1 in 5

1 in 5...
1 in 5...
1 in 5…

That was the phrase that danced through my head as I entered that stuffy hospital room. I willed it to stop, but the reality and irony of the situation only made it reverberate through my brain more loudly. 

Four hospital beds graced the walls of the decent sized room, each was filled with a mother and child.  Tired faces looked up at me as I stooped to enter the door behind angel khAla.  Life makes women seem tired here, but the tiredness that graced the faces of these new mothers was deeper and more profound.  There was a tautness that came from worry and fatigue.  The hovering over a child you are powerless to make better will bring weariness to the face of any mother. But these women; their lack of money, knowledge or confidence in themselves or the doctors who claimed to help them weighed their frail bodies down like a ton of bricks.

Each held a small bundle in her arms. Three of the four bundles were sleeping quietly. The fourth squawked like a frantic chicken. Pain and fear and hunger filled its tiny eyes and spilled out into the room through its weak voice.

Grandmothers hovered and nitpicked and fussed over the women and children.  In a few minutes I would be inundated by them as they advocated for their loved ones.  A few minutes after that, they would back down with their pleas after my repeated insistence that I was not a doctor and I most likely couldn’t help them.

The mother and child that angel khAla and I had come to see were in the first bed on the left.  A tiny tiny boy peeked out of layers of clothes and blankets. His face looked peaceful as he slept, but the thickly penciled-in eyebrows gave his face a harshness its perfect features did not deserve.  10 days old he had been having trouble nursing from the start and had just stopped 4 days before.  Coincidentally the cessation came right after a ‘doctor’ from a pharmacy had given him a mysterious miracle injection to ‘make him stronger.’ Angel khAla joked with the mother (her neighbor) that she couldn’t believe the baby was still alive after not nursing for 4 whole days. The mother’s tired eyes revealed that she didn’t find it as humorous. She commented that something was wrong with this baby. Her three other kids had no problems nursing and had been just fine. Maybe God just wanted this one to die.

I tried to reassure her that her statement wasn’t true at all, but it was a little hard to concentrate with the Squawker behind me and the other grandmothers hovering and asking for my help.  Angel khAla had her hands full as she tried to translate for so many of us at one time.

The mother made an attempt to nurse, but the baby barely opened his mouth and after one suck was done trying. His eyes hadn’t opened the whole time I had been there. Again and again she tried, from one breast to the other with no success.  He seemed perfectly content to lay lifeless in his dream state.  The Squawker behind me spit up all over her  mother. The mother pleaded with me to examine her child. I explained that I wasn’t a doctor and I only knew a little about nursing based on my struggles with my own son.  Rather, angel khAla told the girl this as she translated from the local language to the village dialect for me.  All of the women in the room nodded their heads except the Squawker’s mother who feebly explained that she didn’t really speak the local language or the village language, but a third language. My head was swimming by this point.

I went back to focusing on the little boy while angel khAla tried to communicate more with the Squawker’s mother..  I cleaned my hands and stuck the pinkie of my right hand (very important) in his mouth.  I immediately hit a wall – his tongue. It was stuck to the roof of his mouth like glue. I knew immediately that I had most likely found the problem.  He wasn’t able to actually latch on because his tongue was in the way.  And the milk that streamed down the sides of his mouth each time he tried to nurse was also a result of this – he couldn’t fully swallow with his tongue stuck to the roof of his mouth.  I gently pressed his tongue down and he quickly latched onto my finger and started to suck. I worked on massaging his tongue down to show him what it should feel like.  By this time, his eyes were open and he was interested in getting something in return for this work.  After a few minutes, I had the mother latch him on – a quick transfer from my finger to the nipple.  He latched right on and started nursing.  His open eyes started to flutter closed once the milk hit his belly. The mother started to unlatch him and exclaimed, ‘he’s done.’  I tried not to laugh, but found it hard to refrain.  The poor kid hadn’t eaten in 4 days. She had just told me that she hadn’t tried to nurse him since 10 that morning (it was 4:30 pm). And here she was ready to close up shop after he had gotten a few drops.  She hadn’t even had a letdown yet!  I explained how babies get happy and sleepy when they eat, especially when they were as weak as he was. I told her that they need to have a full feed to be healthy. I encouraged her to rub his feet and head so that he would keep nursing.  He sucked away for 10 more minutes.

