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At The Edge

Before I went home for my leave I had removed myself greatly from the events that were going on around me. I was still performing my job and trying to do the most we could, but emotionally I had found a middle ground. A way to interact with the events that we encountered while not feeling too much happiness or sadness. I say we because everyone goes through the same joy and sorrow here. Some of the staff such as the midwives and nurses are much closer to it than I will ever be. I think the people here have found a way to moderate what they feel, their anger and sadness. Are the abominable things that happen here normal? No, they are not acceptable, and people don’t accept them here, but it is the way it is sometimes. Perhaps if we allow these things to affect us too much, we will crumble.

We had a woman come to us in labour on Saturday with twins. As we were sitting having a cup of coffee our midwife Kuol came to tell us there was a problem. He had done an ultrasound and discovered that the second baby was sideways in the woman’s uterus. Korir the clinical officer came to me, explained the situation and said, “these cases are usually 50/50.” We hoped that once the first baby was born the second would turn the right way. I saw Kuol later and told him to work his magic and do the best he could. He was frustrated that this mother had not come earlier. She was scheduled to come ten days prior but, perhaps because of a lack of understanding of how important the checkup was or a reluctance to walk through the recent floods, she had waited until she was in labour. What this meant was it was almost impossible to transfer her, and her babies lives and her own were now in danger. When the medical staff began counselling her and asking why she had not come earlier, her eyes welled with tears as she realized her mistake.

I saw Kuol the next morning and asked him how the woman was doing he shook his head, and said she gave birth. “Did they both survive?” I asked, he replied “yes, they just took a while.” He went on to

explain that the second child came with his arm first. Kuol told him that would not do and pushed the arm back in. He repeated this a second time, until the baby came with his hand on his head, and Kuol guided him out. A very good way to start our Sunday.

Jubilation. Relief. Joy.

Early the next morning I was sleeping in my bed at six am and was startled awake. I had trouble falling asleep the night before, thinking about life and the different paths we choose. I awoke as I heard someone coming in my tent, I found myself coming out of a deep sleep, oblivious to where I was. I recognized the sound of the zipper but couldn’t figure out what is happening as I was stuck in that limbo between dreaming and awake. “Yeah …….Kris,” it was Jok, another NGO worker that is staying with us here and organizing healthcare in Duk County. “There is a woman in Poktop that has been in labour for two days, she has twins and the first baby is stuck, it has died and they need Kuol to take it out.” I process this a bit and measure having no midwife at the clinic against needing to help this woman. “That is terrible, of course he can go, try and get back tomorrow.“ Usually our staff members are not supposed to travel around the county, but this is obviously an emergency that requires Kuol’s expertise. Jok sat exacerbated and frustrated at the common occurrence of such situations. , “if only people knew what was going on in Duk County….ahhh” he trailed off and went to get ready.

They were off on their trek about an hour later, ready to travel to Poktop which is four hours through thigh high water at this time of year. This type of walk is exhausting as your legs drag and your feet continually slip in the mud that lines the way. We got a call later in the day telling us that it was not twins and the baby had been removed. The mother was recovering and Kuol and Jok would return the next day.

The next morning we heard that the mother had died. She was extremely anemic and, as our clinic is the only place for hundreds of kilometres that could transfuse blood, she could not get a transfusion where she was. The community decided she could not be carried on people’s shoulders as she was too weak, and they would have had to move at night through the same 12 km of water.

When Jok and Kuol returned today we sat and talked about what had happened. When they arrived in Poktop the woman’s stomach was severely distended from the trauma. Someone in the village had attempted to remove the baby with rudimentary tools, sometimes fishing hooks are used, so that it could be pulled out. When Kuol began his work he described how the baby’s corpse could no longer hold its form and his limbs became detached as he tried to remove it.

Hopelessness. Despair. Sorrow.

I believe this is why I found the middle ground in the past. To ride on the emotional roller coaster that is here, is sometimes treacherous. While you climb to high heights, you can always hear that clicking chain, knowing that at any moment it is going to release, and you could be plunged over the other side. I am trying not to block these things this time, trying to make sure I feel, trying to make sure I get angry, be sad, not lose myself, to be aware of my own humanity in the impossible situations that sometimes present themselves here. But sometimes it is certainly not easy.

I can feel the weight, I didn’t feel it last year, but I do this year. The weight of the responsibilities increasing, the dry season coming, the emergencies increasing. I explain sometimes that this place seems like the edge of the world. Maybe we have to be careful not to fall off. I debate how much of this I should share, how much I should unburden myself by burdening others. You certainly don’t put the details of the second story on facebook. How much does it help? How much does it make us desensitized to abysmal situations that exist?

Aid workers often do not go down these paths. I find many of them do not think of these things, we try and tell ourselves things are getting better, even if the progress is slow, they are improving. Hopefully you feel you have a hand in that. But it is the what ifs, the why nots, the why didn’t this or that happen, that make you peer over that edge. Why didn’t that woman go to a health facility earlier, why didn’t the facility she visited have the proper medicine, materials, and staff to help her, why didn’t she come to our clinic where she could have been helped? It is these unanswerable questions that drive anyone facing tragedy to second guess, to wonder how things could have been different.

We broke even in these two days, two lives brought into the world and two lost. These are the odds we are trying to improve. Hopefully they are getting better, and I know the medical staff are making a big difference here on a daily basis. We will try and pull as many back from the edge as we can, and keep ourselves from tumbling over in the meantime.


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