Sunday, July 11, 2010

The Rook

            So we--humanity--insist that the body shall still cling to the wire.  We put out the eyes and the ears; but we pinion it there, with a bottle of medicine, a cup of tea, a dying fire, like a rook on a barn door; but a rook that still lives, even with a nail through it.
                                                          -Virginia Woolf

           Even with a hundred dollar bill you can't do everything.  I return to FEPSI about once a week after leaving Kahambu in their care.  Each week she is laying in the same position in the bed, but several times I see her actually eating the food her daughter gives her and she even focuses her eyes on mine for a few moments.  The Doctor says she is walking on her own sometimes and they have treated her for the physical effects of her rape.  They have given her an HIV test and miraculously, it comes back negative.
          After a month, the head Doctor tells me that they have finished treating the direct symptoms of the rape and it would be best for her to be transferred to a Center for Psychological Health around the corner.  I don't like the idea of moving her when she is clearly getting better at FEPSI.  I don't have much of a say, and I try to trust the Doctors even though it's impossible to tell who's actually a doctor, who is a nurse and who is just a random person walking around in a lab coat.  I don't like the move but I come back the following week to help them transfer her to CEPIMA.
          Kahambu looks like a Queen.  When I peek into the room behind the wooden partition she is sitting up in the bed, perfectly straight with her head wrapped in scarlet and a string of plastic pearls around her neck.  She has a tiny bit more meat on her bones and when I greet her she responds without hesitation.  She gives no more than the typical one-word response but everything I see is an improvement from what she was a month ago; even the plastic pearls.
          While I wait for Kahambu's daughter, Devoté, to collect their things and wrap clothing around her mother, the three little girls who are present today bounce around me in brilliantly white and orange dresses.  I laugh with them and take pictures of their happiness.
          When all is ready, Kahambu rises from the bed, and with a nurse at her side she walks one foot in front of the other and begins to descend the stairs.  I walk in front of her, one stair at a time, staring openly with a huge smile on my face like a child at the circus for the first time.  The nurse helps her slowly into the back seat of the FEPSI truck after a few workmen unload several bags of cement from the truck bed.  Ambulances don't exist.  Her movements are slow and cautious, but have certain confident fluidity to them.  She is present, in some sense, in what's going.
          CEPIMA is only a few short minutes away.  On the ride there I'm glowing in the front seat; I'm ecstatic about her progress but apprehensive about the fact that we're switching roads when this one was going uphill.  The entrance to CEPIMA is a brown metal gate hiding brown dirt buldings.  I walk in first, intent on finding the person in charge so I can establish a room and a bed and make sure les filles are equally settled.  Inside the gate is a tiny dirt area in front of tiny dirt buildings with a tiny dirt pathway winding between.  There is no light here and at least 30 men and women are milling around in the small space.
      -Is the Doctor here right now?  I ask the general population.
      -The doctors are crazy too! Someone yells from the group.
          I don't like any of it.  The dirt ground, the dirt walls, the men and women mixed everywhere, the supposed medicine within all of it.  Everything is moving too quickly but with Kahambu, her daughter and especially the three little lights attached to me I can't slow it down.  Kahambu has walked in slowly behind me with the help of Devoté.  A young woman in a white coat appears and ushers us into a mud closet.  Kahambu is helped onto a stiff wooden bench with no back to it.  I know she's uncomfortable, I know this is the most she's walked in three months, but she doesn't indicate anything with her face.  She simply plays along.
          I explain to the nurse that we are coming from FEPSI and hand her the Doctor-written note with the official FEPSI stamp.  The woman looks at it and begins asking me questions, ignoring Devoté sitting on Kahambu's other side.
      -What's wrong with her?  How long has she been like this?  What caused her to become like this?
      -I don't know anything, really.  I know she was raped about three months ago.  She didn't leave her bed for three weeks.  She was sick before that, but was eating and speaking and walking fine.  After the rape, she stopped everything.  Beyond that, you have to ask her daughter.  I would like to help if I can, but it's not actually my family so I don't really know, and all of the decisions will be made by her daughter. So it's best if you speak directly with her.
          The nurse turns to Devoté and begins speaking in rapid Kinande.  After a few minutes she turns to me and without provocation, explains.
      -The daughter says that her mother lost her husband to the war and that was very painful.  Then she lost seven children to the war, the same war that continues always here.
      -Seven children?  I ask.  I can't absorb the number.
      -Yes, seven.  The nurse shows no emotion.  Kahambu as well is sitting next to me blankly staring at the ground.
