My team in Zemio isn’t a very “huggy” kind of team. They are brilliant, funny, fantastic people, but more inclined towards a high five or an arm punch than any sort of overtly demonstrative affection. All well and good between professionals you may say, but I’m one of those tactile creatures who’s day feels somehow incomplete without at least one good hearty “squidge” from a friend and after a couple of months of this, although used to it, I am feeling decidedly hungry for some simple affection in some small corner of my soul.
Our days start at the hospital with any number of issues to deal with -pharmacy is low on its consumption sheets, someone from OPD hasn’t shown up, maternity needs oxytocin ordering and so on an so forth. Much of my last month has been consumed with some unpleasant drug number discrepancies in our stock and I am spending a disproportionate amount of time studying stock cards and reviewing pharmacy orders to minimise the possibility of things going astray. Sometime last month after a typical morning’s welcome to the hospital, I scuttled over to the Inpatient Department slightly late for the beginning of the ward round and stood blinking in the shaded paediatric room while my eyes adjusted to the sudden gloom of the room after the bright sun outside.
Our main IPD is a series of small several bedded rooms arrayed along a raised veranda which, disregarding health and safety, isn’t railed in or anything but drops precipitously a metre or so down to the red rocky ground below. To date I have not seen anyone fall over the edge although I have myself kicked a few overly adventurous chickens over the side when they come straying into the wards in search of scraps.
I repeat the process today to a chorus of indignant squawks and rejoin Rob our doctor reviewing a droopy looking toddler in bed 5. Malaria, vomited his first couple of doses of oral treatment yesterday, so has been in overnight for IV therapy. He’s doing better but still looking somewhat mournful and clingy to his mum. As Rob scribbles the days treatment on his chart I blink down at the little fellow and register vaguely at the back of my mind that there is something peculiar about his eyes, but before I can bend closer for a look it catches my ear that this is one of our guard’s children - hmm, MSF staff are usually provided with mosquito nets for their families, I wonder if a distribution has happened this year... my mind wonders into the feasibility of doing this ASAP and then drifts back to the stock problem as the ward round moves on. I don’t examine the child’s eyes any further.
The day passes and that evening is spent in the main store room reviewing our drug counts with Zoe our log admin. More excel sheets, more counting pill pots, more numbers that don’t match up. At nearly 9pm we lock up the depot and trudge back to the main house, too depressed by our conclusions to do much more than thump each other half heartedly on the back and unenthusiastically agree to pick up where we have just left off the next evening.
The following morning follows a predictable routine and I am late for the ward round again. This time however bed five is empty and a small chunky and decidedly energetic blur is racing up and down the IPD veranda hotly pursued by his mother. Safe to say he’s feeling better then!
Oral meds will be ordered from the pharmacy for him to be discharged home with a bit later. He slows down briefly to gawp at the two white faces on the ward round and his mother seizes the opportunity to pick him up and tucks him onto her hip. As he regards Rob, I stare curiously again at his profile and the unusual cast of his eyes again and try and figure out what exactly is troubling me about them.
Down’s syndrome. That’s it. This baby has Down’s syndrome. The first I have seen in an African child.
My heart wrings a bit inside me because in this remote corner of Central Africa, where education and health care is enough of a battle to come by anyway, there is scant chance that a child with learning difficulties is going to have a chance to develop to his full potential. Right now however he has just survived malaria and is looking pretty resilient, so my sympathy seems misplaced as I watch him wriggle free and set off exploring again while his mum plods after him trying to prevent him from pitching head-first off the veranda edge.
The rest of the ward round is punctuated by his small rotund frame trotting at speed past the rooms, and occasionally nudging though the forest of our legs to gaze at our patients with us. Circa bed 14 he makes another headlong gallop for the veranda edge – I’m slightly closer to him than his mum at this point so race after him and scoop him up. Rather than the protracted yelling that usually results when a white stranger touches them, this little boys sits in my arms calm and quiet for the first time this hour and looks up at me, wide eyed and quizzical. I poke my tongue out and a solemn face with slanted almond eyes pokes one back at me.
The next few minutes of the ward round is entirely lost to me as the previously restive toddler in my arms stares at up enraptured by the faces I am pulling – God bless children for being so easily amused – and mimics them back to me. Pursed fish lips have him foxed for a while and he reaches up a pudgy hand to explore the shape of my sucked in cheeks and in the process makes a sterling effort to relieve me of my glasses.
By the time the ward round reaches bed 18 the weight of his sturdy frame is straining at my arms and we have exhausted my supply of amusing expressions, but rather than wriggling down and running off again, he snuggles against me and tucks his head onto my shoulder as if quite content with this new vantage point on the world. I rest my cheek against his small woolly head, close my eyes, hug him into me for a long moment and the ache in my arms vanishes, as does the little unanswered ache in my soul that’s been craving some human touch these last months.
This wasn’t an event I was going to write about– it’s practically pointless, no one is the hero in this story; there’s no dramatic moral, funny ending or anything in particular but it is a moment of this mission that is burned into my memory and when I read the recent outlandishly insensitive tweets on Down’s syndrome that Richard Dawkins has been bandying about it seemed to need to be written.
I have no idea about Mr Dawkins’ thoughts on humanitarian workers, or what drives us. I imagine like most seemingly emotional subjects that altruism is something he takes rather a sceptical view of, alongside his apparent worth of people that he labels genetically “imperfect”. Well whatever my value may or may not be in his eyes, moments of spontaneous affection like that feed me and drive me and motivate me and you don’t need to be genetically flawless to give or receive or need them.
MSF could cure this boy’s malaria, but we sadly can’t treat or look after Downs – the potential cardiac problems, the ear problems, the educational stimulus that he will need - not long term, that is beyond our scope. The world’s doctors may or may not yet find a way to prevent Downs from manifesting, but personally I think it doesn’t need to. That small “imperfect” child in that small moment gave this imperfect girl what she most needed and what I think most people need most days if we are only honest with ourselves.
A healing hug.