Baby Edgar & The $28 - A True Story from Guatemala (Wherein Anita encounters a crying mother, a dying baby, and a shack with little food and five malnourished kids who don't go to school.) September, 2001
Anita met a lady she didn't know on the street last Monday afternoon around 12:30. The lady was crying so Anita stopped to ask what was wrong. Under the blanket this mom had a 5-month-old baby, almost lifeless. "The doctor said my baby is going to die", she rasped helplessly. "My husband gets out of work at 2 pm, and maybe then he can borrow Q200 (US $28) so we can take a bus to the hospital (45 minutes away by bus) and get my baby admitted.
It was drizzling and looked like rain, so Anita brought the mother and baby back to our house to wait, and so she could examine the baby further. The baby's face was cherubic, plump rosy cheeks and big brown eyes. To look at his chubby face, you'd think he was healthy. (Here, that condition is called “baby sugar" condition)
But Anita was horrified as she further examined Baby Edgar. Under the bundle of clothes, his body was shriveled up to almost nothing with deep wrinkles on his tummy, indicating a drastic, rapid weight loss. His lower arms and hands were almost white and were cold and limp; and his feet were swelling, indicating lack of protein in his veins to keep the liquid in his veins.
He hadn't been drinking anything for days, vomiting, diarrhea. Esmeralda hadn't been able to breastfeed for six weeks because she had been sick and in the hospital. The grandmother hadn't been able to get him to take a bottle during the three weeks the mother had been in the hospital. Anita weighed him. Baby Edgar had gone from 16 pounds to 9 pounds in about six weeks. He was in very bad shape, and it was clear he wouldn't live more than a few more hours without some immediate care.
Anita quickly mixed up some rehydration fluid and started to feed him with a little dropper, like the one you’d use to feed a baby bird, or baby squirrel. Little by little he started taking the fluid. That would be his life support for the next two hours, until we could get him to the hospital. It was this drop-by-drop hydration that kept him alive until he later received an IV at the hospital.
Executive Decision – time for action We concluded that the baby might not live until the end of the day - it was time for some decisive action. We certainly didn’t want the complications of a baby dying at out house. So we put the mom and baby in the van and we went to wait for the father to come out of work. He had already left work by the time we go there, and was walking all over town to try to borrow the $28 he needed to admit the baby to the hospital. But he wasn't having any luck.
"We've got to go to the hospital right now", we told the father. "But I can’t, I don't have the money", he said softly, chagrined. We assured him that we’d lend it to him and not to worry, but that we had to leave right now.
At the private hospital, which was really not much more than a clinic and not a very clean looking one at that, we sat with the mom while the doctor signed the admittance form and collected the Q200. They started Baby Edgar on an IV with later administration of antibiotic to kill what the doctor believed was an intestinal infection.
The 'hospital' room was a large room with six beds in it, no curtains; dark and didn't smell very good, either. Very basic, you would say, even for here in rural Guatemala.
The Nurses - The Young and the Useless The young nurse was respectful, professional and kind to these poor people. Edgar's mom wore 'typical' clothing, like the indigenous people wear in the villages, but this young nurse treated her fairly. Later, when the nurses changed, and a nurse wearing indigenous clothes took over, we could see a noticeable change in attitude. She was rough, rude and didn't want to be bothered with these poor people. She shut the door of her office and wouldn't answer the door for the father when he needed water. I went to the main office and complained again, and the other young nurse came down to open the door. We got a little (reluctant) attention, but I could see that this was going to be a long night for the poor father. This poor treatment is common, we find.
The Parents Want to Leave the Hospital After the baby was on IV for an hour and we could see he was responding to voices and moving his eyes back and forth, the parents found out that there would be more costs. So they wanted to leave right then and there. No, I told them, "You must keep the baby here for at least two days.... we will lend you the money for this." The father said "Thanks that is very kind, but I don't want to get into more debt than I already am ... so we should go". I assured him that we would make this a gift from our medical mission and that we'd take care of all expenses if he promised not to leave the hospital (which would have meant certain death for the baby.) He agreed, and we mixed up some powdered formula and started giving Baby Edgar this formula by dropper.
