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Sunday, November 30, 2014

A desert of hope

For the last week I had the rare opportunity to travel to an area of Africa that is recovering from civil war and both witness and participate in the rebuilding of a nation.  Great stuff.  I could write volumes but if I do I won't be invited back, so I'll just give some vague and general observations.

Jesus said, "You have heard that it was said, 'You shall love your neighbor and hate your enemy.'  But I say to you, love your enemies and pray for those who persecute you, so that you may be sons of your Father who is in heaven.  For he makes his sun rise on the evil and on the good, and sends rain on the just and on the unjust. . . ."

Scene One:  Eating dinner late one evening, six chairs pulled up around a small round table, goat and rice and chips and chicken, I look around.  Four nations, all of whom have reason to distrust one another due to past injustice and acts of terrorism.  But in that moment we are humans only. We share stories, childhoods, dreams, hard work, ambitions, hunger and joy.  It is all to easy to think of any category of people as dangerous, or different.  The remedy is to meet one on one. This is what the Kingdom will be like.

Scene Two:  Straining to understand a language that seems to be English only all the consonants are pronounced differently, I listen to a Family Medicine Resident present a patient.  I am doing rounds with the only post-graduate trainees in the country, teaching about fluids and apnea and feeding and infections and all the familiar (to me) nuances of pushing down the appalling 10% infant and 10% maternal mortality in this place.

Scene Three:  Fifty 5th year medical students crowd into the classroom, and I lead them through and evidence-based approach to child survival interventions, question them on a differential diagnosis of chronic cough, draw a 4x4 table to explain the concepts of a test's positive predictive value.  The brightest is a girl seated to the side with the few female students, veiled, but whenever I meet her eyes I see she gets it.  This is the hope of the future.  These are the people who will decide policies, promote public health, perform surgeries, comfort the dying.  They are the only resource of this desert, human potential, the sheer will upon which development will build.

Scene Four:  This one was the most surreal.  After a week of solid work, we take a late afternoon off to climb (with an armed escort of course) a hill that overlooks the town.  Half-way up a little girl who is outwardly indistinguishable from the cohort of her scampering cousins sits by the side of the steep rocky path.  "You speak English?!" she pipes up in a shockingly American accent.  J is 12, back from California on a visit to her maternal relatives, a bit unnerved by the heat and dust and unfamiliarity.  She takes my hand like a lifeline and we climb together.  Welcoming, educating, loving the nations as they pour into America yields trust and makes the world a smaller place.

Scene Five:  A little girl whose requisite conservative dress includes a long flowing flammable polyester dress gets too close to the open cooking fire, and goes up in flames.  We don't see her until five days later when she is severely dehydrated, in respiratory distress, minimally conscious.  The polyester melts into her skin and the burns are deep.  In spite of careful dressing and a line and fluids and antibiotics and oxygen, she does not survive.  The last half hour I lean over her bed with a bag-valve-mask I found on a shelf, and keep her breaths coming and heart beating, but I know we have lost the battle.  I am frustrated that unlike Kijabe, I can't talk to the family and comfort them as I am used to.  I don't have an ICU with a ventilator and pressors.  This is a preventable, tragic death.  Someone looking for the next public health campaign:  flame-resistant fabrics in all countries where girls both have to cook and cover themselves at age 6.

This country is a paradox of rubble and hope, of harsh sun and cold night, of burgeoning new universities and extreme poverty.  I am thankful to have been the recipient of their hospitality, and to have been a tiny part of the sun rising and rain falling.

1 comment:

Jill said...

Thank you for sharing your experience to the best "allowable" degree! the last two scenes will stick with me...