Saturday, January 7, 2012

.my soapbox

this is what happens. this is the end of the road. the end of a long
line of public health terms and politically correct statistics.

this is where babies with faces of old men die because they are tired.



the place where problems of poverty ignorance bad water corruption and
not enough food collide.

it started six months ago, although it really began centuries before
with fat cats in powdered wigs who promoted colonialism over a glass of

6 months ago, a mother was pregnant again and her first baby was only a
few months old

she was pregnant and she was tired.

she stopped breastfeeding the first baby thinking she could not support
both of them.

here we can interject words like family planning and child spacing and
other such terms that could have made our mother less tired

so suddenly our baby isn't getting milk anymore.

and then he is drinking unboiled water from the village well.

and then he has parasites

and then hes just not that hungry anymore.

and mabye his belly swells and they think he is fat. and he gets more
and more tired.

he plays less and starts having diarhea.

about the time we can start counting the ribs from ten yards away the
parents realize something is wrong.

they borrow money from family and friends and take him to the nearest
health center.

but he can't keep down the medicines they buy. and maybe while they
were away from home he is not sleeping under a mosquito net anymore.

or maybe he never was.

and now our baby has malaria and they finally get on the bus and bring
him here.

and we start on in IV quinine and tell the family to give him small
glasses of water and bui made with rice and peaunut butter and bananas
every hour.

they nod their heads and don't do it. maybe they don't understand.

they don't know how sick he is.

and now the center of the chest is sunken and concave and each
individual rib is sharp and splayed like a dish rack.

and he isn't drinking what little they are giving him

and they think that because he is on IV quinine he is getting enough
fluid but it is only 7 drops per minute and only serum glucose at that.

(many parents will not give their children anything to eat or drink
while they are on IV quinine because they somehow think that is what the
perfusion is for)

and finally we buy him IVF because there is no way they could afford it.

he is unconcious now but we give him dextrose and several IVF boluses
and he revives and even drinks something.

he looks better and sounds better and I think we can save him.

I think we have given him what he needs in that fragile moment between
just in time and too late.

and its like the skin is stretched so taut across his chest just so it
can be bunched and wrinkled all over the rest of his body

he cries and his face creases and crinkles in all the wrong places and
the only way to describe it is that he looks old

a one year old with the face of the aged

a one year old with eyes that have perhaps seen more suffering than many
see in a lifetime

and we think he is anemic but his hemoglobin is nine

they give him more bui and he revives even more

but then he starts convulsing

and thats not right, he isn't supposed to still be having convulsions on
day four of IV quinine.

and then he isn't breathing well

and five minutes later he is dead

and we don't do CPR because we have no oxygen

we don't do CPR because even if his heart started beating again all the
factors that led up to this death, right here, right now, those won't go

and they cover his face and close his eyes and leave to face a funeral
that will be far more expensive than proper food would have been in the
first place.

so was it the malaria that finally got him in the end?

was it the malnutrition?

or was it perhaps that he was born in the wrong country in the wrong
village and in the wrong world.

he had everything against him the moment he opened those wise luminous
other-wordly eyes.

he was born into a world in which nothing is fair and no one is equal

he was born and he has died and I no one will remember his name

no one will see his face

a nameless shadow that lived and died in a country where parents
deliberately have as many children as possible because they know that
they are going to lose some of them.

and I am not an economist or a historian.

I don't have a single answer for how we can make this better.

for how we can bridge the gap between rich and poor, between right and
wrong, between justice and rhetoric.

but I do know that it must be bridged

I do know that this is not right.

I do know that it is the cruelest of injustices

I do know that we cannot be comfortable with this as our status quo

and I do know that there will come a day of reckoning in which this
child is remembered.

and really, is there ever going to come a day when things are fair? no.

and is there every really going to come a day in which peace can be
experienced? no.

and is there ever going to come a day that isn't saturated with
thousands of senseless deaths? no.

but that doesn't mean we can't fight for it anyway.

that doesn't mean we can't dream the impossible dreams anyway.

that doesn't mean we can't give of our wealth anyway.

that doesn't mean we can't help that one person anyway.

and maybe you can't go to Africa. and maybe you aren't a doctor. and
maybe you don't have a degree in public health or work for some
fashionable NGO. that is okay. you don't have to be that person. but
you DO have to remember the forgotten. you DO have to involve yourself
in some cause which does not let you be indifferent. you DO have to
find a way to touch someone's life. you DO have to get out of your
comfort zone. you DO have to give something that you have to someone
who has less than you.

it is your responsibilty as a human being.

to protect life - that most inalienable of human rights.

how will we be remembered?

in this, the first global society.

How will history be written?

how will our generation be defined?

we must fight to uphold all human life as sacred. we must fight for the
forgotten. for those that have long since been given back to the
earth. for those that have not yet been born. we cannot live
comfortably in a world in which one side of the continent is drowning in
an orgy of excess while the other side is dying from scarcity and neglect.

we can be the generation that dreamed the impossible dream.

60 years ago the world was shaken with a a holocaust. with a society in
which it was in fact possible to murder 11 million people. and 60
years ago we said never again.

but when my eyes roll over the ribs of this child, i wonder if we meant it.

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