Different Approaches to Life. And Death.

It certainly has been awhile since I last posted.  I am going to attribute that to summer break, ongoing heat, ongoing adjustments, and, to be honest, graduate school research.  Plus, I think there is truth to the fact that heat can sap motivation.  When it is continually above 90 degrees inside by my laptop, motivation to reflect, recount, relive, and then productively document is considerably strained .  Not that a lot has not happened which I would like to share.  Rather, I could write about painting a World Map on the side of a school with donated paints, planting permaculture garden beds with the help of community volunteers, applying for funding and attending meetings at the Embassy, traveling through Namibia via unreliable public transportation and hitching, having my passport stolen and credit card numbers traced, fighting mice in my pit latrine, or any number of daily occurrences to which I try to continually adjust.

However, as it has been a spell since I posted, I am going to follow up to my last post about my host nephew Desmond.  Sadly, he passed.

When I last posted, Desmond was in the hospital for TB or pneumonia (the official diagnoses was never revealed to me or to Mr. Magoro – the school principal).  He stayed at the hospital for 14 nights and finally returned home with his mother Vivian.  I was home when he returned and although he wasn’t exactly spry, he definitely had regained some strength and a sense of life had returned to his face.  Upon seeing me, his smile was meek, but he had filled out a bit and looked like he was on the road to recovery.  (Of course, “filling up” was not difficult as he was literally skin and bones when we took him to the clinic.  Come to think of it, upon leaving he sadly and eerily reminded me of the TV commercials airing in the US in the 1980s about famished children in Ethiopia).  Vivian carried a bag and when I asked if it was medicine from the hospital, she looked inside the bag as if she had forgotten she was carrying it.

The medicine inside was antibiotics and what I thought to be a type of steroid.  Desmond was supposed to take the medicine for several weeks.  That was in late October.  I asked if and when he was to return to the hospital for a follow up.  The answer?  December.  A child admitted to the hospital for 14 nights for advanced TB and the first follow up is not for 6 weeks?!  Still, I thought maybe there was some language issue which was causing me to misinterpret.  Maybe he would be returning earlier for a medication refill.  Maybe I didn’t understand the whole of what was being conveyed.  Actually, I figured, that was pretty likely.  The good thing is that he was home and looked better.

So the initial weeks when he was home, he stayed out of school.  October turned to November and Desmond started looking weaker quickly.  His condition visually deteriorated fast.  He never felt well enough to return to school and his coughing and inability to hold down food returned.  In fact, his best chance to return to school would have occurred the day immediately following his return from the hospital.

I talked to Mr. Magoro about it the first week of November.  Mr. Magoro agreed to speak to the family.  The following day he came by the house after school and again urged the family to take Desmond back to the hospital.  In recounting their conversation to me later, he even said that he was forthright to the point of saying that if the family were to wait until December for any medical follow up, Desmond “may not make it.”  He also said he suspected that they were not giving Desmond his medicine regularly.  Despite his strong opposition against the way the family was handling Desmond’s care, Mr. Magoro said there was only so much he could do.  We had convinced the family to take Desmond to the hospital once and look what had happened.  At least, that was the family’s viewpoint according to Mr. Magoro.

I tried to empathize.  Tried to put myself in my host family’s place.  I realized that the family had reluctantly sent Desmond to the hospital one time against their own personal beliefs.  The hospital kept him for two weeks after which he returned only slightly better and immediately worsened.  Now, Mr. Magoro and myself were back again urging them to have Desmond returned to the hospital.  But to them, the hospital was the cause of the problems and not the place offering care.  The family was agreeable for him to keep his follow up appointment in December but not for his returning to the hospital immediately.  Although I could “see” their position, I had a hard time empathizing.  I didn’t think the situation was being handled appropriately.  For instance, Desmond of course would stand hardly a chance without regularly taking the medicine issued to him after the hospital discharge.  Moreover, I got the sense that the family believed the hospital stay had actually made him worse and had he just stayed at home for those two weeks, he would be better now.  How do you argue with this belief when the fact was that the family did not want him to go to the hospital initially and after “trusting” our belief that it was for the better, he returned without any notable improvement?  Where was our track record for continued wisdom?  They followed our advice once but the situation did not improve.  Why follow it again?

On my way to school the Monday morning of the second week of November, I came around the side of the house and found Desmond curled on his side on the ground.  I stopped abruptly.  I honestly was not sure if he was alive.  I looked down and saw his small body slowly rising and falling.  He was breathing but was in a deep asleep.  Flies were walking on his arms and face but he showed no sign of noticing through his sleep.  I stared for a few minutes unsure of what to do.  I had the sense he was living his last days.

Desmond had once again been left to his grandparents (my host family).  Desmond’s mother, Vivian, had returned to University the week prior.  Desmond’s father has never been in the radar of his upbringing.  I knew getting these grandparents (my host parents) to react exigently would be futile as the site of Desmond sleeping would not be considered abnormal (even outside on the ground where my host mother often lays for naps).  Plus I would not be able to effectively convey my concern in pure Sepedi and without family around to help with the barest of translations, I would enter a web of confusion.  So I left for school and discussed it with Mr. Magoro.  He calmly told me that there was simply nothing more that we could do and I would have to accept that we had done everything possible but ultimately it was “the family’s decision.”

