It was always going to be a distressing visit to the hospital. Placed on top of a hill the drive up to it twists and turns so that it slowly reveals itself in stages, a grey corner here, a window there. Even hanging half out the car it’s impossible to take pictures of it and once you arrive in the car park it’s best not to attempt it.
There are a number of Askari by the iron gate entrance; plastic bags and trousers are forbidden so it’s important to keep a kanga in your handbag to wrap your bottom half in. Apparently it’s for respect but my highly patterned, brightly coloured kanga seems more offensive and inappropriately jolly with this backdrop of grey concrete than the khaki trousers I seem to be living in at the moment.
Inside, it’s more intimidating but for different reasons. The walls are cracked and peeling, scarred with gouges and divots that are like the aftermath of a bomb explosion. The ceilings are covered with mould and waterstains. Inexplicably, someone has paid to have the floor retiled throughout but this newness only serves to highlight the decrepitude everywhere else.
I should have been better prepared. My first day in Tanzania found me in a paediatric unit crowded with new born babies. There were 3 or 4 tightly wrapped bundles to a bed, too weak to move or cry. Space was at a premium so even the in-trays had been utilised as makeshift cots. Mothers are only allowed to visit at feeding time and if surgery means you’re unable to climb the stairs to your child then a lack of resources and staff often means that the baby lies forgotten, unchanged and unfed for days. The abandoned child we’d gone to see was severely dehydrated and malnourished. The nurse looked frazzled.
The child we were visiting that day had come in with its mother. Amy had been asked to help by bringing clothes and nappies in as currently the mother was too sick to care for her. And then we found her. Alone in an adult size bed, Doctors’ strikes had meant she’d been left there forgotten and unfed for 7 hours, lying in her own faeces and urine. Her hair was ginger due to malnourishment, her lips cracked with oral thrush indicating something awfully deficient in her immune system. I helped change the sheets, dressed her in the clothes Amy had brought her and held her as Amy tried for an hour to get her some food. It was like pulling teeth – everyone appeared overworked and the suggestion was made that, having missed two feeds, she now wait for the 3pm one… It was hard to be calm in the face of such logic but eventually Amy got the formula.
As I was holding her I looked around at all the other mamas sitting with their children and wondered why no one had thought to check on this tiny girl, to give her some of their food and water, to ask someone who was caring for her?
If a nation’s greatness is measured by how it treats its weakest members, what can be said of Tanzania? Amy’s orphanage is filled with abandoned, abused and neglected children. There are hundreds of street children in Mwanza, making their homes literally in the rubbish dumps, prostituting and stealing to get money for food and drugs.
In turn they themselves are having children, often as the result of rape, and a whole generation is being born and brought up with the streets as their only home. Seen as the scourge of the city, they are beaten, abused, pimped and murdered – the local morgue has five bodies of young people, unnamed and unwanted, every day.
But is it fair to judge when circumstances have meant people don’t have the luxury of altruism or charitable feeling? If, due to extreme poverty and high medical costs, a family decides that the full time care and expense of a disabled child, who will never bring in an income and eventually die, is insupportable and make the decision to abandon that child so they can feed their remaining other children, can I not intellectualise that and see it for the horrific Sophie’s choice that it is? It’s turning out to be one of the hardest things about being here, trying to reconcile my still very western beliefs and values with behaviour and treatment I see, often borne out of conditions here rather than an inherent lack of feeling.
And all is not lost. There are some amazing people in Mwanza who’ve set up incredible projects – passionate and committed people who are in it for the long haul, speak fluent Swahili and are generally younger than me (which is pretty intimidating when you’re sitting round a table with them all). But that will have to wait until another post….