There are few things more beautiful than a child's smile.
I've spent the last few hours uploading and editing photos on walgreens.com so I can wallpaper my room with my kids' faces. My limited vocabulary falls woefully short of describing the joy that pervades my heart when I look at pictures from this summer. Videos are even better, and memories are best of all. So many memories resurface when I flip through these photos...
I remember the first time Jessie cried. I was beyond ecstatic, because it was the first time she had found enough strength to use on something as nonessential as complaining about a diaper change. It made me so happy that I kept poking her just to see her protest.
I remember playing with the kids on the playground one evening just before sunset. They were all crawling through the metal tunnel, but Jack was too young to really understand. He would crawl through and then just turn around to go back rather than going back around to get in line. Chola stepped up to help and carried little Jack around to the beginning of the tunnel every time he went through.
I remember teaching a Bible story about compassion and service one morning. The kinders couldn't seem to understand why Jesus would ask us to feed and clothe people; after all, their clothes were neatly folded on the shelf, and their food was prepared and served at every meal. I explained that not every little girl and boy has food to eat, clothes to wear, or a bed to sleep in. Johnny was rather hung up on the lack-of-beds situation. "Auntie Meghan, I will become a carpenter and build beds for the princesses."
I remember climbing the mango tree in the courtyard one morning while the kids were eating breakfast. They didn't realize I was perched up there and all came out to play, frolicking around and chattering in Bemba beneath me. Finally, Henry spotted me. "Look! Auntie Meghan flew up the tree!" The next hour consisted of lifting the older kids up to cling to the lower-hanging branches and fervently praying that none of them broke any bones.
I remember playing I-Spy one afternoon. Ernest: "I spy with my little eye something black." Johnny: "Chola?!"
I remember stealing Jack a couple of evenings in a row and bringing him in to work with him on standing and walking. And I remember the very first step he ever took. Towards me. I got so excited that I squealed at a decibel not normally audible to the human ear, grabbed him by the waist, and threw him into the air. The poor little munchkin was so shocked that he refused to even stand up for the rest of the night.
I remember Johnny taking my hand the day after Jessie died. He smiled so big that I thought for sure he had done something wrong and was about to try and weasel his way out of it. "Auntie Meghan, you love Jessie very much. I know." And then he walked away.
I remember the first time I gave a quinine shot to Gladys. She cried, and I hated myself. I hated that I had the ability to stab a child with a needle. I hated more that it was necessary. But I loved how the nannies called her mine. "Your baby, she is crying too much. Maybe you should take her for a while." Well, okay... if I must....
I remember Johnny's first book. I couldn't find the curriculum that Amy had to use with them, so I made a book with only short "a" sounds for him to read. He has a tendency to say "I don't know," or "I can't do it." Those two phrases were quickly outlawed. Every time he would struggle with a word, he would say, "I know! I know!"
I remember Chola's inability to pay attention for any measurable length of time. He would hear his name and just offer a random answer to whatever question was posed. "Chola, are you listening?" "Nopes." "Chola, what's the first book of the New Testament?" "Small instestines!"
I remember Henry's propensity to run up behind me, leap on my back, and latch his arms around my neck, effectively cutting off all air supply and rendering me powerless to fight back. I generally ended up on the ground under a pile of Zambian children.
I remember Ernest and Queenie's adorable little friendship. Ernest is a tiny weedy little kid with an oversized head and a really high pitched voice. Queenie is exceptionally tall and beautiful. Both are Kinders. During playground time, they would wrestle. The scenario inevitably ended with Ernest on his back, Queenie sitting on him and holding his arms down, and Ernest cackling in laughter and mock terror, screaming "Awe! Awe! Awe!" (No! No! No!) while he futilely struggled to get away.
I could write for hours about the little moments that stole my heart one by one this summer, but unfortunately, I have to go memorize the mechanisms and side effects of a dozen different drug classes instead. Doesn't that just sound like so much fun?!
Until next time,
Mwende ubushiku bwapalwa.
Wednesday, September 28, 2011
Sunday, September 18, 2011
10 Reasons Why I Know I Was Made for Africa
1.) I’m never on time. To anything. Ever. Neither are Zambians.
2.) I absolutely despise cold weather. 70 degrees in the winter? I’ll have to put on a jacket, but I think I can make it…
3.) In the bush, nearly everything is outside your control. It’s the only place in the world I’ve ever been able to set aside my control-freak personality, because really, what was the point? You do what you can to prepare and prevent, but most of the game centers around reaction.
4.) I frequently find myself referring to “going home” when talking about Zambia. This leaves newcomers to the conversation with the curious misconception that I grew up in a mud hut in southern Illinois surrounded by half naked children and village goats.
2.) I absolutely despise cold weather. 70 degrees in the winter? I’ll have to put on a jacket, but I think I can make it…
3.) In the bush, nearly everything is outside your control. It’s the only place in the world I’ve ever been able to set aside my control-freak personality, because really, what was the point? You do what you can to prepare and prevent, but most of the game centers around reaction.
