The P Word

For a complete update on Angelina & her surgery see my post here. For some of my thoughts on this experience keep reading. 

I never dreamt this is the kind of adventure my internship would hold. Many times throughout this week I've caught myself think "Is this reality? Is this really happening?" It has been such an exciting, exhausting, wonderful week.

And though I have at times felt completely unqualified to be getting medical care for a child I've just met, in a country I've just arrived in, I have seen time and time again that everything we need to be able to care for Angelina has been provided. I recognize my qualifications don't come in the form of medical knowledge, or Ghanaian language skills, but that I am here to serve as an advocate for a child who simply needs someone with a voice. I am capable of fighting through the system to ensure Angelina gets cared for, and I have experienced enough of life in West Africa to know a little about how to do that.

Navigating the hospital system has been an incredible challenge. If I wasn't overcome with a deep sense of focus and drive I know I could easily throw my hands in the air, scream, or cry. Doctor to patient communication here is poor, and the communication between staff is not any better. We hear different answers to the same question every time we ask, and wrong answers have catastrophic effects for Angelina's care. Before the surgery we were sent away from the hospital on more than one occasion by nurses, and every time when we pushed for answers and sought out doctors we were told not to go anywhere and that the surgery was still going ahead. We were given different prescriptions from different doctors, told Angelina shouldn't eat after 6pm/4am/6am/10am before surgery, and were never told Angelina would need special feeding formulas after her surgery (so we rushed out to get them for our starving child who hand't eaten in 24 hours).

Constantly asking questions, searching out second opinions, and spending time waiting for information that never comes has been our past two and a half days. And though it has only been two days the constant toggling between long waits and rushing to care for urgent needs has been exhausting. I can't imagine navigating this system alone like some of the mothers here are. And I know Angelina's mother could not have managed this on her own: with her beautiful meekness and quiet voice, I wonder if she ever would have made it past the waiting room.

This fight through the system comes with a personal struggle too.  And though I find joy and excitement in serving as an advocate or the "Strong One", as a bus driver on the trip down here called me, there is an uncomfortable element in it all too.  I have struggled with navigating my own privilege in such a complicated system.

My white skin brings me advantages most days in West Africa (along with my fair share of teasing, and occasionally a lack of respect) but never before have I confronted my privilege so much in a single day as I have at the Komfo Anokye Teaching Hospital. And yet there is no "proper" way to communicate this privilege either. How do you grapple with the fact that you being a foreigner, specifically a white foreigner, brings advantages that others here don't receive? I accept it because of how it has helped Angelina, but I have not come to terms with it. The knowledge that my presence here has lead to a different kind of care for Angelina is both a relief (I could be here to do that!) and sickening (Why is that I need to be here? What of the children that don't have a Brittany or a Katie?).

I feel the weight of this discussion on me every time I walk through the Visitors Gate at the hospital. The strict visiting hours (6am-7am, 3:30pm-5:30pm) mean family members who arrive at the hospital late come up against a locked and guarded gate that bars them from entering the hospital. Occasionally I have seen family members discuss urgent needs with the guards and be let past, but I have also seen guards physically restraining family members so they couldn't pass. And yet as I approach the gates they are opened, and I am ushered through with barely a hello. I can go back and forth in the evenings, doing multiple errands, passing through through military check stops and the 'Visitors Gate', while some cannot get past even once. I accept it because it means I can bring the mother food, or the child milk and bananas, but I still don't think it is okay. It just is.

Yesterday I walked past a woman outside the children's emergency department crying the cry of a mother who has lost a child: the kind of deep, wretched, wail that I never want to hear again. There is a little boy across from Angelina's bed in the ward who has an oozing tumour the size of his head, growing from his neck. His small frame is so malnourished he looks extraterrestrial: an oversized head balanced on a thin skeleton, it's impossible to tell his age. And when I see his mother caring for him during visiting hours her malnourished limbs and large smile make my heart ache. This isn't how it should be, I think. It just is.

And in all of this I know I look on with a visitor's attitude. I can, at any time, choose the best my system has to offer. I am educated and able to understand complex medical issues, I have preventative medical care and emergency medical care, and I have the means to access them at any time. Wherever I am in the world I am privileged because of who I am and where I am from; I can witness the medical system here with the full knowledge that the best this system has to offer, this reality, will never be thrust on me.

The ugly truth is that there are multiple realities in this world; as a visitor I can waltz between them, visiting when I want, and leaving just as quickly, while walking past mothers and fathers and children who have only this reality. It's that's why the visitors gates bother me so much. It's not the fact that I can visit Angelina whenever she needs someone, it's that the visitors gates are a physical representation of my privilege and consequently a representation of the injustices of this world.

Walking through the visitors gates is a momentary insight to the ugly parts of our world and to the brokenness that cannot be repaired by man alone. Development work will never do away with the multiple realities, the power and the privilege, that divide us. This is something that requires something bigger than us. For now all I know is that this isn't how it should be. And yet it is. And somehow, I am responsible to take what I have and to use it to serve. And that itself is a scary, and wonderful, thought. 

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Update: I wrote this post in the morning of June 14th before returning to the hospital for another visit. When I returned  I passed by the small boy's bed, this time partitioned off from the rest of the room. Through a break in the partition I could see the small boy's frail body draped from head to toe in a sheet. I refused to think about it. Maybe he is sleeping I told myself. In the afternoon when I returned again to visit I couldn't pretend any longer: I knew what I'd seen. All evidence of the child had disappeared: his things were tidied up, his bed was being prepared for another patient, and his mother who so diligently came for every visiting hour was nowhere in sight. This is the reality that shreds your heart. This is the reality that shouldn't be.