Health & Children in West Africa - Jan 2006

My husband says that this is one of the most depressing updates I’ve written! I have to apologize at the beginning for that. But living overseas is full of dramatic highs and lows, and I can’t seem to pull myself out of the lows these days.

I came home for lunch yesterday and our cook/housekeeper mentioned that she had a problem that she needed to discuss with me. Her son had been stuck in the eye with a stick while playing with a friend. What had originally been diagnosed by one doctor as an infection was in fact much more serious. Now if he doesn’t receive surgery, he will lose sight in his eye. Her question to me was, could we give her a loan so she could pay the $200 for the surgery? Her son is five years old.

Two years ago in January, her husband went in for a “routine” heart operation at a local hospital. The operation went fine but he died of a post-operative infection. When something goes wrong at the hospital here and you are poor, you are just screwed. No one sues anyone; they just live with the consequences. So our housekeeper is desperately afraid the same thing will happen to her son. She has been crying in the kitchen for the last two days.

All I could tell her is that she shouldn’t worry about the money (of course we will help her pay for the operation). I can’t even imagine if it were happening to my son. But what I can’t do is assuage her fears about the hospital. Any hope I could give her would be insincere and she knows it. What I did tell her is that she has to be strong for her son. He needs to believe that everything is going to be ok. But I’m worried.

One of the zookeepers who used to play with my kid on his weekly visit to the Accra zoo recently died in childbirth, along with her baby. This happened at the hospital that, ironically, the First Lady of the U.S. visited here in Ghana last week, and was showcased as one of the U.S. government’s “success stories” in supporting improved healthcare. But there were complications in labor. A surgeon was called, but he didn’t show up in time, and both mother and baby died. As per the local custom, everyone at the zoo is wearing black.

A friend recently recommended that I write more about what I know—what it is like to have a child here. I guess I’ve been avoiding it since it’s scary to think about and I’m trying (more and more unsuccessfully I fear) to be balanced in my interpretation of life here. But the fact is my husband and I live in constant fear for our son’s health, and it’s not just the normal parental paranoia. For people who have the insurance or can afford it, serious injuries here are dealt with by putting someone on a plane to London or Germany or South Africa—one flight a day. Time-sensitive emergencies have no solution. The last place you want to take your kid here in an emergency is to one of the hospitals.

So we watch our kid like hawks. He can’t drink the bathtub water. He has to wear shoes when he plays outside. He cannot be outside at dusk when the mosquitoes are out. He can’t go near the animal cages at the zoo. And every time he has a fever, he gets a malaria test.

Our Embassy health unit is wonderfully supportive. They take every call from every worried parent, all hours of the day or night without complaint because they know that in Africa, you have to take fevers very seriously. Every one could potentially be malaria, which, if not caught in time, can be fatal. And every bout of diarrhea could be cholera or giardia.

Lucky for us, our one-year-old is overall very happy and healthy and developing wonderfully. But we worry about his speech development. If you spoke to our nanny, you might start to understand why. Her English is not great, and I’m starting to wonder if the misunderstandings we have are not just cultural. Most of the time I have a hard time understanding her. Don’t get me wrong—she is a wonderful and caring person who comes up with great, imaginative games to play with my child. He loves her to death and I know she loves him. But at the end of the day, she will not be the one teaching him to speak English correctly or challenging him intellectually. I’ve told her it’s ok to speak to him in Ewe, her own language. Maybe that is what he is garbling to us at the end of the workday.

Last week our son had stomach problems. By Friday he was lethargic but not dehydrated. Something was wrong, but we couldn’t figure out what. Then I realized our Nanny had been giving him the wrong mixture of formula for the past few days. I almost strangled her. Then I almost fired her. Now I make the bottles myself.

A woman from my office has an autistic kid. She told me today she is leaving Ghana to go back to the U.S. to get her kid the support he needs so he can enter kindergarten soon. This is the second person from my office that has left Ghana over the past year because of a child’s educational needs. Even the $13,000/year private schools here are not sufficiently equipped to provide the support for kids with learning disabilities.

Parents with older children here say it is hard to answer the questions their kids ask them living here. What would I say if my child was old enough to ask me about the lady who begs on the traffic median or the guy I saw on the street with elephantiasis a few weeks back? How would I explain the people touching his hair or why all the neighborhood kids ask him for money? I’m glad my son can’t ask me these questions yet because I don’t have the answers. And I’m starting to wonder after 15 years of development work if I ever will have them.

So I guess it’s hard being a parent here, one more reason why it is so difficult to get people to serve in Africa. I’m living the cliché that things like security, health, schools, and distance from family become so much more important in my life now that I am a parent.

One thing that clearly separates life in West Africa from other more developed places is that there is no neighborhood you can move into to evade misery here. You can’t drive a different way to your office and not see it. There is no wall that can protect you or your family from it. And sometimes, it gets to you.

So I spend my days secretly thankful for how lucky we are, while at the same time live with a constant twinge of guilt because we can leave this place one day. And I will keep my fingers crossed until I’m in a place where the water and mosquitoes and hospitals won’t hurt my baby.

p.s. The operation for Courage, our housekeeper’s son, is March 7, 2006.