By Dana Iglesias, MD
I have lived in Egbe, Nigeria, for one year.
It feels like much has happened to me, to others and around me.
Over the last few days, I’ve been quiet and reflective about life here in Egbe and happenings around the hospital. It is one thing to know basic statistics about a place and another thing to live them day to day. I know many medical facts especially related to mothers and babies. I’m pretty biased in this way because, well I’m a woman and I enjoy providing maternity care. I also agree with many others when they say that the health of nation is determined by the health of its women and children.
What is the reality of numbers?
So I know, academically, that 2/3 of the women having babies in Nigeria are cared for by other women who are NOT skilled or trained to treat and identify basic important health problems related to pregnancy. I also know that the rate of death for children under five years old is about 124 per 1,000 per year. In the U.S., this number is only six.
The best way I can explain the child mortality rate is like this: in any Nigerian town with 1,000 children being born annually, 124 of these children do not make it their fifth birthday. That’s a lot of children, right!
I know that on average, people in Nigeria live to the age of 54 years old. It is more common for people to die at younger ages in Egbe.
So, what is the reality of these numbers? How does it affect my day-to-day life here?
Children are brought to our doorstep weekly who are on the verge of death and do not make it. We get frustrated to the point that when a parent says his or her child has been sick just for one or two days, we don’t believe it because of the obviously critical state of the child. We start to wonder if we are doing everything we can for our patients. Treating a seizing child with malaria becomes routine to the point that we forget that it’s non-existent in the U.S.
In the last week we have had:
- A one-year-old with anemia, sickle cell disease diagnosed and malaria
- An 11-month-old with anemia, likely leukemia, and malaria
- A four-year-old with meningitis or severe malaria, slowly awaking from a coma, but still with high fevers after one week
- A four-month-old with AIDS and malaria
- A one–year -old with severe asthma needing help to breathe
- An 18-year-old with sickle cell, anemia and malaria.
The rate I gave of 124 per 1,000 per year starts to feel heavy and very real, when you see child after child come in with sickness. It begins to weigh on you emotionally and spiritually.
“So here is where I will be“
The loss of a child deeply affects a family. Parents become unhinged watching this fragile life expiring in their hands. This is not a time when we are able to do or say anything.
So what do we do? Sometimes I’m not even sure. Rationalizing facts and statistics, doesn’t help. Knowledge doesn’t help. Prayer does help. But in the end, you have to “Be.”
You have to be present. You have to be present to this family’s pain and suffering. You have to be present to the loss you feel within yourself. You have to be present to the fragility of life.
I am grateful for the Psalms. Psalm 121:2 says, “My help (and hope) comes from the Lord the Maker of heaven and earth.”
In the deepest part of my being, my faith tells me that I am not in control. I do not have the final say. I am a part of a larger story that is written by God.
God has called me here, so here is where I will be.
Dana Iglesias, MD, is a MedSend physician who currently heads the family medicine residency training program at a mission hospital in Nigeria. This article was originally on her personal blog in September 2015.