Friday, September 2, 2011

Monica's Story

A picture I took of her shortly before her death... when I still hoped.

It was a busy clinic day with lots of preggos coming and going and two labors in various stages of dilation. So when a car pulled up I didn’t even notice.

But soon afterward there was a small tap at my door. One of the newest translators timidly informed me I had a labor. Sighing in mock frustration, I quickly went to meet my new labor at the clinic entrance.

Honestly, I was not ready for what I saw.

A small girl --looking no more than 12 years old-- lay pathetically against the entrance door. Beside her a woman with pleading eyes locked gazes with me; she was doing her best to hold the child upright.

“Is she pregnant?” I asked not believing someone so young could be ‘in the family way’.
“Yes, but she is sick,” one of the translators informed me.
“Bring her inside,” I said and quickly turned on my heels. I needed to inform Margaret of this new development.

Once we got her inside, I could see the small belly-bump low in her abdomen. Yes, she was definitely pregnant.

“How old is she?” I asked, trying to hide the disapproval in my voice.
“Fifteen,” I was informed by one of the many family members in the room. It’s as if half the village had entered my 10 foot by 12 foot cubicle.

“What are her symptoms?” I quarried while systematically checking her vitals from head to toe.

She was lethargic and barely able to stay conscious. There were no fevers and no reports of convulsions but I instantly thought of malaria.         --It’s always malaria.

Desperately fighting to breathe she gasped for air at the rate of 90 breaths per minute. That’s a breath and a half a second!

By this time Margaret had joined me and quickly looked at her eyelids to see is she was anemic.

“She’s a plus-plus for pallor,” she informed me then showed me her paper-white lids. I’ve never seen anyone so pale.

“She’s severely anemic,” I informed the family, “How long has she been like this?”

As we continued taking her vitals, the family informed us of the little they knew of her case. She was living with her uncle in Wau. Yesterday, she came home to be with her family. They brought her in to see us once they realized she was having trouble breathing.

“That’s it? That’s all they know?” I asked more than a bit confused. This girl has been sick a very long time. Why were they only now seeking help? I wondered. But that didn’t matter. Caring for her was what mattered now.

She measured to be about 7 months pregnant, but she could have been more. None of her family members seemed to know, and she was too exhausted to speak.

As I searched for heart tones with my doppler, I wasn’t expecting much. If this child was still alive, it’d be a miracle.
        --But I found none and eventually gave up.

How does a 15-year-old living in a big city get this sick? How?

After wavering back and forth on whether to give her IV fluids and consulting with the rest of the staff, we decided to test her for malaria. There had to be an underlining condition for it all.

She was positive. Malaria --that parasitic curse-- had struck again.

We gathered her family together and explained that she was desperately sick. She needed a blood transfusion immediately or she would die.

They listened.

“If she gets new blood she can recover,” I assured them, “But we are a small clinic. We have no blood here. You must get her a ride to Wau right now, so she can live.”

Four pairs of eyes searched my face as I explained. They could see she was dying. The only question was whether or not she could live.

“Get her a blood transfusion right away and she will live,” I went on. The steel in my voice was unmistakable but I realized I no longer felt the need to beg. They would either go or not.

Once I finished speaking the grandfather left without a word.

The girl’s mother and two aunts helped us to get her to the observation room and we started her on malarial medicines.                                  --I had hope.

Three hours later, her grandfather had (miraculously) returned with a car. I had even more hope. I even took a picture of her so I could ask you to pray.

Five minutes later she died.

She died with a few final gasps with her head on her mother's shoulder while her aunts prayed. One aunt left the rooms in deep wails. Another sat quietly knowing --too grief-stricken to speak.

They knew long before I would even admit it.

She was dead.

Dennis and Tom came to pronounce her because I was unwilling to admit it. I kept fighting for more hope. But in the end her heart just gave out.

Later on as the pastors came to minister to her family we learned more of her story.

The pastors praying for her family after her death.

Her name was Monica. She was 15 years old. She lived with her uncle in Wau. When she got pregnant out of wedlock he was furious and kicked her out of the home. She begged for months from friends and strangers. No one knows how she survived. When she got sick she had no money to seek treatment and no money to get home. Finally a stranger took pity on her seeing that she was very sick and let her hitch-hike back to Tonj. She died in our clinic the next afternoon.

She died of heart failure due to severe anemia caused by untreated malaria.

All of it could have been prevented had she known about us and come. Had she been able...

Pray that such senseless loss would end. Pray that we can find a way to get these women the prenatal care they need and deserve. Pray that no more 15-year-olds would be lost.

But just pray...