The hospital requires that one of the parents stay with the baby 24/7. Well that's a bit of a hardship for this couple. Although they are only 24 years old, they have four other children at home, and the husband works 5 1/2 days a week for $137.50 a month. But the hubby agreed to stay at the hospital overnight, because the mother has a very severe case of thrombosis (we are actually concerned about her health-she should be in the hospital, too). He didn't want his wife in a situation where she can't lie down. You see, you aren't allowed to lie down on any of the unused beds or they will charge you for a day's stay of Q25 (US$3.50) a day. So the parent that stays has to stand or sit by the baby's bedside at all times, all night.
We went to the father’s workplace told them that he was in the hospital with his baby son and that he would be back in a few days. The Koreans who run the place are tough, and because he missed more than one day, they suspended him for an entire week. So, the father has time to be with his baby and care for the five other kids, but now he will lose 25% of this month's pay.
Something We Didn't Like - Where's the Soap? When I went to wash out a bottle, to make milk, I was told that all patients have to bring their own soap, toilet paper, towels and whatever thing that they need to use while at the hospital. Ok, I said, but I want to wash out this bottle for the baby. Too bad, you have to go get your own soap. So I went to complain to the main office and asked them to simply let me wash out this bottle at the nurse's station, wherever the nurses usually wash their hands and so on.
Well, there was no soap there, either! Only a little plastic bag of Fab! clothes-washing detergent. No disposable hand towels, no soap, nothing. That is when Anita and I said to each other 'something is wrong with this place.' About that time the rude nurse came in after attending a patient, rinsed her hands in cold water, wiped them on her skirt and went out to the next patient! I complained about this to the head doctor and his excuse was, "well we don't have many resources here, and it is hard to buy what we need, but the nurses *should* use the antiseptic soap that is in another room. ‘What about disposable hand towels?’, I asked. "Oh, we only use regular towels and wash them every few days." was his professional reply. Ugh! Sure enough, dirty terry cloth towels hung by the sinks.
We Go to Another Hospital The following day the father told me that, after he had explained the he didn't have enough money to stay here any longer, the doctor gave a letter to transfer the baby to the IGSS. IGSS is the free, government hospital but you need a special card to get admitted, which you can only get after six months at a company that signs up for IGSS. Fortunately, the father had such a card. In the nearby town of Antigua, the IGSS staff is very unprofessional and rude and we know they make many misdiagnosis. They had told the mother last week – “Go home, your baby is fine.’ They wouldn't fully examine the baby and wouldn't treat her kindly and didn’t seem to care at all.
But the doctor assured us that the IGSS in Zone 9 in Guatemala City was good. I put on my suit and tie (in this way we are sure to get top level attention) and drove them down to IGSS. Anita went in with them while I parked the car, and by the time I had got back inside, the admitting clerk at emergency had given him a number "34" and told him to wait his turn, which could be a long time. The father had explained to the admitting clerk that the baby had just come off IV at another clinic and that the other doctor had said this was an emergency. "Fine, I understand", the clerk said, "Your number is still 34".
Worried that all the work we had done would be lost and that the baby would be in terrible condition again if he had to wait around for hours, I asked to see the supervisor. I showed my passport, indicating that I was with them, had brought them and that we had a medical clinic and that this was a serious case.
Miraculously, they called us in three minutes, and several wonderful doctors attended to the baby in the emergency ward, promising to do tests and workups right away and let us know the results. Great! (Dear Reader, I know this sounds once again like the Ugly American and it may be somewhat true. But, we barely saved the baby's life two days before, and I wasn't about to have these parents wait and watch the baby lapse. Besides, with these poor people from a rural town, I don't know what care they might have received if we weren't right there with her.)
