Today, I buried one of my patients. Her name was Meskerem. She grew up in Shone, a village about 70 kilometers away. She probably lived in either a grass or mud hut. I don’t know how old she was. Her brother said she was seven, but my guess is she was at least 16. He said he was 10, but he is probably in his twenties. Their parents had died “many years ago” and he had finished raising his sister. She had married, but during the pregnancy her husband left her.
I met Meskerem and her brother yesterday. I think his name is Etenabalu, but it is long and hard to say, so sadly, I don’t know. His worn clothes were falling off of his skinny body. His shoes were lacking soles. Lou, a medical student from Britain has been working with me this week at Otona. We had gone to work and Meskerem had just arrived. She had been in labor for three or four days. She was in shock. Her baby had died and was rotting in her pelvis. The stench was horrible.
Her brother had gone around their village and asked people to give him money to help bring his sister to the hospital. It wasn’t enough. The government hospital doesn’t take care of patients unless they have money or they have a letter from their village saying they are poor. Her brother only had 53 birr left (just over $3). SInce the hospital wouldn’t do anything without a letter, I decided to bring her to the Christian Hospital. They found the keys to the ambulance, but couldn’t find the driver. I offered to drive, but they wouldn’t hand over the keys, so I found a bajaj. When we left she was half dead.
Once we arrived things moved fast. We have three visitors for a little over a month and all three of them have the same blood type as the patient, so if they weren’t helping with Meskerem, they were giving blood.
Do not read this paragraph if you don’t want to know the nastiest part of my job. When a woman is in labor and the baby is stuck it is safer to do a destructive delivery for the patient, so that is what I did. I had to crush the skull of the baby and then pull the head out in pieces. Once the head is out the baby can fit through. As the mother was screaming, the nurses held buckets for me to vomit into.
We thought that her uterus ruptured in the process, so we had to bring her to the operating room. We opened her to find a dead uterus, so she got a hysterectomy. About eight hours later she died. The infection, the insult of surgery and the exhaustion from a four day labor had been too much for her body to handle.
After I got home I was talking to a friend. I had left her brother up at the hospital. He only had a blanket and had been sleeping on the sidewalk outside the ICU. People sleep out there every night. I don’t know when he had last eaten. I couldn’t save his sister, but I could feed him and give him a couch to sleep on. Thank you Danny for encouraging me and telling me to take care of him, when I didn’t think I had the energy to do so.
Today, was a day like none I have had here. An Ethiopian friend, the gardener at the hospital, Etenabalu and I planned a funeral. We bought a wooden box, got permission from a church to bury his sister, hired grave diggers and talked to the authorities about burying her. Then we went to the grave yard.
The grave yard is on the side of a hill. There are no grave markers, but hundreds of graves. The grave diggers had dug a hole for Meskerem and found that the grave had been previously used, so they asked about where some of the bones go in the body and kept digging. There were only about ten people there. The only one that new her was her brother. The men lowered her wooden box with a cross on it into the
ground. They then put plants over the casket. From what they explained it is saying that she is now in God’s hands. We said a prayer and then the men started covering her casket with dirt. When they were at about 2-3 feet below ground they threw in a lot of thorny branches in. This is to keep the hyenas out. They filled the hole the rest of the way. Etenabalu pushed the dirt down with his feet and put a plant at each end of the grave. Traditionally, the family stomps the dirt down. Etenabalu was all she had and all I could think was who will stomp on his grave when he dies?
My heart is broken today. I am so grateful to know that this is not the end.