4.) I frequently find myself referring to “going home” when talking about Zambia. This leaves newcomers to the conversation with the curious misconception that I grew up in a mud hut in southern Illinois surrounded by half naked children and village goats.
5.) I hate wearing shoes. It makes my toes feel like they’re in prison. They don’t like it. They were made for Africa too.
6.) I really don’t mind being unreasonably close to people, which is good, since Zambian buses are packed like sardine cans and people in the market have no concept of personal space.
7.) I love kids. All of them. As long as there is breath in my body, there is no such thing as an unwanted child. The street kids in Kazembe are very friendly little companions for morning walks.
6.) I really don’t mind being unreasonably close to people, which is good, since Zambian buses are packed like sardine cans and people in the market have no concept of personal space.
7.) I love kids. All of them. As long as there is breath in my body, there is no such thing as an unwanted child. The street kids in Kazembe are very friendly little companions for morning walks.
![]() |
Photo courtesy of Zeger Van den Broele |
8.) I don’t mind dirt. I actually kind of like it. You should get truly dirty at least once every day.
9.) I’m a complete adrenaline junky and thrive on adventure. Believe me, there’s nothing more adventurous than health care in the bush.
10.) This little girl fit perfectly in my arms, and she was African. Therefore, it only stands to reason that my arms were meant to hold African babies. Logical? I think so.
Those of you who know me well.... Anything to add?
Monday, September 12, 2011
Tale as Old as Time
Directly across from my bed is a tall wooden wardrobe, the lyrics of a Regina Spektor song whose promise plays on repeat in my heart affixed to the side. Framing those lyrics are several 4"x6" photos. They are the first thing I see every morning, which is nice-- it guarantees I'll start the day with a smile.
Photos are a precious reminder of the 22 little souls who are, for now, growing up without me. They come in handy when I begin to wonder if it was all a dream, but they are a poor substitution for reality.
A slightly better supplement is video. I didn't take any myself, but a couple of other volunteers have steadily begun posting their videos on cyberspace. With Sarah's permission, I would love to share one of hers and the story behind it.
The kids watched "Beauty and the Beast" for the first time this summer, and it blew their little minds. They only had time to watch half of it on the first day, and we stopped the movie at the part where the Beast is trying to save Belle from the wolves. The kids' reaction was pretty unanimous: the Beast was bad, the movie was scary, and the wolves were winning. None of them mentioned Gaston at all; he was neither threatening nor important. They immediately dichotomized the characters, labeling them as either good or evil. Chola kept saying, "Auntie Meghan, it is not over yet?" as though to assure himself that the story wouldn't end with wolves.
Photos are a precious reminder of the 22 little souls who are, for now, growing up without me. They come in handy when I begin to wonder if it was all a dream, but they are a poor substitution for reality.
A slightly better supplement is video. I didn't take any myself, but a couple of other volunteers have steadily begun posting their videos on cyberspace. With Sarah's permission, I would love to share one of hers and the story behind it.
The kids watched "Beauty and the Beast" for the first time this summer, and it blew their little minds. They only had time to watch half of it on the first day, and we stopped the movie at the part where the Beast is trying to save Belle from the wolves. The kids' reaction was pretty unanimous: the Beast was bad, the movie was scary, and the wolves were winning. None of them mentioned Gaston at all; he was neither threatening nor important. They immediately dichotomized the characters, labeling them as either good or evil. Chola kept saying, "Auntie Meghan, it is not over yet?" as though to assure himself that the story wouldn't end with wolves.
Scheduling prevented me from watching the second half of the film with the kids, but they had no reservations about watching it again. This video is a combination of clips from the second time through. If you watch their faces closely, you can see the journey of misunderstanding, judgement, and redemption that this movie took them on.
My favorite part is Jennifer's sheer delight at the end. You can almost see her eyes shining out the message, "Yes! This is how it's supposed to be." Later, Johnny told me that Belle was right to be Beast's friend even though he was mean.
"Auntie Meghan, Beauty's love saved the Beast. Beauty knew what he could be."
Truer words were never spoken. Amazing Grace, how sweet the sound, that saved a wretch like me..."
When Gaston attacked the Beast, there was a general outcry of fear and confusion from the kids. "Why is the Beast not eating the man?!" Again, Johnny in his infinite wisdom answered the question. "He knows Love now. When you forgive then you don't fight back." (I'm so proud... He's been listening!) Those are big word from a little boy whose daily challenge in self control is trying not to physically pounce on whichever kid intentionally broke his tent on the playground this time.
