Greetings from Kabula, western Kenya!
I didn’t put up a post over the weekend, partly because there were some events I needed to process before writing about them. My friend and co-worker here in Kenya, Dr. Don Givler, wrote something last night that is perhaps better than I could have done, so I am cutting and pasting it here.
“Life Is Hard”
Our friends Ray and Jan Downing have worked at Webuye District Hospital in western Kenya for over 15 years. A routine part of Ray’s hospital tour is a mural painted on the wall outside the Pediatric ward. The mural, painted by a Kenyan, shows a boy who has climbed up a tree that he had been chopping down. He has dropped his ax, and below him are a lion and a crocodile. In the tree above him is a swarm of bees and a snake. And it is obvious that the tree is on the verge of falling down. Ray’s question to his visitors is, “Why would someone paint such a mural outside a Pediatric ward?”
After a pause, Ray observes that to paint a mural with happy, safe children reflects a reality that most Kenyan children will never know. The fact is that no one knows what the artist had in mind when he painted the mural. But anyone who has spent time in Kenya knows one message that is implicit in the mural: life in Kenya is hard.
This past week our group of medical students, residents, and faculty physicians came face to face with the reality of life in Kenya. On Friday morning, as we were waiting to leave for our mobile clinic, a man arrived with his 8 year old daughter. It was apparent that she was seriously ill. She lay limp in her father’s lap. Her breathing was rapid, and the blood flow to her skin was poor. She was pale, and her liver and spleen were both enlarged. Parts of her medical history were vague, but we learned that she had recently been admitted to the district hospital and had been given a blood transfusion. Her condition had improved and she had been discharged home. Unfortunately, her improvement was only temporary, and her father brought her to us. Her diagnosis was at best uncertain, but her condition was grave. We treated her as best we could, and we urged her father to take her to the hospital. He assured us that he would. However, later that day when we toured the Pediatric ward at Bungoma District Hospital she was nowhere to be seen. The next day we learned that she had not been taken to the hospital, and later that evening she had died at home.
We sat around the dinner table as we processed the news of her death. We had many questions – some expressed, and some silent. For those of us who had previously worked in Kenya her death was very sad, but not a complete surprise. But to some of the others it was both shocking and deeply distressing. For the remainder of the weekend we all grieved in our own ways. On Sunday afternoon two of the students walked to the viewing at her grandmother’s home.
No amount of experience in Africa will remove the sadness resulting from the unexpected death of an 8 year old girl. That is especially true when our western perspective might lead us to the conclusion that her father did not care enough to take her back to the hospital. I do not know why her father decided to take her home, nor do I know if taking her to the hospital would have made any difference. Anything that I could suggest would be conjecture and would not be helpful.
However, her story is a reminder that illness and death is a daily reality in Kenya. The resignation with which Africans respond often seems to us non-Africans like passive fatalism. Perhaps it is. But I wonder if it isn’t simply their way of coping with sad realities that are beyond their control.
Life in Kenya is hard.