The Ethiopian Life Cycle?

It probably sounds funny, but one of the highlights of my day is
visiting patients who are in the malnutrition room.  Unlike American
hospitals which are usually bright and cheerful (esp. pediatric
units), ours is somewhat drab and dark.  The malnutrition patients,
mostly children, are all in one room which consists of gray walls, one
window and four metal frame beds.  There is a small box of toys; some
wooden blocks, a jump rope, a few balls and some pretty tattered
books.  All the reading I have done on malnutrition suggests
encouraging parents to engage their children in play in order to keep
up their cognitive functioning.  The kids who come to us are in pretty
bad shape as they must be diagnosed with severe malnutrition to be
treated in-patient at the clinic.  Not surprisingly, they generally do
not have much energy and are quite lethargic due to their poor health.
I find that most times when I walk into the room the patients are
lying down with family members beside them sitting quietly and just
staring out into space. It’s easy to understand why parents aren't more
proactive about engaging their child, as the kids are pretty out of it
and I don’t think it is in the culture to “play” with kids in general
the way we do.  Plus, I am not sure how good our staff is about to
passing on this information and encouraging it.


Each day I go into the room and try to make the kids and their
families laugh a little (usually at my expense of being the weird
farengee-- white person) to lighten the mood a bit. I teach the kids
to give me a high five, poke their belly to make them laugh, etc.  I
recently started playing with the toys and showing family members how
to use with them.  People have actually started picking up on it and
several times I have walked in and seen them using the blocks or
reading to their kids—which I should point out is really making up
stories since the books are all in English.


Anyway, for the past week there has been a woman at the clinic with
her baby who had both malnutrition and vitamin D deficiency.  The
woman is about as lovely as one can be, constantly holding her child
while also helping others in the hospital.  One day I went in and
found her braiding the hair of a very sick woman who was being treated
for phenomena.  Her ten year old daughter was also with her, helping
out in any way she could (remember here patients have to basically
take care of themselves—preparing their own food, cleaning, etc). For
the past several days I saw the mom cry more and more as her child was
not improving.  The doctor thought maybe he also had TB and began
treatment for that, but he still did not improve.  I kept hoping this
child might prove to be a miracle baby. Not that anyone deserves to
have a child die (of such a preventable disease no less) but there was
just something so unfair about this situation.

This morning I came into the room and found her crying. The nurses
explained that they would be leaving today as the baby was not
improving. Her family would come and they would walk several hours
back to their village to let the baby die at home.  I tried to express
my pain for her and rubbed her shoulder, though I am sure it was no
consolation in a time like this.  As I wrote in a previous post about
death in the developing world, it is just as painful and heartbreaking
here as it is in the west.
 

Minutes later I was informed that a different malnutrition patient
(this time an adult with severe protein deficiency) had delivered a
baby night before.  In the middle of the night in the malnutrition
room she delivered a baby boy by herself.  By this point she had been
moved to the OB room and mother and baby seemed to be doing well.  The
woman had responded well to treatment and was in the final stage of
being able to eat a high calorie supplement, plumpy nut, on her own.
Now that she had her baby and her signs were good, she would also be
discharged today.  We brought in a blanket and onesie for the baby and
said congratulations to her husband and mother who were there.
     
So in one day, a baby was born and yet another was going hone to die.
I am sure a better writer could come up with a clever ending to this
post, with some deep meaning to why this all happened today….but I
don’t think I am that person.  I guess to me it just shows the
randomness and unfairness that life is for so many people. Who knows
what is in store for either family or what lies ahead of them…but as I
have seen in my short time here, such is the life in the developing
country.