Sunday, August 15, 2010

Esther

Esther will be the little one I always remember distinctly in my beginning weeks in Doro.

The beautiful little three year old came to us in respiratory distress, with sepsis, malaria, severe anemia and with a illeus (bowels not working) complicated by malnutrition. She weighed about 10 kgs and looked skeletal except for her badly swollen abdomen. For three days we worked with her, providing various medications, concentrated oxygen, prayers and tried to keep her comfortable.

On her second evening in the clinic the mother announced that she was going to leave with her because she was afraid of sleeping at the clinic alone with only a guard outside. She referenced her fear of the evil spirits. I promised to stay with her so that she would not be alone with the child but about the time darkness arrived two of the mother's acquaintances arrived from the closest town and said they would stay with her. They grew agitated when they realized none of them had a flashlight and said they would leave. I gave them my solar lantern to use and promised to return to check on them a couple of times during the night.

Esther made it through the night and the following day our visiting doctor decided to change the treatment plan as she was still spiking fevers up to 103 regardless of the broad spectrum antibiotics we were giving her through an IV and the malaria treatment injections she was getting daily. My heart gained some hope with the new treatment plan, so with the interpreter I explained it to the mother and began implementing it, giving new injections of differing antibiotics.


About two hours later Esther's father arrived for the first time since her admission. Together he and the mother informed us they were ready to take her home. We explained again the new treatment plan and how her weakened condition would probably not survive a long walk to their village, even though she would be carried. We also explained as gently as we could that without the IV fluid and medications she would most likely not live long at home.


I realize now that they already knew this, but had made the decision to take her home and let her die. We had one of our community health workers share the Gospel with the mother and helped her gather her things for departure. I hung back as my co-workers helped her pack as I had by this time lost my composure and was hoping only to keep my sobs quiet, as I could not stop them from racking my body.


As the mother left I walked out with her. She looked at me and said something to the effect that she wanted to sleep at home but would consider bringing Esther back the following day for more treatment. I believe she was actually trying to comfort me in my distress. She herself was stoic.

I try to understand the mentality of the people here who are so accustomed to pain, death, hunger and need that another death in their family causes them to think more of the kawaja's (white foreigner's) pain than their own suffering.