        -When she came to Lubero she married another man and they had two more children, her daughter, here--she motions to Devoté--and another daughter who lives in Musienene.  But there were more problems with the war and the second husband started drinking, and he drank himself to death.  That wasn't too long ago and that was when she stopped interacting fully with the world.
          I know Kahambu's "illness" before I met her was that she would leave the house and walk through the fields on her own.  I guess that's what the nurse means by not interacting fully with the world.
      -Then she was raped in Lubero, and that is what you know.
          She finishes and waits for me to say something.  I want to leave this mud closet, this horrible so-called health-center where patients wander around with no emotions but bitterness and resignation; I want to leave this city, this country.  I want to throw Kahambu and have her land in a clean hospital in the United States where Doctors can be sued and medication is monitored and recorded, not strewn across a wooden table and doled out like candy.  I want to see white walls around her and sparkling needles.  I want all of these people to be okay.
          The two twins of the grand-daughter crew, Lydie and Lyssie enter the dark closet searching for their mother.  Lydie taps me on the knees and lifts her arms to be picked up.  I place her on my lap and wrap my arms around her.
      -What about security during the night?  I'm pretty sure the little girls won't be sleeping here, but will Kahambu be safe at night and will the little girls be safe during the day and the evenings when they're here?
          I hope to god the girls aren't ever here close to dark; but for all I know they could end up sleeping here too.
      -Are there always nurses here? Do men and women stay in the same areas?  Can she have her own room?  Are you sure there is security?  Completely certain?
          The woman laughs at my rapid fire questions and assures me there are nurses all the time and that everyone is constantly monitored.  I don't believe her but things are still moving too quickly for me to change directions.  Kahambu is slowly sinking towards the ground next to me; her once perfectly straight posture is now the top of a question mark.  The more I talk the more she suffers.
          I feel something wet on my jacket and look down at my arm.  There is crimson smeared all over the baby blue.  Lydie has open wounds running up and down her arm that I didn't notice before.
      -What happened to her?
          The nurse stands up while asking Devoté my question.
      -She fell of the motorcycle.
      -Why did they not clean and treat these when she was at FEPSI?  I say more to myself than anyone else.
          The nurse disappears and returns with a bottle of neon purple liquid that she says is rubbing alcohol and a cotton swab.  She soaks the swab and starts wiping the blood off of my jacket.
      -No, what are you doing?  Please, clean her arm before you clean my jacket.
          Lydie's blood is creeping down her arm in thick gobs, although she doesn't seem to notice.  She seems more frightened about the fact that I have blood on my jacket as a result of her little arm and have thus displaced her from my lap.  I don't know how to say, don't worry in Kinande.  The nurse looks at me like I'm crazier than all of the patients when I pull away and point to Lydie.  She steps forward and keeps wiping at the baby blue.  I'm seeing the hierarchy of respect more and more as something that drastically gets in the way.
       -I don't have much money on me, I say, once the nurse has finished wiping my jacket and dabbing at Lydie's arm.
      -I know you don't provide food, will 5 dollars be enough for Devoté to feed her mother for a week?  I think I can come back in a few days but it may be a week.
     -Five dollars will be plenty for the week.  Maybe you can give me a little something too?
          The question is not new, but at the moment I want to stab the nurse in the leg with the pen she's holding.  I would never do that though because it would probably get infected and there wouldn't be a clean hospital to treat it in.  I have no control over Kahambu's health or prosperity or happiness and I'm can clearly see myself reacting to it like a five year old.
      -I have to go, I say.  Devoté can answer yoru questions, I'm not actually in the family so I don't know all the things you should be asking.
          Again, anger and frustration are getting the better of me.  I do have to leave though, it's getting close to evening and I can never be out after dark.  Nobody can.  I give the 5 dollars to Devoté, keeping my remaining three dollars for the moto-taxi back to the Crosiers.  I walk through the gate not quite knowing what just happened, feeling completely confused and out of control.
          When I get back to the Crosiers, I can see through my fear a bit more clearly for a minute or two.  The men and women mixed together in CEPIMA were all battling les maladies psycologiques and I only saw two white jackets amidst all of the confusion.  I just left a completely incapacitated woman and four tiny, completely vulnerable girls in a 'health-center' comparable to the U.S. 'mad-houses' of the 1940s.  I have images of frightend and confused patients finding the innocent little girls accidentally alone, and taking out their confusions on them.  I start panicking again, trying to find a way to get back to Butembo immediately.  It's already night and nobody will even listen to my requests.  Dieu Donnée is going back to Butembo the next morning and I beg him to take me with him.  He seems reluctant; after the previous trip with me involving a woman the width of cardboard, too many children and not a lot of control, he's been reluctant to take me every time I've asked.  I ignore his uncertainty and convince him to take me anyway.  Poor guy.
