Fever

So Annabelle’s fever didn’t go away.

Dr. Rob, an American doctor working at a clinic within shouting distance, made a couple of house calls to check out our lethargic baby with chills. Two malaria tests came back negative. There was no visible sign of a bacterial infection anywhere. Probably just a virus easily picked up from one of the hundreds of kids she has played with in the last two weeks. All you can do is keep her fever down and wait it out. 

Bryan and I weren’t overly concerned. After all, kids get sick no matter where you are, right? In fact, we have probably already missed out on several rounds of daycare and playgroup bugs that have worried our peers. Night-time syringes full of ibuprofen are just a part of the parenting package. So we waited.   
  

But by day five her high fever was still breaking through the ibuprofen after only a few hours and she wasn’t eating. And to make matters worse, Bryan got sick. Really sick. A quick finger prick showed that he had a good solid case of malaria and now that we were past the point of a virus’ lifespan, it was deemed prudent to treat both my babies for malaria. Annabelle’s coartem pills were crushed up and disguised in smears of peanut-butter only begrudgingly swallowed. She didn’t get any worse, but neither did she get better. Bryan swallowed his fistful of drugs willingly and got significantly worse. His fever soared and I woke up in the night to the bed shaking he was shivering so violently. But in 48 hours he was revived, eating and moving around again. Such a relief.

After a week and a half of the roller-coaster hope of seeing Annabelle up and playing or eating a cracker only to watch with worry an hour later as she lay in bed miserable again we decided to take her down the road to the nearest hospital. Dr. Rob had left by this point for his R and R and the mere doubtful mention of the word typhoid by his nursing staff was enough to make the fifteen minute drive by motorcycle seem like a pleasure ride (yeah, we’re not the more impressive NGO in these parts when it comes to transportation right now…). If my baby hadn’t been so hot and my belly so tight with harmless contractions, the image of me seven and half months pregnant with a one and half year old strapped to my back jostling behind my husband through the dust kicked up by land cruisers and herds of cows, I would have been laughing the whole way there. 

The hospital is a cluster of oddly built cement structures staffed by one doctor a couple of nurses and a handful of dubiously trained lab techs, surgical assistants and the people who take your temperature and clean up all manner of things from the floors. As we walked in the courtyard we stepped around people lying on mats in the shade while their relatives cooked sorghum porridge over small fires. We were welcomed with hugs by a lab tech who was a dear friend throughout our time across the border and he quickly ushered us around the corner to see the doctor. We picked our way through the steady flow of men, women and children and waited for a moment while our friend knocked on a green door. In a moment a man in scrubs, boots, gloves and a shower cap peeked his head out and gestured for us to remove our shoes and then follow him back inside. I stepped into the dark room in my bare filthy feet and realized with a feeling close to dread that we were in the OR. A young girl was lying naked on a bed and crying, more from fear than pain I think, as she was being prepped for surgery. Various people in surgical masks scooted politely around us as plastic chairs were scraped across the floor for us to sit in. 

The doctor took his time examining Annabelle right there in the OR and eventually grimaced apologetically and said he would recommend putting her on a quinine and heavy antibiotic drip immediately. He moved his head in the direction of the wards we had seen literally overflowing with people and said quietly, “But I don’t know if admitting her here is really what you want to do. We could put her in the maternity ward but even that…”

It’s a very disorienting sensation to experience two extreme and opposing truths simultaneously. On one hand I was struggling to be brave in the face of my moderately sick baby being touched and greeted by people in a place where a thousand different diseases festered in the very air she was breathing. I was feeling pretty proud of myself managing to do that too, until I entertained the prospect of her being hooked up to IV for a week in a bush hospital. And that scared me. On the other hand I was painfully aware of a kind of shame that came with the only doctor treating a thousand people infinitely more sick than my child being pulled out of surgery to give us his attention because of …what? The color of my skin, my friendship with hospital staff, my connections with the hospital donors? Those two realities felt like they were going to rip me in half in that moment.        

At this point all I could think was, I am not tough enough for this, I am not tough enough for this, I am not tough enough for this. My daughter might be but I don’t think I am.

While someone went to gather the medicine for Annabelle we sat outside on a bench and talked about options. Annabelle sat quietly on my lap and watched while a girl only a couple of years older than her on her own mother’s lap on the bench next to us was given an IV in her tiny wrist. Dingy bandages bruised with iodine covered severe burns across her back and torso. 

Life in North Africa seems to constantly throw serious decisions at us that must be made in approximately 30 minutes. (Or as it was politely pointed out to me recently, maybe Bryan and I just attract/are attracted to those scenarios in the first place…) After some deliberation we decided to take advantage of a cargo charter flying in the following morning with fencing materials for our new compound. We could give Annabelle an injection of antibiotics that night and then she and I would be on our way to Nairobi the following morning. A week of intravenous meds without lab work seemed like overkill for such a little girl. But ignoring her fever was out of the question. Our whole family flying out in twelve hours’ notice seemed unnecessary with so much left to be done in North Africa in the next two weeks. But us all staying in, especially a pregnant mama and sick baby seemed equally silly.

So after a short night, Annabelle and I said a modest goodbye to Bryan on Wednesday morning at the airstrip while a cluster of kids watched on and WFP helicopters reverberated overhead. By the time we hit Lokichoggio she has already gone her first twelve hours in ten days with no fever. We were unable to get a ride out of Loki so a friendly taxi driver helped me find “the best” local clinic (think one yellow room with posters of happy Chinese children overlaid with trite sayings about happiness fraying on the wall and wet basins stacked beside boxes of cough syrup in the corner) where an obliging doctor administered the second antibiotic injection.

By the time we reached Nairobi the following day and finally made it to our pediatrician’s office and shared our story, we were both fried. 

But, my baby was healthier than she has been in two weeks. 

Thank you God.  

Once again, I find myself battling mixed emotions. I am overwhelmingly thankful that she is healthy again. I breath such a prayer of thanks every time that cool little forehead snuggles into my neck. But a part of me wonders too if we overreacted. Now that I am in Nairobi for two weeks without my husband and with a perfectly healthy little girl, I can’t help but think, should we have given it another day or two? Plus, I suspect rumors have flown around the world (as much as we try to contain them) that my daughter was dying of some terrible refugee camp disease and had to be medically evacuated out. (If you could talk to the bush pilots who had to scrape three hours of cartoon stickers off their windows they would assure you that Annabelle was just shy of fine by the time they got to her.) And I also think about that doctor in North Africa who has seen it all recommending to put her on IV drugs immediately, and I know that while we can be thankful for a quick recovery, there are some things you just don’t mess around with in this part of the world.

I guess more than anything I am grateful. Grateful for the opportunity to overreact, underreact…just to act at all is more of a privilege and a gift than I could have fully imagined before last week.

Thank you so much for your prayers. We are richly blessed.