"Do you want to come with me to take a lady into the hospital in Ziguinchor?" Boaz asked.
"Yes... I do. I'll try to be quick."
I ran beside the peanut fields to my house about 150 feet away to change from my work shorts into my last clean clothes (a pair of scrubs I pillaged from a donations pile in Peru, donning with them the role of jungle dentist). Boaz was soon nursing our ambulance skillfully across the badly pitted surface of the road. Dr. Andres (a visiting GP who had worked in Niaguis not long before), Nurse Jean Sambou, and I sat in silence punctuated only by periodic rendezvous with especially savage potholes.
In Senegal, the village is the family unit. The act of life is simply played on a larger stage; as the village is bounded only by the river, the rice paddies, or the untamed vegetation which surrounds it. When we arrived at the mud-brick house, the family was there to greet us... the village family, that is. Women lined the walls of the house, sitting in chairs or on the ground. A crowd of men stood separately under the shade of a mango tree in the front yard. We pushed through the stares to enter the low doorway, as Boaz waited outside with the Ambulance. We were led to a back room, dark except for the dusty light which filtered in from the outside door. In this dim world there gradually appeared two women. Our patient lay face up on a blanket which intervened between her motionless form and the dirt floor. Above her, an older, heavier-set woman stood hunched over in sweaty anguish. The story was simple enough:
"The girl gave birth a few hours ago" --here, the older woman gestured obliquely behind her.
"She bled a lot. Yes, quite a lot."
"She was sitting up after the birth, talking with family. Then she stopped talking. No, she wouldn't respond. So we called you ..."
Dr. Andres knelt on the floor. Pulse -- weak, but still there. Barely breathing.
She stirred once in a weak, restless way.
Cell-phone light to check her pupil reflex. Nothing. That's bad. She's brain dead.
Dr. Andres rose from his knees, brushing the dirt away as he did. He spoke in english to Jean: "She's brain dead. I'd star CPR and take her to the hospital, but even in the unlikely event we could make it 30 minutes over the deeply rutted road, she will be a vegetable. Maybe you should explain to the family... I don't know the culture well enough."
Jean spread his hands palms up in the universal gesture of futility. Turning to the older woman, he explained the situation to her in french. Family members who had been eavesdropping from the door now pushed into the room.
"Why don't you take her to the hospital?" "Is she dead?"
"No, no, she's not dead..." said Dr. Andres. Jean knelt to find her pulse. We joined as he adjusted his fingers for a second try at her wrist... different position... try the neck ... try the foot... nothing ... wait! was that something? ... nothing now, no ... no ... no ... nothing.
Family men chiseled by hard work now surrounded us. "What's going on?"
"We're very sorry, but she was effectively dead before we arrived..." Jean explained again and again as each relative pressed in and wanted to hear the truth for themselves. Grief etched its determined lines over their faces as we watched.
"What about the baby?" Someone asked.
The older woman turned wearily to the bed behind her and scooped up a small bundle of rags. In the faint light, I saw an impossibly tiny form swathed in a single dirty cloth. The mother, it came out, had not yet fed her baby. Hours after birth, this baby -- which at 1.5 kilos would have been committed to a NICU in the states -- was indeed in a bad position.
News of the mother's death reached the outside of the house before we did. As we considered what to do, the wild wailing of relatives and friends pierced the former whispered silence. Some were in favor of us taking the mother's body out in the Ambulance, but the family at length asked us to take the baby and leave the mother. The older woman -- who turned out to be a family friend and midwife of sorts-- moved with us carrying the baby to the ambulance. Amidst the wailing women, one passed out cold, but was revived within a short time.
On return to the clinic, we wrapped the baby in a clean towel, and committed the care of the baby to LaRae's capable hands. The first few days were "touch and go" for the baby: risk of infection was enormous ... and dehydration proceeded from the baby's disinclination to drink from the bottle. Dr. Andres placed an IV after several attempts and much prayer in the baby's threadlike veins, and from that point, there has been gradual but steady improvement. LaRae has carefully tended to the baby (now named Fatou by relatives), and the sure reward of such loving care has been that the baby has gained a good amount of weight and smiles a great deal.
The saddest part of this story is the prologue, which was related to us several days later. Fatou's father is an alcoholic ne'r-do-well that depended upon his wife to support the family and his habit. The wife had continued to work at collecting sticks throughout her pregnancy in order to keep food on the table for her lazy husband and small children. This doubtless contributed to the premature birth, but the true irony is that the mother's life-giving spirit -- her overwork during pregnancy -- may have been what killed her.
This strange juxtaposition of life and death reminded me of what Christ did in dying for us, that we might have His life. He who lived that we might live also died that we might live. In some ways, we fought harder for Baby Fatou's life in those first days because we realized at what price she had be born. Do we realize at what price Christ purchased our birth as His children?
"Greater love hath no man than this, that a man lay down his life for his friends." John 15:13
"But God demonstrates his own love for us in this: While we were still sinners, Christ died for us." Romans 5:8
"This is how we know what love is: Jesus Christ laid down his life for us. And we ought to lay down our lives for our brothers." 1 John 3:16