While she fed him I went to see the Squawker.  Angel khAla explained that she was 1 month old and had pneumonia. She had been in a Basic Health Clinic for 5 days and had been transferred here to M-ville this morning…well yesterday as it had taken them all day to get here.  Their village was far far away; different ethnicity, clothes and language, in a hotbed of insurgents and military operations.  The husband came in and out nervously to check on his wife and child.  He himself looked young, but compared to his wife, looked like an old man.  She didn’t look a day over 14.  This was her third child – a fact that still seems impossible to my brain.  She, just a child herself, sat holding a screaming infant.  Mother and babe both had looks of desperation etched on their tired faces.  Though mine probably didn’t show it, I felt desperate for them – having no answers and no help to offer. I asked if the baby nursed (because remember, this is all I know a little about). She whipped out her breast, stuck it close to the lips of the screaming child, pulled it quickly away and said, ‘nope.’ I tried to encourage her to pick the baby up and help it to nurse, but there was too much going on for the advice to register.  We couldn’t understand each other, she couldn’t stop nervously rocking and patting the babe, and it couldn’t stop screaming.  I still have this sick feeling in my gut when I review my mental picture of those desperate eyes. 

Back in the corner lay another sleeping baby.  It’s grandmother explained that it was also 10 days old and had had a horrible fever all night long. She went on to say that the baby had been sleeping all day because it had been so tired from screaming the entire night.  Or from being doped by medicine? I asked and not surprisingly, it had received a shot immediately upon arrival to the hospital and quickly fallen asleep after.

It came up in the chat that the baby hadn’t nursed ‘in a while’. I cringed as I asked what ‘in a while meant’. 9:00 am was the answer I received and it made me wince.  I asked the mother and grandmother if they had eaten since then.  Obviously they had eaten lunch and looked at me like I was crazy for even needing to ask.  So why hadn’t they made sure the baby had nursed? I asked the rhetorical question…only to receive sheepish looks and slight nods. 

The grandmother defensively said, ‘it has been asleep and we didn’t know that babies need to eat often.’ I explained that every 2 to 3 hours is healthy for a baby and encouraged the mom to try to nurse.  She picked the baby up and as she brought it close to her breast, the baby’s mouth opened as wide as it possibly could.  It’s gaping wide mouth waited two inches from the breast, it’s neck not able to stretch any further past the clothes and blankets it was mummified in.  The mother dejectedly sat the baby back down on the bed and said, ‘see, it won’t eat’. Again, a laugh escaped me. 

“Did you see how wide open his mouth was?!?” I asked excitedly.  “That was perfect! You just have to put in a little effort and help him. Lift him up to your breast.”  Immediately he latched on and nursed like a champ for a few minutes.  Her let-down perfectly coincided with the increased room temperature resulting from more logs being thrown on the fire.  The baby’s eyes began to happily close.  The mother started to pull him off and declared he was finished.  As with the first mom, I encouraged her to rub his head and keep him awake so he could continue to nurse.  He sucked away happily.  The grandmother jabbered excitedly about how much I was helping…I wasn’t really…  She said, “we are poor people from the village and we don’t know any of these things. How are we supposed to know what to do without any help?”  I could only nod my head in agreement. 

The forth baby was just finishing nursing and lay in her beautiful mother’s arms.  She was older but just as sick with a stomach problem.  The grandmother informed me that her i.v. (standard saline solution) was done for this round and asked if I would shut it off and pull it out for her.  I once again stated very clearly that I wasn’t a doctor or a nurse and I couldn’t do that.  They finally consented and went to get a nurse. I let out a sigh of relief. 

Darkness was beginning to fall and I had two boys at home and guests coming for supper.  I reluctantly began to say goodbye.  I reminded the mothers of little things – help your babies eat every 2 to 3 hours, help massage his tongue down, keep them awake through a full feed.

I thought of a million other things I should have said on the way home and kicked myself for neglecting them. I found myself so overwhelmed with the needs of those four mothers in that room…not to mention the millions more like them that inhabit this land. Such easy and vital information in birth, breastfeeding, childcare, hygiene, etc. is not accessible to so many in this place.  They are not stupid or incapable or worthless, they are just disadvantaged and not informed.  SO much could be prevented…so much. 

1 in 5 still rang through my head. 

1 IN 5 CHILDREN IN THIS COUNTRY DIE BEFORE THEY REACH THE AGE OF 1.

1 IN 5 CHILDREN IN THIS COUNTRY DIE BEFORE THEY REACH THE AGE OF 5.

Never before had those statistics been more real or heartbreaking or sickening to me. I desperately pra.yed for those babies and their mothers. That no matter how greatly the odds seemed stacked against them, that they would NOT become that statistic – that 1. 

As I opened the gate to my yard and saw the round face of my sweet healthy boy smile up at me, tears filled my eyes.  I hugged him tight as I marveled at how blessed I am and how good I have it. 

Oh how I hope and pray that those 4 little ones will defy the harsh realities of this land.  Desperation runs strong for so many here. Survival is all they can manage.  I find myself pleading for God’s mercy upon the broken and hurting of this world – that those statistics would fall away like dust – that wholeness would be the anthem of the people of this land.  At least I can dream, can’t I?