Africa: A Struggle to Survive

When people think of Africa, commonly they picture malnourished children, famine, drought, poverty, and death. But few actually see it first-hand. Last week I experienced a small taste of this picture of Africa as I encountered my first what I’d like to call “Africa-caused death”.

While visiting a compound in my village, I was handed a tiny newborn baby girl. She was beautiful. As I gazed at this baby sleeping in my arms, marveling at its tiny features, I was told that the baby’s mother, from a different village, died soon after delivering the baby. Because I had heard of other maternal deaths (4 in North Bank West within the last 6 months—which is a lot!), I wasn’t completely shocked. But as this would not be easily accepted in the States, I sought for further information as to the cause. I was told the mother delivered at home by a trained Traditional Birth Attendant, but began to lose too much blood. She was taken by donkey cart to the nearest health center, but by the time she arrived it was too late. The family had passed the baby to extended family as they mourned the loss of this wife and mother of five other children.

Because the mother had passed away, the baby was being given formula. This began to disturb her stomach as obviously breastfeeding would be the optimal choice, but the mother was not alive to provide it. The following day I was sitting at Omar’s (the Community Health Nurse) when the baby was brought in having just had a sleepless night.  The family had taken it to another health professional in the village before bringing it to Omar wanting to get a 2^nd opinion. Omar listened to the baby’s stomach, monitored its breathing rate, checked its temperature, and concluded there was nothing wrong; everything seemed normal. 

A week or so later, while in Kombo celebrating the 4^th of July I received a message saying the baby, too, had passed away. This time I was in shock! How could this be?! She was healthy when I left! Was she dropped? Did she come down with a communicable disease? I had to wait until I returned to village before I could find out all the details. The baby began to have diarrhea from the formula which led to dehydration and then death.  Once diarrhea began the family took the baby to the health center. They told them to stop the formula immediately (saying it never should have been given in the first place) but they should find a breastfeeding mother to provide the necessary nutritional feeding. Although this was tried, the baby refused to eat it. She was taken to the Banjul Hospital where she stayed, struggling for survival. After four days, she lost the battle.

As I tried to process this death, I asked the health center staff what could have been done differently. Could we have saved the life of this baby? They put the blame on the family, saying that they should have never given the baby formula to begin with, but my response to that was, “How would the family have known to not give the formula? There were multiple interactions between health professionals and this baby, providing many opportunities for this information to have been shared.  So why didn’t any of us tell them to not give formula?! We as health professionals are the health experts. People trust us to provide them with the necessary health information to maintain healthy households.  But if we don’t present the correct information, or even present it in a timely manner, then we have not done our job well. I can only hope that we will reflect on this infant mortality and learn from it, saving the lives of future children.