.acanoforangesoda

a can of orange soda

sitting in the dirt beneath my feet

hidden under the peeling teal bench but not well enough. 

a can of orange soda

for me, it always comes back to the soda

it comes back to those little extravagances that keep screaming of their wrongness

it comes back to the idea of giving.  of keeping.  of holding back.

I know I write about this often but it is something that is ugly and urgent and surrounds me constantly with its pathos and frustration

the anger of being lied to

the impossibility of being put in a position where you have to be both the judge and the jury, the mad scientist that peers through dark lenses trying to decipher the fiction from fact

the great weight of the fact that lives rest on the decisions I make every single day

my baby hasn't eaten in 4 days.....the mother has no milk.  Can you buy me a can of formula?  but does she really have no milk?  or is it because the last 3 children died when she was breastfeeding them that in her desperation she doesn't want to give it?  should I wait - try to get the milk to come in, try to get to the heart of the situation?  go to her house?  investigate and intercede and educate and plead and bargain and threaten?  or, should I just buy her the formula.  But, if I buy the formula, am I killing the child?  will the boil the water long enough?  will they boil the bottle?  will they mix it right?  will they give it often enough?  will the baby get sick with parasites, diarrhea diseases, malnutrition?  I have to decide that.  I am not qualified to decide that. 

decisions.

she is exhausted.  every day I come in, hoping she is still here.  and she is.  too thin and too tired, a great lumpy abdomen and small cold arms.  her eyes are always half open - she is still throwing up.  still not eating.  they are giving her a little sugar water but not enough.  You need to buy a 4rth day of IV quinine.  1400 CFA total - $3.00.  expensive.  3 days work.  if you even have work.  no money, he says.  i explain, i insist, i wait.  i tell him to exchange his cell phone.  or a cooking pot.  he does nothing.  he is thin and strong and weathered, wearing a red tank top and fanning the her - gently arranging her blankets - he is haggard and beaten down.  i can tell.  everything about him breaks my heart.  I wait 4 hours.  I come back.  trade your phone.  he turns the phone over in his palm.  how am I going to call le gent au village?  he has a point. 

the orange can of soda is screaming at me.  I have 4,000 CFA in my backpack that is screaming at me.  I look at her.  she is tired.  I have the money.  I can help.  How much do you have?  500 CFA  $1.00.  I decide to believe him.  I can't change her to oral quinine.  not when she's vomiting.  do i buy it?  if i buy it, everyone will see.  tomorrow, everyone may refuse to pay for their medicines.  everyone is watching.  who am I hurting if I buy this tonight?  will tomorrow's child suffer?  will he ever buy anything again? 

but he breaks my heart.  I buy it.  i get ready to hang the perfusion.  I flush the IV, its infiltrated.  no blood return.  She needs a new IV, i say. 

he doesn't say a word.  he takes out an old leather wallet.  unfolds it.  it is empty inside.  a scrap of red fabric.  and tucked into the corner, carefully, is a coin, 500 CFA.  he hands it to me without a word. 

500 CFA.  $1.00.  the last money he has in this world.  but he gave it.  and the worst sickening, heartcrunching fact of the matter is that he gave his all....but will his all be enough to save her life?  would 10,000, no unlimited CFA be enough to save her life?

she is tired.  should I start her on ceftriaxone?  should i give her IV dextrose?  should i wake up Olen and ask him?  and if i do, what do i say?  she is tired.  she is right on the line.  is there ANYTHING else we can do?  but I don't do any of that.  I go home. 

that 500 CFA coin he that he slowly handed me, the energy and the hope it took for him to drop it wrenchingly into my hand - thats the same amount of money I spent on my soda.