The movie left when the volunteers did, but I fully intend to bring a copy for the kids next year. In so many ways that are so far beyond the understanding of those kindergarteners (and this college kid), this story truly is a Tale as Old as Time. I really enjoyed talking through it with them in the next few days. They learned that sometimes first impressions are wrong: Beast had a heart, and Gaston was more of a threat than they initially thought. They saw that different and scary are not equivalent to irredeemable or unlovable (an important message to remember as they learn more about life outside the chainlink fence of their playground). And maybe, just maybe, they found a little bit of Beauty and a little bit of Beast hiding within themselves.
I know I did.
Wednesday, September 7, 2011
"Have a good morning!"
School is pretty much in full swing. I have three tests next week in the Nursing department and a couple of projects coming up soon in Honors. My RA position has steadily become more demanding. I'm a relatively high-strung person with a lot of nervous energy, so the busyness is fine with me. I'm still trying to get back in the rhythm of Belmont life, though.
This summer, rhythm was undeniably a part of life. On a typical morning, Zeger and I would get up before dawn. We would sit in the silence of the pre-morning, perching carefully on the wall and sipping coffee in the crisp morning air. Sometimes other volunteers or Jasmine and Troy would join us. As the eastern sky brightened with the hope that is the dawn, we would slip out of the orphanage and go for a walk. It really didn't matter which direction we went at first; we almost always ended up in the Boma buying fritters for $0.10 a piece from some village kid for a pre-breakfast snack.
Upon arriving back at the orphanage, usually I collapsed on the front steps while we waited for Enock or Peter to let us in. Inevitably, we raced each other to the kitchen for a glass of water. Depending on the time, the kids were usually eating breakfast. The next few minutes were one of my favorite parts of the day. Essy, the lady who works in the kitchen, would look over her shoulder and smile in greeting. "Mwashibukeni!"
"Ea mukwai. Mwashibukeshani?"
"Bwino."
Sometimes she would ask where we had gone. "Naile kuBoma." Often she laughed good-naturedly at my pronunciation, and many times she would say something I didn't understand at all. After I had scarfed down some eggs, I would run out the door to gather the kids' school material as Essy's friendly voice rang out behind me, bidding me to "Have a good morning!"
In every work situation, there are people who throw their hearts into their job, and there are people who are only there to draw a paycheck. Nobody ever does an exemplary job all of the time, and Essy was no exception. Sometimes she burned the food or forgot to turn off the kettle. Cooking and cleaning aside, Ido fully believe that she very sincerely loves those children. If one of them was sick, she asked about them frequently through the day. She cried when Jessie died. One morning I stumbled into the kitchen after a particularly rough night-- between Gladys and Jessie, I had barely slept at all. Gladys hadn't eaten in several hours and I couldn't get her to keep her medicine down. For the first time, I feared I might lose her. Essy first asked how the babies were, and after my short explanation immediately started a kettle of hot water. "Coffee will help," she said. I sat in silence for a couple precious minutes while she bustled around the kitchen. My thoughts were sifting through the temperatures and respiration rates of the last 8 hours, and my ears were pricked towards the open window in case the princesses woke up and wanted to tell me about it. As I filled a glass with filtered water to make Gladys's bottle (which I knew she would barely eat from anyway), Essy called softly after me. "You are trying very hard. Gladys is strong. I think she will make it."
I had a very different relationship with Essy than I did with any of the other staff. I think this is mostly due to the fact that we just worked together in a different context. When Gladys first came to us, she was a very fussy and sick approximately-eight-month-old. She screamed bloody murder if you sat her down for even a moment, but she wasn't really happy being held either. She writhed and whimpered and clawed at her face and stomach in obvious discomfort. She raged with fever for days and was not tolerating food well. One morning I went to make breakfast. No one else was awake yet. Seeing no other good option, I sat her in a highchair and let her scream it out while I scrambled enough eggs to feed myself and the four Morrow kids. Essy watched me run back and forth between the counter and the kid for a few seconds, then she started cooing to Gladys in Bemba. She scooped her up and held her close, and immediately Gladys fell silent. Her exhausted little head rested comfortably against Essy, and for a few precious moments, I think my little angel was happy.
I felt relieved and helpless all at the same time. I would give that baby the heart from my chest if she needed it, but I couldn't seem to give her comfort. Referring to a running joke between the two of us, I shrugged in surrender. "I guess it's because you're not musungu." Essy smiled at me, but her eyes were glued to Gladys. "No," she explained simply. "It's because I'm a mom."
I dearly miss my morning exchange of banter with Essy. On the days she worked, it was as much a part of my rhythm as the sun rising over the arena in the morning and setting over the Congo that evening. We shared one of those rare friendships where each of us was better for knowing the other, even if just in small ways. When I daydream about pulling through the side gate of that orphanage again next May, I imagine that hers will be one of the first voices I hear. She'll probably greet me in Bemba. She may ask me where I've been. And when I dash back out the kitchen door to go scoop up a kid, I'm sure I'll hear her calling after me, "Have a good morning!"
