No Way Out

It was October of 2007. I was in front of a classroom of inner-city high school students in Portland, Oregon with my friend, Anthony Yama. As the Kenyan director of Kenya Keys Mnyenzeni area, he had come to the States for the first time. He wanted to visit a school where there were lots of African-American students. He wanted to see what they were like. (His dismay was great. “They look so unhappy!” he exclaimed.) Madison High School seemed the perfect place to visit. I’d given educational lectures about Africa there for years and a group of students, as well as one of their teachers, are each sponsoring a Kenyan student in our program.Anthony and I were doing a presentation. We were using a format we had used before, a compare and contrast look at our lives. I stated my reality, then he would state his. This time I brought up childbirth. I described the delivery room where my daughter had delivered her very high-risk, premature baby 6 months before. I described Katie arriving at the hospital with a very rare and life-threatening form of toxemia, long before she was due. I described the team of experts that surrounded her, the lab tests, and the decision to do an emergency C-section that saved her life. I left it there.I sometimes think I’ve heard it all, but Anthony acted out a drama and told a story I had not yet heard. My jaw dropped along with students' jaws.“When Lucy gave birth to our firstborn, it happened very quickly. Very quickly. I didn’t know what to do!! It was night time. I’d never seen a child come before, but it was coming. I had to get help for my wife! It was dark and it was raining hard. The baby came so fast.  My heart was beating, beating. I cut the cord. She held our small child. But something was wrong. No placenta came. She was in great pain. We were out in the rain. I ran to try to get a wheelbarrow from a villager. I put Lucy in it, with our very small child tight against her chest, and I pushed her in the wheelbarrow. I ran and ran through the rain, trying to get her to the tarmac (highway) to try to get her to help. We had to wait for public transport to Mombasa (30 slow miles away). I was so frightened!”All I could think about was what that night must have been like for Lucy! It was simply beyond what I could imagine: the excruciating pain of labor combined with darkness and hard rain and bouncing along in a wheelbarrow, hoping to get to one of the overcrowded, dirty buses. Anthony and Lucy made it all the way to Mombasa. She and the baby survived. That story has stayed with me and I was reminded of it when I took the interns to visit the VCT in Samburu.The VCT is the only thing that resembles a healthcare facility in the whole Samburu Division, an area covering some 400 sq. miles.   Mwaka, our host, works there with a group of tough, smart, dedicated people. They have seen it all at the VCT. They do HIV testing and counseling, prenatal care, and offer what limited treatment they can for all kinds of ailments, from snakebites to malaria. They promote and give mosquito nets as well as immunizations, and they deliver babies in their one delivery room. There is a delivery table in the room that looks like a US castoff from about the 1950’s. There are no pain medications. Limited antibiotics. If a woman has complications or needs a C-section, she must “seek public transport to Mombasa.” “Most women,” Mwaka states matter of factly, cannot afford transport.” What happens? They die. They die in the most excruciating way imaginable. Statistics show that about 14% of women die in this fashion. For them, there is simply no way out.As a woman and mother of three, I am taken back to that first time I felt a real labor pain. The searing, all encompassing power of it never escapes you. It jolts you into a whole new blinding reality, a reality you never could have previously imagined. I listen to Cecilia, the nurse, tell us, “What we would most wish for is an ambulance. It wouldn’t even need to have special equipment, but it could at least transport the women in privacy. We have asked the government for such a vehicle for years, but they will not provide.”Mwaka, Celilia, and other noble workers at the VCT, I am home now. It is 4:00 in the morning. I am thinking about you and the women you serve. I am wishing, wishing that they were not left with no way out.