          That night I get into an argument of sorts with one of the Priests.  Worrying about the girls has made me shaky and extremely bad at maintaining appropriate social conduct.  During the day I also heard that the man who raped Kahambu was a man who had come to pray for la malade. It's a common practice for people to pray with and around a sick person.  When the grand-daughters weren't in the hut, the man cut his prayer short and went to hell.  I explain this to Père Benjamin, and I know my exclamations of hypocrisy and disgust are way over the line.  He stays calm and tells me kindly that those are the actions of an individual, not an entire religion.  That man will have to face his demons when he dies.  I want to keep arguing and know that I need to get myself in check, so I go to bed.
          The next day when I arrive at CEPIMA the nurses greet me with excitement.  I ask about la malade de Lubero and they take me through the small winding pathway slick with some sort of liquid to the back of the compound.  Through the little windows I can see cots stacked upon cots.  Kahambu is in a dark room with only two of these cots.  Her roommate is sleeping in a strange position with her face in the mattress and her rather wide dérriere pointing up to the ceiling.  She doesn't wake up or even move when I come in.  I'm very happy Kahambu is not in the milieu with ten or more people in a room.  At the same time, the room is still dark and smells of faeces.  I can't tell if it's a smell that has soaked into the walls with the passing of many patients, or something recent that no one has cleaned yet.  Devoté is sitting beside her mother who lies as prostrate as death on the bed.
      -Where are the little girls?  I ask the nurse who translates for Devoté.  I am worried about them here, I say frankly even though I know the nurse will take offense.
        The nurse does take offense, and I spend several minutes explaining that I'm not comfortable with young children being around men who are ill.
      -That's just how it is here, I say and finally she agrees.  You can't live here and disagree with that.
      -She took the little ones home to be cared for by her sister in Musienene, the nurse finally responds.  Now she is ready to be here for her mother until she is better.
          Devoté has noticed the same chaos that I have and put up the necessary walls around her children.  She has a pot of meat stew and a bowl of fufu in front of her.  She carefully rips off a small chunk of fufu dips it in the stew and places it delicately in her mother's mouth.  I'm in awe of this young woman.  She is returning the favour, giving back the immense devotion her mother gave her; it is how it should be.  It is how it should be, but at the same time, I think, it isn't fair.  Parents see the beginning of life, the explosion of personality and light that come with growing existence.  Parents help it grow, children must help it go out.
          Kahambu's withering body effects me deeply; I can't imagine how it hurts Devoté.  I think about what it's like in the United States with people this sick or this old.  I think of the nursing homes I worked in as an EMT Co-Pilot, the elderly people fading into the walls with nobody around to even notice.  We seem to have lost the courage to perform the task that's given to us the second we enter the world.  I have a lot to learn from this young woman with the beautiful smile despite the broken teeth.
          My panic deflates now that I know the girls aren't walking around in all of this suffering.  I give Devoté ten dollars for medication and leave.  As much as I want to think I'm helping by being kind or compassionate, the only people that are actually doing work are the Presidents in my bag and in my skin.


          After two more weeks I come back to CEPIMA in the hopes of seeing Kahambu waiting at the door.  When I arrive the nurse on duty greets me with the same excitement and ushers me inside.  After several forms and languages of hello I ask her to take me to the woman from Lubero.
      -Oh, she went to the Hospital in Kitatumba.
      -Why?  And why didn't you tell me this ten minutes ago when I arrived.
      -She developed a fever, so we sent her there.
          I leave immediately and hire a moto-taxi to take me to the hospital.  The hospital sits on top of a rock and the roads are almost impassable even by motorcycle.  When I arrive the nurses hear the word Lubero and know exactly where to take me.  Kahambu is now laying on her third cot.  She's so thin she looks like a pattern on the sheets.  Her mouth hangs open and her eyes are rolling back and forth into her head and out again.  The speed of their movement is faster than anything I've seen her do yet.
      -Why are her eyes doing that?
        The nurse or doctor--man in a white coat--chuckles.
      -She's sleeping.
      -You're not giving her too much medication?  What medication are you giving her?  Are you giving her psych meds or pain medication or both?
      -No, she's just taking antibiotics and medication to help her rehydrate.
          It hurts to look at her.  I step back outside into the sunshine with the white coat.  I have a question I want to ask, but I'm not quite sure how to pose it.
      -She's suffering a lot.