This summer, rhythm was undeniably a part of life. On a typical morning, Zeger and I would get up before dawn. We would sit in the silence of the pre-morning, perching carefully on the wall and sipping coffee in the crisp morning air. Sometimes other volunteers or Jasmine and Troy would join us. As the eastern sky brightened with the hope that is the dawn, we would slip out of the orphanage and go for a walk. It really didn't matter which direction we went at first; we almost always ended up in the Boma buying fritters for $0.10 a piece from some village kid for a pre-breakfast snack.
Upon arriving back at the orphanage, usually I collapsed on the front steps while we waited for Enock or Peter to let us in. Inevitably, we raced each other to the kitchen for a glass of water. Depending on the time, the kids were usually eating breakfast. The next few minutes were one of my favorite parts of the day. Essy, the lady who works in the kitchen, would look over her shoulder and smile in greeting. "Mwashibukeni!"
"Ea mukwai. Mwashibukeshani?"
"Bwino."
Sometimes she would ask where we had gone. "Naile kuBoma." Often she laughed good-naturedly at my pronunciation, and many times she would say something I didn't understand at all. After I had scarfed down some eggs, I would run out the door to gather the kids' school material as Essy's friendly voice rang out behind me, bidding me to "Have a good morning!"
In every work situation, there are people who throw their hearts into their job, and there are people who are only there to draw a paycheck. Nobody ever does an exemplary job all of the time, and Essy was no exception. Sometimes she burned the food or forgot to turn off the kettle. Cooking and cleaning aside, Ido fully believe that she very sincerely loves those children. If one of them was sick, she asked about them frequently through the day. She cried when Jessie died. One morning I stumbled into the kitchen after a particularly rough night-- between Gladys and Jessie, I had barely slept at all. Gladys hadn't eaten in several hours and I couldn't get her to keep her medicine down. For the first time, I feared I might lose her. Essy first asked how the babies were, and after my short explanation immediately started a kettle of hot water. "Coffee will help," she said. I sat in silence for a couple precious minutes while she bustled around the kitchen. My thoughts were sifting through the temperatures and respiration rates of the last 8 hours, and my ears were pricked towards the open window in case the princesses woke up and wanted to tell me about it. As I filled a glass with filtered water to make Gladys's bottle (which I knew she would barely eat from anyway), Essy called softly after me. "You are trying very hard. Gladys is strong. I think she will make it."
I had a very different relationship with Essy than I did with any of the other staff. I think this is mostly due to the fact that we just worked together in a different context. When Gladys first came to us, she was a very fussy and sick approximately-eight-month-old. She screamed bloody murder if you sat her down for even a moment, but she wasn't really happy being held either. She writhed and whimpered and clawed at her face and stomach in obvious discomfort. She raged with fever for days and was not tolerating food well. One morning I went to make breakfast. No one else was awake yet. Seeing no other good option, I sat her in a highchair and let her scream it out while I scrambled enough eggs to feed myself and the four Morrow kids. Essy watched me run back and forth between the counter and the kid for a few seconds, then she started cooing to Gladys in Bemba. She scooped her up and held her close, and immediately Gladys fell silent. Her exhausted little head rested comfortably against Essy, and for a few precious moments, I think my little angel was happy.
I felt relieved and helpless all at the same time. I would give that baby the heart from my chest if she needed it, but I couldn't seem to give her comfort. Referring to a running joke between the two of us, I shrugged in surrender. "I guess it's because you're not musungu." Essy smiled at me, but her eyes were glued to Gladys. "No," she explained simply. "It's because I'm a mom."
I dearly miss my morning exchange of banter with Essy. On the days she worked, it was as much a part of my rhythm as the sun rising over the arena in the morning and setting over the Congo that evening. We shared one of those rare friendships where each of us was better for knowing the other, even if just in small ways. When I daydream about pulling through the side gate of that orphanage again next May, I imagine that hers will be one of the first voices I hear. She'll probably greet me in Bemba. She may ask me where I've been. And when I dash back out the kitchen door to go scoop up a kid, I'm sure I'll hear her calling after me, "Have a good morning!"
Monday, September 5, 2011
Babies Know Best
"I close my eyes, and I see your face
If home's where the heart is, then I'm out of place
Lord won't you give me strength to make it through somehow?
I've never been more homesick than now."
There is a strange and dynamic balance between the disquiet of a soul that is stretched by growing pains and the contentness of a spirit that has found where it belongs. Every day, I wonder whether it will get easier being here, so very far away from the children and the country that has stolen my heart and fueled my dreams for over a decade. It doesn't. Instead, I find myself enveloped in a culture whose focus is decidedly self-centered and surrounded by people who are operating on a wavelength that I just can't seem to tune into anymore.
A few days ago, my best friend said something that struck me like a ton of bricks. I was having a pretty rough day, and admittedly, my pining for Kazembe was at an obnoxious high. She quipped something about not feeling like we really connected anymore because I was so preoccupied with a place and a people that she has no context in. How incredibly burdensome and heart-wrenching to hear those words and recognize them as true.