I decided to phone Vivian.  Surely, if I conveyed to her how sick her son was and that he desperately needed medical attention, she would come home and take him from her grandparents and return him to the hospital.

“Yena o lawla kudu kudu!  Yeno o nyaka go ya hospital!”  (He is very very sick.  He needs to go to the hospital).  I was practically yelling at Vivian on the phone.

“Burneece.  I have the school.  I cannot come” was her reply.  Followed by silence.

I was flabbergasted.  How could she stay in the city at school when her son was dying?  I tried to understand that Vivian either did not think he was dying or honestly did not think there was anything she could do even if she were here.  Even still, my empathy ran out before it really even began.  Shouldn’t she be here with her son regardless?

Upon hanging up with Vivian, I tried to plead with Mr. Magoro to take Desmond to the hospital.  I said we should leave immediately, go to the house, carry Desmond off, and take him back to the hospital.   He would be admitted immediately.  Mr. Magoro said he could not do that.

“What if he were to die in my car on the way?”  Mr. Magoro said.  “I can’t take that responsibility.  We cannot take him if the family does not want.”

I realized that he had a point.  Furthermore I realized that if we called the clinic or the hospital to come and pick up Desmond and he were to die at the hospital or clinic (a possibility which I realized was not terribly unlikely), the family would directly blame us for the death and feel that he would not have died had he stayed at home.  I also understood that I was the guest staying in their house and would need to continue staying for nearly a year so angering them and disobeying them was not the best thing for me to do. Mr. Magoro confirmed that even phoning the mobile clinic to stop by the house would be seen as a breach of trust and would anger the family.

“I know you don’t understand.  We have done everything.”  Mr. Magoro seemed to read my emotions and dismay.  He seemed to fully understand that I was not used to how things were being handled and it was troubling me.  Mr. Magoro possesses this unusual ability to see sides of two different cultures and understand that even among the best intentions, there are important differences.  It is a quality of his personality which I have grown incredibly fond of and grateful for during my service in South Africa.  I have often thought he would make a great diplomat.  Hell, he even did the South African unthinkable of physical affection and patted my shoulder.

That was on Monday.  On Wednesday, I left the village for South Africa’s capital, Pretoria, for a Peace Corps meeting.  Upon waking up Thursday morning at a  backpacker in Pretoria, I received a SMS (text) message from Mr. Magoro that simply read: “Desmond is late.”

I phoned immediately and passed on my condolences to my host family.  I explained I would be back after my meetings.

Funerals occur only on the weekends in the rural villages of South Africa and they occur at the house of the deceased.  Desmond passed on Thursday morning and so the funeral would be the Saturday one week out.  I returned to Phoshiri Monday to a completely full house.  Two large “burial society” army green tents were set up in the dirt yard next to my room.  People were everywhere.  A light had been rigged with a long wire into the pit latrine.  Chairs were strewn about in the yard.  Dishes of water were placed in basins with cup along side.

Extended family had traveled from hours away.  People who had no idea who I was and who were stunned to see a white person in the village – let alone staying at the house stared at me blankly.  In this way, it was a lot like the first week in the village.  As I milled about that first afternoon, I found myself continually explaining my purpose and where I was from.  In Sepedi of course which never fails to amuse those unaccustomed to my presence.  As I tried to retreat to my room, I had to pass dozens of people sitting outside of my door, under my room’s window and throughout the yard.  This occurred daily.  They were all staying at the house.  I felt bad for feeling angry and selfish that my privacy had been utterly taken over.  But I couldn’t help it.  Every time I stepped foot out of my room, I was on display.  That quickly became wearing for me.

A large cow was slaughtered Tuesday and the meat lasted until Thursday when a second cow was sacrificed.  And Vivian was there.  She had finally made it home from school now.  And as was the custom, she stayed in the house mourning and was not to show her face until Saturday, the day of the funeral.  I attended several prayer sessions and hymns given in the room next to mine and inside the “fire house” where porridge and cow were continuously being prepared over an open flame.

In the months following this, I have talked to fellow volunteers about this incident and even my mother at home, who had met Desmond during her visit in April.  Indeed, my own mother was tearful on the phone even hearing about it.

It was, and in some ways still is, hard not to be upset with Vivian.  With the entire family.  But as I often have to remember, I am not here to change a way of life.  I am not here to change customs.  My “way” is not always better.  Just different.  I live in a different culture from what I am accustomed.  I knew that going into this and I still treasure the perspectives it has given me.  I have realized that Desmond was not unloved.  Far from it.  There were, quite literally, a hundred people here for a 7 year old’s funeral.  In a village of just over 400 people, the support was evident.  Tears were common, songs even more so, and general support throughout the village was palpable.

I lived through the experience of watching a host family member pass.  A young family member.  And I realized I was often more angry than mournful.  Indeed, my approach may not better after all.

~ by Andrew Bernish on February 1, 2010.