The hospital is overflowing with malnutrition babies. Some puffy and edematous, with their eyes swollen closed; some wasted and emaciated, with their ribs poking through and the skin hanging loose off their bones; some both emaciated and edematous, the worst combination. Some have naso-gastric tubes taped to their faces because they refuse to eat. Some have IV’s for IV antibiotics because they also have pneumonia or fevers. They overflow the little four-bed malnutrition room and fill most of the main hospital ward. Bed after bed of miserable babies and desperate parents.
The smell of urine and rancid butter, the thick stench of so many sick and dirty and vomiting babies, eventually became overwhelming. We moved all the families outside one morning and made the parents bathe their children. They lined up in the sunshine along one cement wall of the hospital where the grass was green and soft. It was quite a sight, a whole ragged line of naked crying malnutrition babies under blue skies in the bright warm sun. The nurses made a bucket-brigade to haul water outside. Solomon cut up bars of soap into little chunks for each family. Their dirty clothes – often stained with urine and diarrhea because the children do not have diapers, or soaked with old vomit because there is no change of clothes if the child throws up on himself – were hauled to the laundry room. We gave each child a fresh set of clothes from the donated clothing pile. Not necessarily appropriate clothes. Boys in dresses, kids swimming in t-shirts too big for them, unmatched shirts and shorts, light summer clothing that will not withstand the nighttime chill of rainy season. But at least they were clean. The ragged line-up of freshly washed babies was transformed into an even stranger sight – a bunch of miserable, malnourished Ethiopian babies wearing cast-off American Baby Gap clothing.
One malnutrition baby died last week. The mother had no husband and no family, and because of cultural taboos, she was not allowed to touch her dead child. There were other people from her hometown at the clinic, but they refused to carry her child for her, because they were not her relatives. The clinic paid a stranger 10 birr to bury her baby here in Chiri, and then gave the weeping mother bus fare for the ride home. Another malnutrition baby died last night. I can guess which one will die next, the skinny girl with the cough that won’t go away. She is so small that her tongue looks like a kitten’s when she coughs. She’s losing weight despite treatment and antibiotics. I don’t know what else to do. My heart becomes more desperate and sad each time I enter the hospital, even though I try to smile and speak words of encouragement. I should focus on the ones who get better. But the death of a child is like a splash of black paint into a bucket of white; it taints the whole thing grey, and it’s nearly impossible to add enough white paint to erase the dark shadow.
By now I must seem jaded or cynical to the other American volunteers here. I asked one of them if they feel anything when a hospital patient dies. No, she answered honestly. You are the doctors, I don’t see the patients every day, she explained. The patients who die are abstract to her. Sad stories, but nothing personal. It strikes me how intimate and emotional our job here really is. How different it is than being a program director or an outreach coordinator. How maybe, after holding a child in my hands and trying everything I know to keep it alive, after comforting grieving parents as they wail and beat their chests, maybe I have earned the right to be jaded and cynical about our work here. This is unlike me. I want to be optimistic and hopeful. But I also want to run away, to hide from the baby with the kitten tongue who will die next, to escape the malnourished children and the smell of the inpatient ward and the pleading eyes of mothers and fathers who don’t quite believe me when I tell them everything will be okay.
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