Hearing silence

Once when the kids were much younger we were at a swimming pool at a game park here in Uganda.  I had my attention on Luke and Caleb who were in the water with me while Jack (<1) and Julia (2ish) played out on the edge.  I suddenly realized I didn’t hear Julia anymore.  There was no splash, no scream, just the absence of her voice.  I turned around to see her little face bobbing just below the surface of the water, looking up, frightened, and I rushed to yank her back up into the air.  It was a disconcerting experience because I realized how easily she could have drowned before I realized anything was wrong.  Her survival depended upon me hearing silence.

I thought of this today biking back up the road.  When I went on the ward this morning and looked around to decide where to start amongst the myriad of problems, I could have been distracted by the frantic crying of a little girl with sickle cell disease in pain crisis, or a toddler with extensive burn injuries, or a fussy infant whose mom had left her alone on the bed to go get something.  But it was the silent child who needed attention, the one who was too sick to cry, nearly motionless, held by her dad.  Though I had admitted Mbambu yesterday with plans for care she had not received any medicine until this morning, and though her blood test results showed severe anemia she had not been transfused.  Her parents can not read the results and do not seem to realize her tenuous hold on life.  She needed someone to hear the silence and mobilize!  So we did, I assigned a nursing aid to escort her to the lab immediately and come back with blood.  But again several hours later as I was distracted by a premature baby whose mother is HIV positive and a Christ School student with pus coming out of her leg . .. Scott walked by and said “That baby looks terrible” and I realized that the mom was sitting there quietly with limp little Mbambu in her lap, still waiting for the transfusion.  Back to the lab, there was the blood ready, it just took someone to notice the issue and make something happen.

I’m on a pediatric HIV advocacy mailing list, and I usually skim through the passionate speeches agreeing in my heart without giving due respect to the importance of this advocacy.  Today I’m thinking about the silence of the children of Africa, how many can’t even get the attention of their parents or nurses or doctor (!) to get the help they need.  Unless we hear the silence we won’t mobilize the resources necessary to pull them up out of the water.  They are drowning, very quietly.