Sunday, December 16, 2007

Birth, Life and Death

Nadia and I stopped by the maternity department this morning to check on Laban, the baby boy born yesterday to the laboring mama I'd met on the road to Maseno. He and his mother are "nzuri, sana" ("fine, thanks").

I smiled. Thirty-eight years ago today my own youngest child was born. Birthday blessings, Kate!

We then took off to Emukasa for this week's orphan clinic and feeding program. A few kids were playing when we arrived at the parish church to set up. Their soccer ball was made of wadded-up plastic bags, tightly tied with string. It was moving to see how the older ones looked out for the younger. I waved and was immediately surrounded by children from every direction. One of the student nurses explained that my routine hand wave -- a forward, vertical flapping motion -- is a gesture interpreted in Kenya as "Come here." No wonder I've found myself trailed by beautiful children these past many weeks! They must have all been trying to figure out what in the world the crazy mzungu wanted. I need to remember to wave in a sideways motion from now on.

A young Maseno pharmacy student posed a question to me about the orphan formulary during a break in our patient schedule: "Do you prescribe different amounts of medication?" "Yes," I responded, misunderstanding his query. "Based on weight in kilograms. We use a smaller dose for children, for example." "No," he persisted. "I mean do you prescribe different amounts for wazungus (plural of mzungu)?" Uncertain about the nature of his concern, I reassured Eric that the same amounts are prescribed in America as in Africa for the same conditions; that our bodies are all created equal, regardless of nationality and regardless of skin color; and that no one is shortchanged on dosage. We both fully understood, however, that many second, third and fourth generation drugs are simply not stocked here.

Availability, not dosage, is a very real issue in Kenya.

[CORRECTION: Unfortunately, upon my return to the States, I read a new JAMA study about pain control medications within the US: "Whites More Likely to get Narcotics in ER," the headlines trumpeted. I owe Eric and his brothers an apology. We all do.]

Another student reported, during our ride back to the hospital, that the December 27th national elections may need to be postponed because a large number of ballots had been misprinted. People throughout the country are anxiously awaiting the government's decision.

We returned to the hospital for afternoon rounds and were just finishing up when an elderly man was admitted with severe dehydration and anorexia, suffering from an apparent intestinal blockage. An NG tube was inserted, he was put on IV's and sent for diagnostic xrays. I helped his son and a staff nurse wheel the gurney to the xray department, three buildings and a few thousand yards away, through the hospital grounds. The films were completed, but the patient went into agonal breathing on the xray table and died on our way back to the ward.

As the nurse prepared his body for the mortuary, the doctor spoke to the son. It was a cultural faux pas, but I reached out and touched Francis' shoulders to express my own sorrow. "You and your family will be in my prayers." "Asante, Sister," he graciously replied. Nadia and I spoke quietly with the young man for a few moments. "Do you have a way to contact your family members?" He nodded and began to call them, as we sadly returned to Rotary House for the evening.

"...Give rest to the weary, peace to the dying, and all for Thy love's sake. Amen."

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