Her age is 20 years. The skin on her face is dark with a golden hue, and is as smooth as well churned butter. She is shy, but I can see a fierceness burning beneath her averted gaze and sweet smile. I feel awkward asking her questions but there is so much I want to know. What are her days and nights like? What tasks consume her time? What thoughts consume her mind? What are her worries and cares? What are her passions and loves?
The mother is at the Azezo Health Center for an antenatal care visit. The child growing inside of her took form 28 weeks ago and this is her first visit. You can see the love she has for the child in the way she strokes her belly with her hand. You can see her love for the child when you imagine her trudging an hour through the mud to cover the ground between her rural dwelling in the hills and the health center where she seeks care for herself and her baby. You know it is not easy for her to come. She has another little one at home to care for. Her daily responsibilities are vast and consuming. She came because she knows it is good.
The midwife asks her questions about her health history. “When was your last menstrual period? Do you have any chronic illnesses? Have you ever had malaria? Do you use an impregnated bed net? Can we test you for HIV?” She answers with single words. “Yes, no…” When she lies down on the exam table the midwife manipulates her swollen belly as she attempts to determine the lie of the child, and estimate the gestational age. The small room is crowded and two eager midwifery students gaze on and drool over every word their wise teacher offers them. I know what it’s like to want to know everything, to want to learn it all right now. But don’t forget about the person lying in front of you, I find myself thinking. Be present with her. Be curious about her.
After she is done in the exam room I walk in silence with the mother through the waiting room filled with cries and coos as mothers holding and feeding their brand new infants wait in the immunization line. We walk outside and across the muddy grounds, which try to steel my slip on shoe from my feet once or twice. We arrive at the window of an adjacent building. The lack of a common language prevents us from sharing words, but we communicate with touches and smiles. She offers her blood and urine to the laboratory technician for examination then sits outside on a covered bench to wait for the results. It’s warm and sunny and she invites me to sit next to her. Kefyalew, our trusty translator arrives on the scene and we begin a brief conversation. She delivered her first baby at her mother’s home as is customary in her village. I say a quick prayer of thanks that the delivery was free of complications and that mother and child are alive today. She says she wants to deliver her second baby at the health center and I offer my encouragement in support of her decision.
Her lab results come and we walk back to the exam room to present the completed lab slip to the midwife who has a few more questions and teaching points and then she is free to walk back home through the mud. We say good-bye and I head back to the University Hospital in a bajaj.
This mother carried her pregnant belly an hour through the mud and postponed the duties that will surely await her when she returns home, for a 30-minute visit at the health center. Is it worth it? Does she really need to make the journey again in 6 weeks for a similar visit? She is healthy and her baby appears to be healthy. There was nothing abnormal in her labs. She would probably be fine delivering at home by herself again. But what if they did find something? What if her blood pressure was high, or the baby was breech, or her HIV test was positive… She must come back. I pray she comes back. I pray she tells her friends and neighbors to come. I pray this prayer on behalf of all those whose lives have been altered due to the lack of this care. I pray that the work I am involved in here sees the realization of its intended effect, and brings more women and children to health centers for this precious care. Is it worth it? It is certainly worth it.