Hello, Baby - Welcome to the World

When I accepted a Princeton in Africa fellowship as a grants intern with the IRC in Liberia a year ago, I had high hopes for my return to West Africa. Dreadfully nostalgic for my time as a Peace Corps Volunteer—a time in which (don’t laugh, Ginsus) I felt like every day was meaningful, interesting and pushed me to my limits—I told myself that I had to get back to Africa. So what if I’m not really interested in grant writing or donor reporting? Even if my job is somewhat mundane and tedious during the day, the time I spend out of the office getting to know the culture and people of Liberia will make it all worth it. Or at least, so I thought.

Six months in, I realize that I may have been a *teensy* bit optimistic in my expectations. Stuck working in an office all day long, in charge of such stimulating tasks as filing grants and ensuring consistency of font sizes in reports for our donors, I have often wondered to myself whether taking this job was really worth it.

But then there are days like this one where I get to see or do things that teach me something about myself and about life, and I remember what I came here for. The day began several Saturdays ago with me tagging along with an IRC surgeon on his rounds at our hospital in the town of Sanniquellie. As is the general rule with most African hospitals, the air was heavy with the scent of sick people and wounds festering in the heat. Dr. Sahlu and I began traveling around the wards, checking in on the patients. There was a ten year-old in the throes of tetanus seizures, a fifteen year-old with an abscess that had eaten her entire left leg, an eight year-old whose teeth were knocked in when his brother’s machete slipped while chopping wood. It was a depressing scene, and one that brought me back to my time in Mali—a time which was defined by an intense desire to stop people’s suffering on the one hand with a feeling of complete and utter helplessness to do so on the other. As I felt the usual rush of tears, I tried for a moment to channel Dr. Yang from Grey’s Anatomy—she would think this was cool, not sad. But for better or worse, I have never been able to steel myself against the sight of people suffering, so I failed to see anything thrilling about the cases before me.

After Dr. Sahlu completed his rounds, his work for the day was done. I decided to stay behind, however, and take advantage of the opportunity to spend some more time in the hospital. I headed to the malnutrition ward to check on a friend I had made earlier in the day, whose two year-old daughter Fanta was suffering from acute kwashiorkor (a form of protein-deficiency malnutrition where the child is so bloated that he or she often looks fat to the untrained eye). When I entered the malnutrition ward, however, I found no sign of my new friend or any hospital staff. The room was empty except for Fanta, who lay alone on her hospital bed. With a tube up her nose and too weak to move, the little girl just lay there, her frightened eyes following me as I came to sit down next to her. “I ba wa na sisan,” I say in an attempt to explain to her in Malinke that her mother will be back soon. Really, though, I have no idea where her mother and everyone else has disappeared to and can not help but wonder how long they have been gone and Fanta lying here all alone in the world. I stick my pointer finger in her tiny hand, and she slowly closes her fist around it. Not sure what to do to make the little girl feel safer and less in pain, I decide to sing her a song—a decision, I might add, that is completely out of character for someone who is so tone deaf that she even lip-synchs in the shower. Yet, from “Twinkle, twinkle, little star,” to “I’m leavin’ on a jet plane,” I sang pretty much every lullaby or soothing song I could think of until Fanta’s mother and a nurse finally reappeared. Whether my attempt at singing really did anything to comfort Fanta, I will never know—but I always feel it is better to try.

With Fanta being looked after again, I moved on to the maternity ward, where Dr. Sahlu had left instructions with Martha, the midwife in charge, to show me around and let me help out with any deliveries. After about an hour of idly chatting and playing with newborns, an ambulance arrived with a woman in labor. All of a sudden, I found myself crammed into the delivery room with Martha, the woman in labor and her mother. Since I had helped out with deliveries at the health center I worked at in Mali (I was in charge of things like fetching instruments, providing a hand to squeeze and helping lift women onto and off of the delivery bed), and given that privacy does not really exist in most African hospitals, neither the scene nor my presence in it felt strange to me. Where this experience started to diverge from previous births I’ve witnessed was when Martha looked at me and instructed: “Put on some gloves.” Unsure where this was going, I nevertheless did as told and put on a pair of gloves. Martha then giddily shoved me up in front of the woman in labor, explaining how I should insert my hand inside her to feel the baby’s head and the placenta, which was torn. I have to admit, in this moment, I was feeling totally unqualified to be inserting my hand inside a pregnant woman’s vagina, but Martha and the others smiled expectantly. This was how Martha and the rest of the midwives at the hospital had learned to deliver babies, and it was how all the midwives I worked with in Mali had learned. So I followed suit. With Martha standing over my shoulder and explaining what to feel for, I moved my hand around the baby’s head and felt the tear in Anita’s placenta. The whole experience lasted less than a minute, but it was incredible. And while I still don’t see myself becoming an obstetrician one day, the experience did make me excited about learning to deliver babies on my own one day.

Shortly thereafter, baby John emerged. “Hello, Baby,” Martha said as she wiped him off and wrapped him in a cloth. “Welcome to the world.” In the maternity ward, Anita’s mother, friends and family couldn’t stop hugging me, Martha and each other. With everyone so joyful, I couldn’t help but again feel a contrast between this moment and those I experienced in Mali. Whether it was because Peulh culture eschews strong expressions of emotion, or because even a successful delivery was far from a guarantee that the child would survive, or for some other reason that escaped me during the nearly three years I was there, I cannot remember ever witnessing such effusive happiness and thankfulness following a child’s birth in Mali. I have no reason to believe that Peulh women love or value their children less than the Liberian women on the maternity ward this day, but the contrast in their reactions was striking and I could not help but wonder why. Perhaps it was due to cultural differences, perhaps geographic (the women in the hospital were city women and not rural women as in my community in Mali), or perhaps it was just this particular group of Liberian women that were so ecstatic. Regardless of the reasons, it was yet another moment where I wished I had an anthropologist’s eye and was therefore better able to understand variations in culture and their significance to health.

In the end, this day was one of the best days I have spent here in Liberia. Though I saw an incredible amount of pain and suffering, and though I felt helpless and upset for much of the day, there was also joy. Moreover, each of the moments I witnessed was raw and meaningful and made me feel the tiniest bit less ignorant of the realities of life in Liberia. Now safely back in the comfortable and sanitized life of an NGO worker where I mainly see Liberia through the window of my air-conditioned office or a fancy white Land Rover, I carry these rare moments with me. And no matter how uninspired I am at the office most days, I am grateful for all that Liberia has taught me and know that I am lucky to be here for sure.