Thursday, December 17, 2009

Very sick girl in the village...

“There’s a very sick girl in that village. She has an arched back. The family thinks it is witchcraft.”

Those are the words I heard once we were on the bumpy road again after briefly stopping in a village in the east of Sierra Leone, about a thirty-minute drive from Koindu, our final destination. The girl had been sick for two weeks and her family did not want to take her to the hospital. We contemplated turning back, but since we did not have medical supplies with us we continued our journey.

That night, over a plate of rice with potato leaves, I asked one of my national friends why the family is keeping the child at home. An array of reasons was presented to me; lack of money, distance to the hospital, lack of trust in the clinic, belief in witchcraft etc. The next morning, while sitting on the porch, the same friend came by to visit before taking us on a village tour. After an exchange of greetings I again asked about the sick girl. Her condition was the same, she said but she assured me that the family is trusting in God.

I found this statement odd. Witchcraft was said to be the underlying cause, they were trusting God to heal her, yet for the past two weeks the child had only worsened. I was missing any effort on the part of the family. Should everything be left in God’s hands? Why leave a critically ill child in a hut, waiting, when there was clearly something that could be done? Was this my Western mindset or medical background getting in the way? I was frustrated and wanted to do something.

After retrieving my pediatric handbook from my bag I decided we needed to go to the family. I would show them pictures from my book to convince them that their daughter is very sick. But that she likely has a disease that could be cured with medicine. My teammates agreed.

We headed to the village in the land rover, a 6-mile drive on a very rough road; enough time for a million and one thoughts to swirl around in my mind. I could not help thinking that if it were my daughter I would have picked her up and walked to the hospital. I then tried to look at it from their perspective. Sickness and death is embedded in their society. Sierra Leone has one of the highest child mortality rates in the world and a child dying has become part of daily life. Going to a hospital for health care is usually a last resort, hence making hospitals notorious for deaths. This, as well as the high costs involved, keeps people out of hospitals. So, for this family, it was easier to blame the illness on witchcraft than to experience the shame of poverty that would come from asking their neighbors for money.

On arrival I was ushered into a small dark hut and there on a bed of straw, lay the girl, rigid. With her back arched, she was groaning and breathing with difficulty with drops of sweat dripping from her brow. Theresa. Thirteen years old. Sick for two weeks. Started with a headache, a fever and then after a few days she became stiff. A few days ago she stopped talking and walking. It was a textbook case of meningitis or maybe cerebral malaria. Textbook cases generally appeal to doctors but there was nothing appealing about this case. It was tragic.

After discussing back and forth, the parents agreed to take their daughter to the hospital. However, it soon became clear that we would have to drive them, as transport was hard to get. They insisted on going to the Liberian hospital; it was closer and there was said to be a doctor and medication there. I thought that sounded like good reasoning, albeit sad that such could not be found in their own country. There was a little commotion when trying to get everyone in the car and although the child had been in the hut for days, I felt a sense of urgency, partially because the child’s condition was so poor but maybe also because now she was our responsibility. Finally, father, mother, an aunt and a suckling baby joined us in the car and with some difficulty Theresa was laid on one of the seats to rest, with us supporting her so she would not roll off.

The road was long. The fever was raging. Prayers were being said, for Theresa and for grace at the immigration check points. Since we were not expecting to be crossing the border today, we did not have our passports at hand. Only one person had a photocopy. Fortunately that, along with the sight of an extremely ill passenger, was enough for the immigrations officers to wave us through.

Once in Liberia we asked for directions to the hospital. Thankfully it was an excellent hospital with skilled staff, clean rooms, and emergency care. The nurses went swiftly about their business as they cared for Theresa and within minutes a kind doctor entered the room to examine Theresa. He then said one word, which put my mind at ease: “meningitis”. I was pleased to know that Theresa was in competent hands.

After blood tests and administration of drugs the doctor mentioned that he would prefer to treat with another drug, but it was out of stock. On hearing this we headed to the village center in search of penicillin vials. To be honest the ‘pharmacies’ were shacks and looked like places that would sell knock off drugs. However, the ‘pharmacist’ was able to show me the correct medication, still in date, for a very good price. Satisfied with the purchase we hurried back to the hospital so that Theresa could receive her first dose. At that time we also realized we needed to head back to Sierra Leone, to make sure we met the same immigration officers at the border to avoid any trouble. On leaving Theresa behind with her mother, all we could do was hope. I had seen cases like her respond well to treatment, but have also seen the victims die. We prayed.

* * * * * * *

Two days later the news reached us: Theresa had died. Thoughts raced through my mind. Why? I questioned. But despite the excellent care she received, it had been too late. Her body had given up. This was not the desired outcome. But this was reality.

That same morning we were heading back to Freetown, and decided to stop at Theresa’s village to pay our respects. As we approached the compound there was a large gathering of people outside, people who had come to share in the grief of the family. To share in the meal that would be served later in honor of Theresa. I could not help but think that maybe these same people could have helped get Theresa to a hospital earlier in the first place; again, my Western mindset.

After condoling the father he led us into the hut. And there on the floor lay Theresa’s lifeless body, her granny mourning at her side. After paying our respects we chose to pray for the family as they cope with their loss, for comfort and peace and encouragement and that somehow, in the bigger picture, something good will come out of this situation. That somehow their village would be positively affected by this seemingly unjust situation. And then, in that moment of sorrow, I saw something beautiful. I saw Theresa’s body wrapped in a beautiful bright pink cloth, a cloth that to me represented new life.

As we resumed our ten-hour journey back to Freetown we were subdued, pensive. Silently rejoicing in the fact that Theresa was no longer suffering yet deeply stirred by the injustice of the situation; another child gone. How many more would follow? And how could we make a difference?

Copyright 2009 by Sandra Lako


Simone said...

Hi Sandra,

I came across your blog while doing research for my senior honors thesis. I am researching Sierra Leone's struggle to improve its maternal and child health. I would greatly appreciate it if you could contact me back at or I am really interested in your insights on maternal and child health in Sierra Leone because of your experiences over the past few years.

Thanks for your time and your good work in my homeland,


Chris Grant said...

Hi Sandra, Your Sierra Leone Blog,Videos and pictures have reminded me of my time in that country. I was part of IMATT 2006 - 2007 and really enjoyed working with the people of Sierra Leone. It was a time of very mixed emotions for all kinds of reasons as you probably know having lived there yourself. I am full of admiration for the work people like you do and the way you dedicate your lives to it. I am very humbled by your dedication, and despair at my very poor efforts of not doing enough to help people in need in this world. Thank you for being you and I will try to do more some how. Chris

~ Act Justly. Love Mercy. Walk Humbly. micah 6:8 ~