A night at home alone – what bliss!  I had sent my husband off to enjoy a long night of playing soccer while I was enjoying a night of solitude (the first moment alone I’d had since arriving).

I caught up on email, read a favorite magazine I had stashed into my suitcase at the last minute and was preparing to cuddle up on the couch and read for awhile before drifting off to sleep.  And then the phone rang – Miriam, who had grown up in the orphanage and was now in a struggling marriage, had given birth in her home.  My husband had loaded her into the car and was racing to the emergency room.  I jumped off the couch, grabbed some change from the counter and ran out to catch a taxi to the General Hospital.  Miriam had learned the week before that her baby was breech and most likely had the umbilical cord wrapped around its neck.  She had been scheduled for a c-section but was terrified to have the procedure done, and thus induced her own labor and stayed home for the delivery.  The cord had indeed been wrapped around the baby’s neck, keeping her from breathing for the first 5 minutes until a neighbor performed CPR on the little girl.  Miriam was bleeding badly and hardly conscious when Tony arrived at her home, and the baby had not yet cried.

Upon arrival I discovered that the General Hospital is aptly named for the population it serves – the general public, those without money or social privilege that would afford them better health care.  Tony rushed into the emergency room with Miriam in his arms, calling out for help, while an employee from the orphanage followed close behind with her baby.  Nearly every case at the General Hospital is an emergency, so entering the emergency room doesn’t elicit the urgent care we wished it did.  A group of doctors casually instructed Tony to put Miriam on an empty bed and assured us that they would attend to her shortly.  They leisurely finished their conversation and eventually examined her without washing their hands or donning a pair of gloves.  Before they would proceed with treatment, they needed to see her identification card – paperwork takes precedence over medical care.

That set the tone for the rest of the night – delays, unexplained treatment options, misplaced medical records, and overlooked medications.  Dried blood stains spotted the tiled floor while the odors of various medicines and bodily fluids mixed together, creating a stomach turning stench.  When no space remained in the standard rooms, patient beds began to line the hallways while family members slept on the floor or on nearby benches.  At 3:00 am we went home to catch a few hours of sleep, returning the next morning to find Miriam in a “standard room” with 45 other patients – no privacy curtains, no bathrooms, no call buttons.  Miriam sat for most of the day on a metal folding chair that was missing the backrest portion of the chair.  She had not yet seen her baby girl because she was in observation as doctors tried to evaluate the extent of the damage due to lack of oxygen when she was born.  However, this also meant that she had not been breast-fed in these first 16 hours of life.

After that experience, I have come to dread late night phone calls.  The General Hospital has quickly become my least favorite place to be – I literally have to force myself to walk the halls and overlook the distracting conditions and archaic medical procedures that surround me.  With all the preparations we’d made and all of the expectations we’d developed regarding our new position as directors of an orphanage, I had somehow failed to think of how many medical situations we would encounter with 50 children under our care.  The General Hospital is now a regular part of our work.  Great.

My first experience at the General Hospital with Miriam shook me emotionally.  I spent a lot of time pondering what it was that had shaken me most – why it quickly became such a hard place for me to go.  The most significant thought I’ve had is that the hospital is a flagrant reminder of the reality in which we are living.  There are many conveniences available here that start to mask the reality that we are living in a developing third-world country.  The joy of our work typically overshadows the poverty and lack of resources that we are dealing with.  But when I walk into the hospital, all of that falls away and I’m left staring at the broken equipment, unsanitary conditions, and poor medical knowledge that reigns in the building.  Lack of money keeps the doctors from having soap to wash their hands with or gloves to protect themselves and their patients.  Poverty not only hinders proper preventive health care, but proper emergency health care as well.  That overwhelms me in a way that I’m unable to articulate – it is a deep grieving in my soul that this is the reality for 80% of the people in our area, and sadly it is probably the reality for 80% of the world. I’m slowly learning that in the moments when I feel pinned up against a horrible reality, when I want to escape to the comfortable place I come from, God’s grace is sufficient for me.  Not sufficient in a Sunday School class answer kind of way, but truly sufficient to carry me through the moments that I don’t want to be living through.  And that’s the grace that led us to live here in the first place.

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