It was a slow day, frustratingly so. People who weren’t really sick but worried about being sick took much of the time at the clinic today for the interns who work at the mission hospital in Lubango. Worry can be a killer, as can stress. The folks we saw were suffering in their own way, but desperately trying to find help in testing and imaging that continually comes back normal, frustrating the patient and causing them to come back repeatedly for prescriptions for their suffering. I left with Audrey and Anna, a Canadian missionary and her niece after clinic ended.
“I hope it’s ok if we take a small detour,” Audrey said as I climbed into the truck. I looked in the back seat. We had a couple of visitors. I guessed what was happening. “This man has just been released from the hospital and is too weak to walk all the way back home.” No problem, I understood. We dropped off one passenger a few blocks away, then meandered off on a side road over dirt paths for about three miles between fences protecting the grounds of large farms to a rocky pasture area in between. We bounce our way slowly over rutted dirt paths to a modest enclosed compound. An 8 by 8 foot stick enclosure where I can hear a couple of pigs relaxing. Multiple healthy appearing goats nibble at shrubs outside. A beehive shaped earthen oven stands beside the pigs’ enclosure. They don’t seem to be worried about the implications. Inside are Abino’s uncle’s family. They greet us with smiles and welcome us. Mud brick homes, a swept dirt floor in the courtyard, a menagerie of chickens, goats and a pig come to greet us. Small and larger children poke their heads out of doorless doorways and windowless windows, curious to see the visitors. The man of the house appears, well worn clothes, a 1960’s jacket with “Texaco” on the sleeve, a young woman with a baby on her back. The baby looks healthy. All of the rest of the children and the adults appear malnourished and growth stunted. A child coughs repeatedly from inside the house. “This man was near death a few months ago from TB,” Audrey explains. “He says he feels well now. He used to be skin and bones.” He looks like he hasn’t fully recovered.
We say our goodbyes and head back along the dirt path past a rural soccer field. A few neighbors line the path and motion that they wish to talk with us. Audrey interprets, “I have been requested to ask you to see my grandfather.” A young girl, eyes hopeful, clothing well worn stands at the window. “Where does he live?” asks Audrey. The girl gestures in the direction. We don’t see anything but a field. We are puzzled. She points again. There appears to be a pile of rubble flattened in the distance. “That place looks like it burned down,” declares Audrey. We are dubious that it could be a dwelling for humans. We pick our way over rough stony pasture to the point where it appears we can’t go any further in a pickup. We step gingerly around cacti and thorny bushes to the entrance of the enclosed living quarters. A eucalyptus tree stands at the end of a fence row. A seven foot high stick fence encloses the courtyard, a four foot high door swings warily open for us and we step over and duck under the wall and into the courtyard, tidied by daily sweeping, a mature vine growing in a metal canister on either end, winding its way up and over the tops of the buildings arranged in a square. Curious children emerge from the 8 foot by 10 foot mud brick shelters, their tin roofs held on by some scattered stones and the vine draped over them. A rectangular sign reading “N’gola POST” hangs on a small woven table. It is upside down. No one in this enclosure can read. A man shuffles from under a branch covered awning into the light rain, his stooped thin frame wrapped in a heavy cape, bare feet, pants worn, the cuffs long gone, a ragged t shirt over his chest, visibly shaking. “He is a person of some influence here,” Audrey whispers. He greets us warmly and takes a seat. Audrey explains that I am a medical doctor and would like to examine him. I look at him carefully while Audrey learns a few details about his illness. His eyes are watering, his skin a little pale. He has virtually no fat reserves, he appears weak, his skin is warm, he coughs and shakes from having chills.
I reach for my stethoscope, tucked away in my computer bag. “He’s been sick for three weeks,” Audrey interprets. “Chills, fever, body aches. Drinking and eating a bit. Coughing a lot. He went to the government clinic and was tested twice for TB, but the tests were negative. Wasn’t tested for malaria, and wasn’t given any medicine. Just a shot for his fever.” I nod. They are missing the diagnosis. Listen to his chest, hand the stethoscope to Ana, who is a premed student. Crackles and wheezes in his lungs on both sides. Feel his skin. Listen to his heart, and have Ana listen to its rapid cadence. Seen it a thousand times before. He has pneumonia, likely malaria too. He needs medicine soon. It’s Friday evening and terribly inconvenient to get him some. We ponder over what to do. Audrey will be seeing some family members on Sunday morning for church. Perhaps she can get him something by then. She explains to the man. He sits, shaking, nodding, he understands, he appreciates us coming. I turn away.
My heart is breaking for this human being. How can life, how can this world be this unfair? He has nothing, he is dirt poor, grinding poverty, unable to escape, children can’t go to school because the older ones need to care for the younger ones. He has no transportation, can only walk, but he can’t walk without terrible risk to himself to get help, and then he doesn’t get help. What’s he supposed to do? How many more are like him? I look around the courtyard at the faces of the children, the women, old and young standing there expectantly, silently, hoping. He is their provider.
Audrey steps forward. “Do you want to say a prayer for this guy?” I ask. She nods. We place our hands on his shoulders. There is still a little muscle there, still a little fight. Perhaps he will make it. “Amen,” we say together. I hold his shoulder just a bit longer. Then we are gone, a fleeting moment, through the courtyard, around the eucalyptus tree, past the cactus and thornbushes, to our Toyota pickup. “Could you turn down the a/c a bit?” request Anna. “I’m freezing back here.” We wave at the girl standing behind us, watching, wondering at our lives as we wonder about hers.
“They don’t send their children to school,” Audrey explains, “because they don’t see the point. They need the children to help them. Although that’s changing a bit.” She tells of the young man who we brought home from the hospital. At 23, he is working to finish the sixth grade, and might go to an accelerated seventh and eighth grade as well. Children come out of nowhere and stare as we drive slowly by. There are many, far too many to be sustainable on this modest strip of land between the well-established farms surrounding their impoverished pasture.
A teenage boy drives cattle home from the field. Audrey points to the church she and her husband established sitting on a hill a kilometer away. I want to know if all of her church members are this poor. She laughs. “We didn’t plan it that way,” she states. I get it. It’s nicer to have rich people in your church, that’s the way we plan things. Who wants a church filled with impoverished villagers? None of the tele-evangelists would be successful with these people as their parishioners. But this is the church she and her husband have chosen. They scrape together financial support to treat their medical problems as they arise, stretch their dollars as far as they can.
We bounce back across the rough roads, swapping tales as we go, of peace initiatives between two warring tribes in northern Kenya, patients who recovered from TB, developing medical programs in Ethiopia among the refugees, teaching women to sew and crochet, malaria, TB, human suffering, and how blessed we are to live this life. And what do we do about suffering. We’re just 3 miles off the main road to Lubango, but we are on another planet.
As we approach the tarmac, and what some of us call civilization, the houses become bigger, with cement walls around them, and gates. A small herd of cows peers through the unfinished gate of a house in progress. They’ve moved to the other side of the tracks, it seems. Where grinding poverty meets material success. My mind is on Kalinga, the man in his little, neatly kept scrap of earth, the place he clings to as his home. Someone once said, “Blessed are the meek, for they shall inherit the earth.” I’m trying to find out what that means. It seems to me that Kalinga is the definition of meek. I don’t understand everything about heaven’s justice, but this makes sense. And I trust that some day, this little scrap of earth will be replaced for Kalinga with something of far greater value. And he will be home.
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