Saturday, September 24, 2011

Uphill Battle.

I’ve not wanted to write for a few days. Personally if I could have hid under my bedroom rug and cried for a week straight, I would have done it.

Why so emotional? You ask.
Simple. I feel like a total failure.

I’m still struggling with the language after being here a year and a half. That’s the longest it’s taken me to learn a language while living in country, and I have to ask myself why.

I’m still confused by the social interactions, especially with my prenatal girls. How do I make connections with them? How do I build relationships with them? How?

Plus I’m seeing strange fruit... superficial fruit, and I don’t like it. Many of the women I witness to say they are believers but then cannot tell me who Jesus is. They believe because they heard about Him once or they were baptized as a child. Is that spiritually satisfying?

But if I’m honest with myself, this week’s emotional roller coaster has more to do with my selfish desire for ‘results’ than anything else.
... that and well, I’m feeling used.

It is just starting to dawn on me that all my efforts and all my struggling to keep these women alive and healthy is for naught.

I see a minimum of 500 women a month for prenatals. I wear myself out treating them for STDs, teaching them comfort measures, and evaluating their gestation.
--Some of them are grateful and take responsibility for their well-being. But more often then not, all they want to know is their gestation.

Here’s the rub.

When I inform them that they need to deliver at the clinic because of X, Y, or Z, they nod politely then don’t come.

Afterward they bring their baby in sick, or more often still are carried in on stretchers with outrageous perineal problems, insisting I do something about it.

Why? Why do they ignore my pleas for them to deliver at the clinic, only to bring me their (TBA or Family caused) problems?

These problems could have been easily avoided had they just come to deliver at the clinic.

Sigh.

This week one of my prenatal ladies came to tell me her baby died during her home delivery. She expressed regret for not coming for my help. She now understood why it was important, but it was too late for this child.

This week another woman came --not in our program-- needing a blood transfusion. As I watched her protractedly heave and vomit even the tiniest fluids we gave her while burning with fever, I knew that her severe anemia was a result of untreated malaria and postpartum hemorrhage. Her one month baby lacked the rolls of fat common to healthy neonates. Instead I was greeted by protruding eyes and a starved look of pain too severe for one so young.

This week one of my prenatal girls chose to deliver at home, even though she repeatedly assured me she’d come. She lives less than 10 minutes away by foot and was expecting her 4th child. But during her delivery, her TBA/Family decided to make her push and push and push... until her perineum swelled to twice the normal size. Only when they saw the damage they caused her did they come for help, demanding I do something. 

I told them how to fix it and gave some analgesics. But the time of ‘doing’ had passed. I could have done a lot (to avoid this!) had she just delivered with us.

Had she just come...

So much of my work is preventative. I’m trained to see warning signs and treat them quickly. I’m trained to strategically run ahead of a problem so that the mother and child won’t get ‘harmed’.

But if they won’t come...

Sigh.

They have to come to prenatals...
They have to take the advice I give...
They have to deliver with us...
... only then can I really help.

Like I said, 500 women stream through our gates monthly for prenatals. That means 500 should be delivering here, but only 20 actually do.

This uphill battle of begging them to come and scaring them with maternal mortality statistics has to stop. It’s not working.

Nothing is working.

How do I get through to this community? How do I convince them to come to the clinic to save their own lives? Honestly, how?

Pray for me. I love what I do, but I feel like a failure.