In so many ways, I desperately want and need to fit back in here. I am way too much of a social animal to survive an isolated and solitary existence. The simultaneously terrifying and satisfying fact of the matter is that I simply am not who I was three months ago. But somehow, I'm still me. If that in any way makes sense to you, please feel free to explain it to me. In an odd way, I see many of my friends going through the same thing. Relationships are starting and ending. Friend groups are rearranging themselves. Living situations have changed significantly from last year-- some of them are off-campus, some moved from dorms to apartments, some who had previously lived together split up, and some who barely knew each other are living together. One of my friends is preparing to study abroad next semester, and another is contemplating spending next summer doing international missions somewhere (I must say, I'm pushing for Africa... I think he has the heart for it).
It's strange, really. I could not have been more out of place in Africa. I think about the Mutomboko ceremony, where at times Zeger and I were literally the only white people in a sea of 20,000 Zambians. How is it that I felt so at home there but feel so hopelessly lost here?
Early last semester, I was sitting at a coffee shop with a girl that I greatly admired but really didn't know very well. She has spent several summers and much of her heart in Russia. I love listening to her stories and seeing her eyes come alive as memories that only she can see flash before them. Nearly every conversation I've ever had with her has wrapped back around to Russia somehow. Post-Kazembe, I understand why.
That village, that culture, those kids-- they've become such a huge part of who I am. A friend joked tonight that my list of priorities starts with Africa, followed closely by coffee, and ends with homework being somewhere way down at the bottom as an afterthought. If you tie God in there with Africa, he's pretty accurate. But I'm beginning to feel that the only way to make it through this school year alive is to somehow stifle that passion for a time. I just don't know how to do that.
On the way back to America, I sat at a little restaurant bar in the Lusaka airport, mechanically eating a ham sandwich and trying not to think about the fact that in just an hour I would have to board that plane. The guy behind the counter tentatively said something to me in Bemba, and instantly we sprang into an exchange of what limited Bemba vocabulary I knew. He thanked me for taking the time to learn. "Keep studying. You will make someone very happy when you come back to Zambia and greet them in Bemba." In the front of one of Amy's cookbooks is a story about a native who told a missionary how he knew the missionaries cared for him. His tearful explanation was, "You ate with us." In Africa, I can do that. I can take the time to learn about their lives and their language. I can sit around a rickety table and eat Nshima with the staff.
Why is it so easy for me to find ways to connect with their culture but so difficult to connect with my own?
At the end of the day, sweet memories and sweeter Jesus carry me through. I wrap up in my chtenga blanket that still smells a little like an African marketplace and spread my textbooks out around me. "Baba Yetu" plays gently from my iTunes, and I hum along absentmindedly as I lay down Augustine's Confessions and begin memorizing the pharmacological functions of benzodiazepine. I send emails and write letters to some of my favorite people in the farthest reaches of the globe-- Germany, Belgium, Zambia, and even Texas. I juggle Skype dates with work schedules and pesky time zones, and I force myself to complete at least some measurable amount of homework before I pull out my list of Bemba health vernacular. I'm not sure how to function in this strange half-existence. All I know is that I will, because somehow I already am. And really, there isn't any other option.
One of my sweetest victories this summer was with Baby Lizzie. She was terrified of me from day one. If one of the nannies was in the room, she would tolerate my presence. Heaven help me if I tried to pick her up and carry her away from the crowd though. Two days before I left, I was in the nursery telling them all goodnight. I sat cross-legged on the floor as half a dozen toddlers and preschoolers climbed off of my back and into bed. Lizzie looked over her shoulder, cocked her head to the side a bit, and then seemingly made a decision. She Frankenstein-waddled over to me, a smile growing on her face. She opened her arms wide and, about two steps away from me, literally threw herself into my arms.
As little Baby Lizzie so wisely demonstrated, some things just take time.
Monday, August 29, 2011
"Stand up and fight, ye yellow-bellied scoundrel!"
Are there any other House fanatics out there? It’s okay. Raise your hands high. Be proud.
As insufferably condescending and irritating as Hugh Laurie’s character can sometimes be, I’m a bit endeared to him nonetheless. I love how imperfect he is. I’m also kind of drawn to broken people, and he is certainly that. Most of all, I appreciate the questions posed by his actions and attitude.
In one episode, Foreman (a Dr. who works under House) hands in his resignation because he sees in House the same vices that dwell within himself. He fears that if he isn’t careful, he’ll turn into House. His parting remarks to House were something to the effect of, “You’ll save more people than I will. But I’ll settle for killing less.”
It’s a dilemma that every medical professional comes up against eventually. Do you take a risk, knowing that your patient might die as a direct result of your actions? What if it’s really a long shot? What if it’s their only shot? Or what if it’s a 50/50 gamble, and they might be just as well off if you do nothing—but you have no idea which course of action will save them, and there’s a pretty decent chance that neither will?
