, and happy that I could help bring this little miracle into the world.
Within twelve hours I was part of seeing someone leave this cruel, hard and unfair world, and part of bringing someone into that same world. I think there are coincidences. I also believe that there is a God, who also incidentally cares deeply for His creation. I think this was one of God’s ways of showing me that despite all the inequities, all the unfairness, and the harshness, there is also beauty, joy, and purpose. I hope that I can make the choices that allow the young boy to live in a better world than, not twelve hours before, the other sick mother passed from.
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