So Far, So Good Baby Edgar isn't totally healthy yet, but he's coming back stronger. He'll be in the hospital several weeks. We're trying to find a lady to care for the five children at home while the mom goes to the hospital to visit and the father goes to work. At this hospital a parent doesn't have to stay full time. In fact, the mother is allowed in only during feeding times every few hours and everyone else can only visit from 2 pm to 3pm each day.
Note: Baby Edgar came home after four weeks, during which time the care was so bad that Gregory made enough fuss so that he met with the Director of the hospital, got the Head of Pediatrics to make special exceptions, and, was influential in getting all the nurses in critical care changed to another ward. Baby Edgar had only gained 2 pounds but the infection was gone and he was stabile. We are continuing to provide special baby formula and he is slowly gaining his weight back.
Oh, and the Problem with the Robbers This family acts as guardians for the owner of a large vacant house and they live in a little two-room shack of a house on the property's edge. It's common, because no house should be left vacant here, ever. (At our house, we even have guardians although we also have guard dogs, solid iron gratings on all the windows, walls and a locked gate.)
Well, in talking to the mom we find out that the reason they have not a centavo to their name, and no food in the house is because the owner is requiring them to pay him for the loss he recently suffered. You see, when the mom was in the hospital, the father went to visit and the children went to another person's house for the day. That same day, robbers stole the washer, dryer and some other things from the owner's big house.
The owner says that the guardians are responsible and must pay him back or he will call the police; and he threatened them with the police, jail, theft and other things. They aren't educated and don't realize that these threats aren’t legal or true and that all the owner could do is fire them. But they are worried about being arrested, losing this job, and losing little shack they live in. So they have been paying most of the father's monthly paycheck for the last two months to the owner! Meanwhile, the family has almost nothing to eat, and no money for the mother's medicine that she needs to stay alive. And, no money to take Baby Edgar to the hospital.
Sometimes Anita and I wonder at the cruelty of Guatemalans to their own people, as in this case of a wealthy house owner to his poor guardian family - requiring their meager earnings to be paid to him, knowing that they won't have food for their children. They live in the tin roof guardian's shack that leaks a lot when it rains, but he won't pay to fix that or buy new metal so that father could install it. (Total cost would be about $40)
What to Do? We're giving groceries to the family, vitamins and special food supplements. All the children look undernourished and very small for their age. Only the one has shoes, and their clothes are torn and ragged. The oldest is 11 years old, but none of them go to school because the father said he didn't have the $4 that they each needed to enroll and another $20 each to buy the needed school supplies. So, none of the children are in school. He said he hopes he can get the money together for next school year, which starts in January. But I doubt it. (We’ll make sure that they do get enrolled, get shoes and clothes, and get the school supplies they need.)
We constantly remind ourselves that we simply can't help people except within the definition of our medical mission - medical care and medicine. But, really, what else can we do but help this family who is living like worms a few miles from our house? Sure, we did our medical thing by being there to help the baby or he would have died that Monday night.
But the cycle will never be broken if those kids don't go to school, so we'll have to make sure they get to school when the new school year starts in four months. We've had to do that before, too, for some other very poor families we met. We don't think there is another option – education is necessary for the long term.
We’ll keep interacting with this family, with the knowledge that we won’t be able to help them with all their needs for the long term. But we are glad for that rainy afternoon when Anita stopped to help a lady she didn’t know.
Epilogue - November 2000 We've kept the family supplied with vitamins and baby formula. Baby Edgar has pulled through fine and is a healthy 14 pounds and growing. Thank you so much to those who donated money and items especially for this family. We've received shoes and clothes, money for baby formula, and money to get them enrolled in school and buy the school supplies. They kids are so excited to know that they can go to school this year.
Hope this story wasn't too long. God has a way of reminding us never to complain and to remember how blessed we are!!