As insufferably condescending and irritating as Hugh Laurie’s character can sometimes be, I’m a bit endeared to him nonetheless. I love how imperfect he is. I’m also kind of drawn to broken people, and he is certainly that. Most of all, I appreciate the questions posed by his actions and attitude.
In one episode, Foreman (a Dr. who works under House) hands in his resignation because he sees in House the same vices that dwell within himself. He fears that if he isn’t careful, he’ll turn into House. His parting remarks to House were something to the effect of, “You’ll save more people than I will. But I’ll settle for killing less.”
It’s a dilemma that every medical professional comes up against eventually. Do you take a risk, knowing that your patient might die as a direct result of your actions? What if it’s really a long shot? What if it’s their only shot? Or what if it’s a 50/50 gamble, and they might be just as well off if you do nothing—but you have no idea which course of action will save them, and there’s a pretty decent chance that neither will?
My least favorite medical procedure that I have ever performed is an NG tube insertion. On one hand, it’s pretty easy—stick a tube in someone’s nostril and push. Getting it down the hole isn’t the hard part. Getting it down the right hole into the right organ is a bit trickier.
The day I arrived in Kazembe, I met a very sick little boy named Nicholas. He wasn’t eating, and that on top of whatever illness he had was causing him to fade fast. Amy and I tossed around the idea of trying a feeding tube, but I was way out of my element. I had never done the procedure on a real person before. I know the theory like the back of my hand, but the actuality is nothing short of terrifying. Depending on the statistics you trust, as many as 50% of NG tubes inserted on neonates are placed incorrectly initially. If the tube is in too far, the milk bypasses the stomach and little to no nutrients are absorbed. If it’s still in the esophagus, aspiration pneumonia will be your next battle. If it’s in the lungs and you push milk through the tube…
The only sure-fire way to verify placement (that I’m aware of, at any rate…) is an X-ray. Wanna guess how plentiful those are in the African bush?
Little Nicholas didn’t make it. I suspect he may have had a heart condition—there was an audible third heart sound. Of course, it’s impossible to know if the condition caused the heart failure or the other way around.
The day I arrived in Kazembe, I met a very sick little boy named Nicholas. He wasn’t eating, and that on top of whatever illness he had was causing him to fade fast. Amy and I tossed around the idea of trying a feeding tube, but I was way out of my element. I had never done the procedure on a real person before. I know the theory like the back of my hand, but the actuality is nothing short of terrifying. Depending on the statistics you trust, as many as 50% of NG tubes inserted on neonates are placed incorrectly initially. If the tube is in too far, the milk bypasses the stomach and little to no nutrients are absorbed. If it’s still in the esophagus, aspiration pneumonia will be your next battle. If it’s in the lungs and you push milk through the tube…
The only sure-fire way to verify placement (that I’m aware of, at any rate…) is an X-ray. Wanna guess how plentiful those are in the African bush?
Little Nicholas didn’t make it. I suspect he may have had a heart condition—there was an audible third heart sound. Of course, it’s impossible to know if the condition caused the heart failure or the other way around.
Let me pause for a moment to clarify something. I’m not blaming myself entirely for the deaths of these kids. That being said, it would be foolish not to acknowledge the direct role that my (and everyone else’s) actions played in the way circumstances panned out. Some of the most impactful lessons my professors have taught me have been in the form of stories about their own mistakes. No, I can’t change what happened to Nicholas and Jessie, but perhaps I can take from my time with them lessons that will save the next one.
When Jessie could not find the strength to eat, it became very evident very quickly that an NG tube was pretty much her only chance. I’ve written about the whole well-meaning-but-inept-midwife-putting-the-NG-tube-down episode before, and since she pulled it out two hours later I ended up having to put it back down myself. A couple days before she died, she stopped eating again. I tried eight times with two different tubes before I finally felt it might possibly be in the right place, and she immediately developed breathing difficulties again. I’m not sure how many times I had to insert and reinsert that stupid tube during the short six weeks of her life, but it must have been close to a dozen if you count each attempt. That is incredibly hard on a very small and weak body. Unfortunately, so is starvation. It was our only choice.
In Jessie’s case, circumstances made the decision for me. It’s not always that easy. Sometimes, you have to choose whether to be House or Foreman.
There are very few instances where I will side with House, but I think that for the most part this is one of them. Abdication of responsibility does not confer innocence. Better to be guilty of trying than “innocent” of messing up. In medicine, that’s a pretty tough pill to swallow. When nurses and doctors mess up, people die.
Many folks, upon seeing Jessie for the first time, totally wrote her off. She was too little, too sick, and too far gone. They couldn’t see anything in her worth fighting for. I did.
Maybe, just maybe, deciding it’s worth the fight is half the battle.