the one that is sitting in the dirt, the one beneath his feet as I search for the IV

decisions


and the woman I interviewed.  she sat there and told me that she wanted to die.  that this life was to much for her.  that 2 months ago, her husband beat her, almost killing her.  that her niece died and she left the compound without permission, to go to the funeral, leaving the children instructions to prepare their father's food.  He came home, saw she wasn't home, the food wasn't ready, and he went to the bar.  when she came back she quickly cooked.  She placed the food in front of him.  it was steaming hot.  he said, why are you serving me cold food?  and threw it in her face, picked up a heavy rock, started beating her. 

as she talked I saw her child.  she had tears streaming down her cheeks.  he was limp and hot and tired.  He had already had 7 days of oral quinine.  he had been throwing up 4 more days after that.  Malaria.  he still has it.  I told her to go home.  if he wasn't better, she could come find me. 

she told me that when the children are sick, her husband refuses to pay. 

so I hospitalized her.  Wrote for IV quinine, IV metro, Mebendazole.  today he is perky and happy. 

and then I saw the father.  sat with him on the mat and had a pleasant conversation.  gave him advice on preventing malaria.  he was pleasant and kind and grateful.  i tried to imagine him hitting her on the head with a rock.  he had a nice phone. 

should I have payed?  would he have payed?  will he pay next time? 

does he know or care that his wife spends every day wishing she were dead? 

decisions

and Florence - I refused to buy her a mango

decisions

And the delegate, from Bere Poste - the chief de quartier - he is dying of TB - last time, several weeks ago, i looked at his carne.  I told him to find Simeon, the nurse in charge of the TB patients.  He found someone else instead. They prescribed him antibiotics and took all his money and sent him home.  He already went through six months of TB meds.  yet, looking at the carne, there are holes.  they weren't given right, they weren't given all at once.  if i were here longer i would take on the TB program.  but i could see he fell through the cracks.  he sat there on the bench, weaving a grass mat with gnarled knobby hand and skinny stripped down arms, getting up periodically to vomit blood.  he put it in a mango leaf for me to see.  blood.  and so what do I do?  do i take him with me to the hospital?  do we go see Simeon together?  do I bother poor Olen once again with yet another problem?  do I give extra time, extra money, extra diligence to try to sort it out?  or do i just tell him to go to the hospital.  He told me he didn't have 2000 CFA.  inside his carne was 4000. I wasn't supposed to see that.   so, i took his carne.  I'll gather the courage and show it to Olen, I'll take it back.  It was something, i did something.  but was it enough?  no.

decisions

the can of orange soda is garish and shiny and insulting.  its still there in the dirt. 

how can I make these people buy their medicines?  how can I do that?  how can i look them in the eye and tell them they have to pay.  They see my nice phone.  they see my laptop.  they see my empty can of soda.  They see my watch.  They see my nice shoes.  and I'm supposed to tell them to pay?  I'm supposed to tell them to give everything they have for a child that might die anyway?

this is just a smattering of examples that happen every single day

these are the things that unsettle me.  because for every situation i give, there is ample opportunity to extend myself more.  to walk an extra mile.  to walk two.  to run a marathon.  I could buy them food.  I could put them in school.  I could pay for my family to get Master's degrees that they desperately want.  I could bring my brother's and sisters to America.  I could buy extra medicines, i could do all of these things

I could

should I?

i think the answer is yes.  but when the needs are so great, so pressing, so difficult to untangle, how do you decide?  and then there is the very valid line of thought against just giving.  against teaching people through experience that the blan, that the nasara is the well from which all free things flow

yet i have talked to women who have walked 3 days without food with a dying child on their back, looking for a white person, falling on their knees in front of their door, and they got helped, and the child lived. 

how far do you go to save a life?  how far do you go to prevent suffering?  I think the saintly, impossible, and daunting answer is all the way

is it really so impossible? 

I know I can do more, I know i can do more 

and maybe that is really at the crux of what is haunting me

the gravity, the weight of every day making decisions that affect people who I barely know, decisions that could mean life or death, and having nothing in me that qualifies me to do so. 

decisions

and a can of orange soda

how much is a life worth? 

how far will I go to save one?

and a can of orange soda