Pregnancy is not celebrated in this village. A woman with child is viewed with a simple, practical mix of pity and respect.
There are no baby showers.
When you are expecting, you can expect to be cautiously optimistic at best.
Names are not discussed until weeks or months after the baby is born. The women here know all too well that infants can and will die. It’s harder to bury a child with a name.
Before I left for my American vacation, my neighbor whispered to me that she thought she was a few months pregnant and wasn’t feeling very well. She asked for advice, and I told her to go to the doctor.
Since then, every Wednesday, she walked an hour round-trip to the local clinic. Every Wednesday, she was told that the clinic is out of tests and medicine and she’ll have to come back the next week.
Around 8pm on Monday night, I heard a tiny voice outside my door. I had spent a long time on the bus the day before and wasn’t feeling up to visitors, so I pretended to be asleep. When the little voice started sounding frantic, I yelled from my bed, asking who it was and what was wrong.
“I’m Hawa,” the girl replied. “Mama’s sick and wants you to call Baba and tell him to come home now.” She hesitated, and then she whispered, “I’m scared.”
I jumped out of bed and opened the door. Hawa, eleven years old with the body of a child much younger and the eyes of a woman much older, stood shaking on my doorstep. We called and called, but no one answered Baba’s phone.
“It’s ok, he’ll come home eventually,” Hawa said, uncertainly.
Adrenaline quickly killing my exhaustion, I told Hawa I’d be over in a minute.
Mama Hawa lay on her bed, emaciated limbs curled around her swollen belly, moaning softly as the waves of pain hit her. She’s 34, but at that moment she seemed no older than twelve. I asked what I could do to help, but she could hardly even reply.
A series of phone calls began. I called another volunteer to ask for advice. I called the village midwife. I called the doctor from the local clinic. I took my phone out of my pocket after mixing a sugar-salt rehydration solution and realized that I had also butt-dialed 911.
In the village, a scream for help is 911. Your neighbors are your paramedics. Anything with wheels is an ambulance.
Mama Hawa rode to the clinic on the back of a bicycle with a flat tire.
Two other neighbors appeared at the clinic to help, and I held a bucket for Mama Hawa’s vomit while the nurse confirmed what no one wanted to admit we already knew.
“You just wait. She will birth. No life birth,” the nurse said to me in proud, sing-song English. Her perkiness annoyed me.
“I know,” I replied in Swahili. “What can we do to help?”
“Do you have any medicine?” She asked. I knew better than to be surprised at the fact that this clinic had no medicine, and produced a few pathetic tablets of paracetamol and rehydration fluid. She seemed genuinely impressed.
“What kind of husband isn’t home by 9pm? Someone else will have to stay with her tonight,” one of the other women announced, looking at me.
During the awkward pause that followed, I reminded myself that these two women had children and husbands to go home to. I had half an episode of Gossip Girl and a skype date with my boyfriend. I agreed to stay, and the other women departed gratefully.
The hours that followed are a blur. While I fought off sleep, I heard the other patient, a woman suffering from pneumonia, talk comfortingly to Mama Hawa in their tribal language. Mama Hawa made a brave effort to communicate but mostly just moaned in response. After a few hours, her husband finally showed up looking frazzled and appropriately ashamed at his tardiness. Moaning turned to wailing and it became clear that we had to find transport to the hospital in town. Fast.
It took several calls to finally track down a functioning vehicle. The moans of a very sick woman mixed with the sputtering of a very sick car, and we slowly made our way to the hospital.
Sitting in a chair, waiting at the reception desk, Mama Hawa’s water broke. There was more fluid than I expected from seeing it happen in movies. Grabbing her to keep her from hitting her head as she collapsed on the floor, I yelled for the nurses.
When the nurses arrived, I finally took a good look around. The ward contained thirty or so other sick women, sleeping or coughing or whining, two in each twin-sized bed. Most women were being looked after by relatives. Others were being taken care of by slightly less ill patients. There was one clogged latrine and no sink, water or soap in sight.
While I wondered at the gross surroundings, a thin curtain was put up. There, on the floor, Mama Hawa gave birth to a fetus a little smaller than my hand. The nurses asked for whatever khangas we had brought as a pool of blood and amniotic fluid began to seep out from under the curtain. Minutes later, the curtain was removed and the nurse handed me a small bundle of fabric.