When Jessie could not find the strength to eat, it became very evident very quickly that an NG tube was pretty much her only chance. I’ve written about the whole well-meaning-but-inept-midwife-putting-the-NG-tube-down episode before, and since she pulled it out two hours later I ended up having to put it back down myself. A couple days before she died, she stopped eating again. I tried eight times with two different tubes before I finally felt it might possibly be in the right place, and she immediately developed breathing difficulties again. I’m not sure how many times I had to insert and reinsert that stupid tube during the short six weeks of her life, but it must have been close to a dozen if you count each attempt. That is incredibly hard on a very small and weak body. Unfortunately, so is starvation. It was our only choice.
In Jessie’s case, circumstances made the decision for me. It’s not always that easy. Sometimes, you have to choose whether to be House or Foreman.
There are very few instances where I will side with House, but I think that for the most part this is one of them. Abdication of responsibility does not confer innocence. Better to be guilty of trying than “innocent” of messing up. In medicine, that’s a pretty tough pill to swallow. When nurses and doctors mess up, people die.
Many folks, upon seeing Jessie for the first time, totally wrote her off. She was too little, too sick, and too far gone. They couldn’t see anything in her worth fighting for. I did.
Maybe, just maybe, deciding it’s worth the fight is half the battle.
Sunday, August 28, 2011
My Little Iwes
Alright, fair warning: It's 1:30 in the morning. There's a really decent chance that this is going to be a fractured, rambling, nonsensical post. I don't believe in proofreading after midnight. Bear with me. I'll try to make it come together in the end.
I've become that person. You know, that one girl... The one who freaks out when someone wastes food. The one with a story about Africa for every situation. The one who harbors unreasonable irritation against Western culture as if she isn't part of it. Yikes.
A few weeks have passed, but I still feel like I'm floating around in Limbo. It's sort of as if I'm watching myself from the outside. Not to prolong the Narnian metaphor beyond it's lifespan, but I wonder if this isn't how Peter, Susan, Edmond, and Lucy felt upon returning "home." Did they see Narnia everywhere? Did they dream about it? Did they close their eyes and cling desperately to memories in a wild attempt to convince themselves that it had really happened? And how, pray tell, did they go back to their normal lives as normal school children?
I wonder if Narnia changed them. I wonder if it changed them and shaped them so much that they no longer fit back into the puzzle they originally came from. In many ways, that is where I find myself-- trapped between two worlds. Not quite Narnian, but a stranger in my own land.
Weird.
Anyway...
Peter, Susan, and Lucy each received a gift to use in their times of greatest need. Aslan sent me one too.
Once upon a time, the dusty and quiet streets of Kazembe began to stir with life. Dust turned the sky a dull orange. People appeared from everywhere, as though they were simply rising up out of the ground. A massive celebration was brewing.
I can tell you more about the Mutomboko celebration later. Pretty much all you need to know at this point is that there were thousands and thousands of Zambians crammed shoulder to shoulder in the streets for pretty much three days straight. Because I'm hopelessly in love with all things African, Zeger and I were in the Boma for basically all of that time. It was absolutely amazing, a little terrifying, and a whole lot of fun.
The first morning we went down, we were all crowded around the entrance to the Mwata's palace for the bringing of the beer (don't ask...). Several dozen village kids were gathered around us (as per usual). I could not have been happier. I could go on for hours about the little moments I shared with them, but for your sanity's sake I'll just tell you about Monica and Cynthia.
They were both beautiful little girls. It's so difficult to guess their age-- they were probably older than I suspected. I would venture a guess at somewhere between 8 and 10 for each of them. Both of them were literally dressed in rags. Cynthia's shirt was falling off, and some of the other better-dressed kids were laughing at her. She kept clutching it up over her shoulder, the shame evident on her face. She was one of many that I took into my lap as I carefully tied the tattered pieces of their clothing back together. I sang softly in her ear and ran my fingers through her brittle hair. Monica stood protectively over her. I wondered if the two of them were sisters, or merely friends fighting for survival together. They stayed with us the whole morning. I tried to talk with them, but their English was very limited. Most of the time, we just stood there holding hands. I was okay with that.
Later that day, Zeger and I were headed back to the orphanage to grab some food. I felt little fingers grab my shirt. As I turned around, Monica pressed something into my hand. It was a small, pink and silver metal bangle. I asked if it was hers. She shook her head and pointed to Cynthia. I reached out my hand, and Cynthia placed her little hand in mine. I thanked her, a little at loss for what to say. She only said one word. "Remember."
I gave her a black hair elastic from my wrist in exchange, and we parted ways. I remember being totally shellshocked. There's a pretty decent chance that this little Iwe had just given me the only piece of jewelry she owned. Maybe not. But maybe so. This terribly dirty little girl who smelled like urine and barely spoke a word of English somehow found the right word to say and made a gesture that spoke louder than words ever could.
