Difficult realities

Aminata* is a young woman no different from most others in my village. In her early to mid twenties, she had a couple of children and is expecting her next child, in her 8^th month. But, like the vast majority of women in my village, she did not seek medical attention throughout her pregnancy. Perhaps because her husband would not give her money for that purpose, or perhaps because she just didn’t see it’s importance. I guess I’ll never know for sure.

And now, on this early March morning, I find her curled up in the waiting area of the health center, weak and tired. She is complaining of extreme fatigue and looks as if all the energy has been sucked out of her. One look at her near white eyelids tells the doctor all he needs to know: advanced anemia. In a pregnant woman, this requires immediate evacuation because it’s especially dangerous for both the mother and baby.  He writes her a referral to the big hospital, and she leaves, presumably to collect the money necessary to make the trip to Bafoulabe, and that’s the  last I see of her that day.

The next day I ask about Aminata. What did they say in Bafoulabe? Were they able to treat her? My CSCOM doctor can only look at me sadly. She didn’t make it to Bafoulabe, he says. She was going to go, but she was waiting on her husband to bring the money and his approval. And she didn’t make it, she died here in Marena.

I’m stunned. How am I supposed to react when a young woman, in her mid 20s, dies of something so absurdly preventable and treatable as anemia (or complications from it)? And not even during delivery, but right there in the 8^th month of the pregnancy. It’s just not right, not just. Not okay. And yet I hear not so much as a murmur of it from anyone in the village. I have to ask my homologue about it, and she simply says she heard, and utters softly about what a shame it is. I don’t hear about a funeral, although I’m sure one must have happened.  Her passing occurred on the heels of an elderly respected man in village—a funeral everyone attended and everyone knew about. The sense of tragedy, the sense of valuable life lost seems muted with Aminata.

I’m faced with death a lot more than I ever thought possible here, and I have to admit it’s something I’m still not fully used to.  I don’t mean to make it sound as if I’m only ever faced with depressing realities—in general life in village is happy and vibrant despite the hardships. But every so often a tragedy occurs that serves to remind me that I still, in fact, live in the 3^rd poorest country in the world, a place where the liftetime risk of dying during childbirth is 1 in 22.  (In ths US, the maternal death rate is just 13 per 100,000). And while I know deep down that the villagers did not trivialize Aminata’s death, that there was sadness and grief and all of the other emotions we go through when people die, a part of me still wanted to scream, to ask them why it didn’t seem to matter, how they could go about their day to day activities when a young woman died so needlessly. A part of me wanted to cry, not because I knew this young woman particularly well, or because I was particularly close to her, but because it was all so wrong. And because no one else seemed to want to–or perhaps no one felt able to–cry for her.

My villagers are doing what they do best….moving on. And meanwhile I’m left with only questions. How can this unacceptable reality change? What will it take for women—and the men who provide for them—to stop taking needless risks with their lives and health and to see the importance of simple preventative measures? These are tasks that are far, far bigger than me, bigger than any one person. And yet I want to play my part. I want, need, to do something.

I don’t know where the answer lies, but I’ll keep fighting.  I’ll keep trying. Because just one more maternal death is simply one too many.

In memory of Aminata and her child.  Ala ka here d’u ma—May God bring them peace.

*I’ve  changed the young woman’s name.