“I’m going to go get an IV. What should we do with the dead baby?” she asked me. I stared at the bundle of fabric and swallowed my vomit.
As the exhausted patient slept in a bed also occupied by an old woman whose cough I prayed was something other than TB, her husband and I took the baby home to be washed and buried in accordance with Muslim tradition. The trip was excruciatingly long. Baba Hawa sat next to me, holding the bundle of fabric and silently weeping. The car broke down twice. We didn’t speak.
When we finally reached the village, I looked up at the stars, slightly dimed by the light of a monstrously full moon. I tried to find the constellation Orion. When I’m lonely or sad at night, I like to look up at Orion and think of him as an impeccably constant companion—there for me wherever it’s dark and not cloudy. But it was already nearing 6am and Orion had set beyond the mountains. Rising from the other side of the skyline, the Southern Cross stared down at me. After a night spent entirely out of my comfort zone, those four stars officiously reminded me that I was very, very far from home.
By the light of the rising sun, I shut my eyes and tried to sleep.
A few hours later, I walked over to the neighbor’s house and found a gaggle of Mamas cooking and looking after the children. A group of young men were solemnly digging a small grave in the yard. Word travels fast in the village. Throughout the morning, friends and family continually stopped by to offer condolence and gifts.
I sat with Hawa and her six year old brother, Muku. Muku was staring at the men digging the grave with an angry expression. He refused to talk, but finally smiled when I showed up with coloring books and markers. Silently I sat and colored pictures of cars while the women cooked and the men dug. I showed Muku how to write his name and after several failed attempts he proudly wrote “WUKU” on top of the prettiest picture. Close enough. I promised to bring it to his mom when I went to see her in a few hours.
After collecting clothes, blankets, water and food—the hospital is “bring your own everything”—I set off again. Mama Hawa wasn’t doing as well as I’d hoped. While the miscarriage may have been the most traumatic of her problems, it turned out she was also suffering from dysentery and malaria. The nurses seemed annoyed at my desire to know what her diagnoses were. Patients here are expected to just shut up and swallow whatever pills they’re given and if that medicine isn’t available, find a relative to go to town and buy it.
In a state of exhaustion such that nothing felt entirely real and everything felt entirely overwhelming, I spent the day looking after Mama Hawa along with two of her relatives who happened to be at the hospital looking after their sick mother.
Around 3pm, I realized that I hadn’t eaten or slept in a very, very long time. I had intended to sleep at the hospital to keep Mama Hawa company, but a fellow volunteer happened to be coming back from town headed in my direction and more or less kidnapped me for my own good. She used a Snickers bar as bait. I sobbed as I left Mama Hawa’s side, terrified that she would die during the night. The other women in the ward spoke comforting words to me, but laughed with each other behind my back. “Who gets so worked up over a simple case of miscarriage, diarrhea, and fever?” they might have been saying. I forced a smile as I left, promising to bring little Muku to visit the next day.
I just got back from the hospital again. Traveling with a six year old Tanzanian kid was interesting. People kept yelling comments—some of which were rather obscene—as we walked hand-in-hand to the bus stop. We caught a ride with a Chinese road worker, which was the first piece of news that Muku relayed to his healthier looking mother. Her niece, a woman about my age and toting a 2-month-old baby, walked from her home about an hour away to help cook and clean for the patient.
I went to town to find milk and fruit and when I came back, Mama Hawa was laying next to the sleeping baby, staring at her with a desperate expression. I asked if there was anything she wanted to talk about, but she said she was just tired. She didn’t take her eyes off of her niece’s baby as she spoke.
When Muku and I got home, I asked Hawa what she had done all day.
“Cooked, cleaned, carried water, and brought corn to the machine to be ground,” she replied. I looked at her with obvious pity, and she continued: “Lots of Mamas came to help me, and I played a little too.”
Throughout this whole experience, I’ve been constantly amazed at the way people help each other out here. A woman I’ve never met walked with me all the way to the clinic in the dark. Patients helped fellow patients. Women came from all over to help cook and keep the family company. Men showed up on a moment’s notice to bury the baby. Though the official mourning process would have been considered inappropriate, friends came from hours away to help the family mourn the hopes they had built over the past months.
We’ve all heard that it takes a village to raise a child. This week I learned that it takes a village to lose a child, too.