That bangle hangs from a beaded cord around my neck. A charm shaped like Africa and painted with the colors of the Zambian flag is nestled in the middle. In my times of greatest need, when I can't imagine going one more single second without holding one of my kids, when the sights and smells slip like vapor through the windows of my memory, I reach up and grab that bracelet. As the harsh metal edges press into my skin, I close my eyes and am carried back to a place where, for me at least, the world makes a little more sense.
I've become that person. You know, that one girl... The one who freaks out when someone wastes food. The one with a story about Africa for every situation. The one who harbors unreasonable irritation against Western culture as if she isn't part of it. Yikes.
A few weeks have passed, but I still feel like I'm floating around in Limbo. It's sort of as if I'm watching myself from the outside. Not to prolong the Narnian metaphor beyond it's lifespan, but I wonder if this isn't how Peter, Susan, Edmond, and Lucy felt upon returning "home." Did they see Narnia everywhere? Did they dream about it? Did they close their eyes and cling desperately to memories in a wild attempt to convince themselves that it had really happened? And how, pray tell, did they go back to their normal lives as normal school children?
I wonder if Narnia changed them. I wonder if it changed them and shaped them so much that they no longer fit back into the puzzle they originally came from. In many ways, that is where I find myself-- trapped between two worlds. Not quite Narnian, but a stranger in my own land.
Weird.
Anyway...
Peter, Susan, and Lucy each received a gift to use in their times of greatest need. Aslan sent me one too.
Once upon a time, the dusty and quiet streets of Kazembe began to stir with life. Dust turned the sky a dull orange. People appeared from everywhere, as though they were simply rising up out of the ground. A massive celebration was brewing.
I can tell you more about the Mutomboko celebration later. Pretty much all you need to know at this point is that there were thousands and thousands of Zambians crammed shoulder to shoulder in the streets for pretty much three days straight. Because I'm hopelessly in love with all things African, Zeger and I were in the Boma for basically all of that time. It was absolutely amazing, a little terrifying, and a whole lot of fun.
The word "Iwe" (ee-way) means something akin to "hey you" in Bemba. I would often hear it used to get someone's attention amongst people in the village. The nannies often address the kids that way. It has also become a name for the street children. They are Iwes. Hey You's.
I heard many people use it in that context as a rather derogatory term. "I had to chase the Iwes off my porch again this morning." I hate that any child is thought of that way. For me, there are few sweeter words. Many of the non-Zambians I came in contact with said that I'm still in my Zambian honeymoon phase-- I'm totally in love with everything even remotely related to Zambia. Maybe they're right. May God grant that it never ends.
Some of my sweetest memories are of my little Iwes. Especially during Mutomboko.
The first morning we went down, we were all crowded around the entrance to the Mwata's palace for the bringing of the beer (don't ask...). Several dozen village kids were gathered around us (as per usual). I could not have been happier. I could go on for hours about the little moments I shared with them, but for your sanity's sake I'll just tell you about Monica and Cynthia.
They were both beautiful little girls. It's so difficult to guess their age-- they were probably older than I suspected. I would venture a guess at somewhere between 8 and 10 for each of them. Both of them were literally dressed in rags. Cynthia's shirt was falling off, and some of the other better-dressed kids were laughing at her. She kept clutching it up over her shoulder, the shame evident on her face. She was one of many that I took into my lap as I carefully tied the tattered pieces of their clothing back together. I sang softly in her ear and ran my fingers through her brittle hair. Monica stood protectively over her. I wondered if the two of them were sisters, or merely friends fighting for survival together. They stayed with us the whole morning. I tried to talk with them, but their English was very limited. Most of the time, we just stood there holding hands. I was okay with that.
Later that day, Zeger and I were headed back to the orphanage to grab some food. I felt little fingers grab my shirt. As I turned around, Monica pressed something into my hand. It was a small, pink and silver metal bangle. I asked if it was hers. She shook her head and pointed to Cynthia. I reached out my hand, and Cynthia placed her little hand in mine. I thanked her, a little at loss for what to say. She only said one word. "Remember."
I gave her a black hair elastic from my wrist in exchange, and we parted ways. I remember being totally shellshocked. There's a pretty decent chance that this little Iwe had just given me the only piece of jewelry she owned. Maybe not. But maybe so. This terribly dirty little girl who smelled like urine and barely spoke a word of English somehow found the right word to say and made a gesture that spoke louder than words ever could.
That bangle hangs from a beaded cord around my neck. A charm shaped like Africa and painted with the colors of the Zambian flag is nestled in the middle. In my times of greatest need, when I can't imagine going one more single second without holding one of my kids, when the sights and smells slip like vapor through the windows of my memory, I reach up and grab that bracelet. As the harsh metal edges press into my skin, I close my eyes and am carried back to a place where, for me at least, the world makes a little more sense.
Subscribe to:
Posts (Atom)