          I try to preface my question.
      -Yes she is.  A lot.
          I chicken out and the words don't sound right even in my head.
               Would it be kinder if we just let her die?
          Throughout this entire process, with all my optimistic muzungu thoughts and faith in having a little money, the only thing I've done is delay a rest that's long overdue and more than well-deserved.  I know letting her rest is the only thing that's left;  I'm just extending her suffering.  Devoté shows up at my side, still smiling and wearing the same hair net around her Amy Winehouse style beehive of braided hair.  I ask her several times what she wants to do, indicating that if she wants her mother back at FEPSI, where she was actually getting better, I can arrange it once a space opens up.  She says to the white coat who says to me that that is what she wants.  I descend down the rock with the moto-taxi.
          The next day, while in the market place buying rice and tea with Frére Maurice I get a call from the hospital.
      -She left the hospital, the man on the other end says.
          The French over the phone is too garbled for me to understand fully so I hand the phone to Frére Maurice, interrupting his attempts to bargain down ten pairs of blue plastic sandals.
      -She left the hospital, he says when he gets off the phone.
      -She left?  Already?
          I paid the hospital bill yesterday but they told me she would be paid up for the rest of the week.  If they forced her to leave because they already had the money they've got a ball of white fury coming quickly their way.
      -Yes, her daughter wants to take her back to Lubero.
      -Oh.  Okay.
          I'm slightly relieved.  That decision wasn't mine to make, but it needed to be made.
      -We can go to the hospital now, he says.
      -But you just said she already left.
      -Yes, but she's still there.
      -She's still there, but she already left?  Maurice that's a contradiction.
        He laughs.She left the hospital care, but she's still physically there.
      -Okay, let's go then.  Thank you.
          We climb the steep rocks once again, barely making it to L'Hopital General de Kitatumba.  Devoté greets us at the door to her mother's room.  She looks uncomfortable with me there.  Every step of the way I've sensed her intimidation, but now she's working hard to come out and actually tell me what she's thinking.  I still don't speak her language, of course, so she tells Frére Maurice.
      -She says she thinks it's time to go home now.  Her mother isn't getting any better and she has a husband in Lubero, and they've all been away from home for two months.  She says her mother has taken many medications and nothing has really helped.  She says she thinks that now, it is enough.
      -Ndiyo sana, I say to Devoté.  Yes, definitely.  I completely agree with her.  I'm impressed by her courage and the never-ceasing smile throughout.
          I arrange an ambulance, which is simply a white Land Rover, and the next day we arrive once again for Kahambu.  She's still wearing the plastic pearls but now they're glued to her neck with sweat.  She is skinnier than when I first met her, something I didn't think possible.  Here eyes have sunk as far as they can go into her skull.  When the nurse moves her to wrap blankets around her body her eyes begin rolling once again and I recognize it as the only way her body has of communicating pain.
      -Please go slowly, I say.
          The nurse goes slowly, but Kahambu's joints still creak and her eyes still roll.  The nurse and two men lift her carefully from the bed.  I make exclamations and repetitively ask them to go slowly and be gentle, but I'm just getting in the way and they patiently ignore me.  The weight of her own body seems to be causing her pain, so anything they do doesn't matter much anymore.
          We place her tiny body in the reclined front seat.  Pére Aristide, who has agreed to drive the car, buckles her seatbelt.  I look at her from the back seat and wonder what it would be like to be inside of a body and a mind that's cutting itself from the inside.  I know she is conscious of her pain and the world; she always responds to my hellos, if just a whisper, and her eyes change their focus following the movement around her.
          On the ride home we drive slowly over the rocks and potholes.  We pick up the four grand-daughters from their Aunt's hut.  Lydie or Lyssie, I'm not sure which, sits on my lap and sucks on a ring-pop bon bon that I brought for each of the girls.  I watch the twin's progression of sleep as her ring-pop drops down slowly to her side and then jerks back up again with every big bump.
          Several times when the road shakes the car violently and I can't see Kahambu's chest moving, I find myself hoping that we will arrive in Lubero to find that she has left this world.
          At the family hut, everything is still the same, even the guinea pigs munching happily in a dark corner.  We carry Kahambu back to her wooden plank in the darkness behind the stick partition; I leave the little family, hating the shape of a circle.
      Now all that's left is the hope that she passes quickly from this life to the next and that the next is a little bit kinder.  She's been through enough.

       Twenty-six hours later I receive a call from Kahambu's niece.  Sometime during the transition from July 9th to the 10th, Kahambu Kyakimua Wenderaki passed from this one to the next.



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