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Living

Worlds apart

Parents in developing countries don't get to ask "Why me?"
By Dan Bortolotti

The Toyota Land Cruiser bounced along the rutted dirt road carrying two dying people, a doctor trying to save them, and a sunburned Canadian writer.

It certainly was not how I expected to celebrate Father's Day weekend.

Last June, I travelled to the troubled African nation of Angola to research a book I'm writing about the Nobel Prize-winning humanitarian organization Médecins Sans Frontières (MSF), also known as Doctors Without Borders. Among other places, I visited a tiny clinic in Kuimba, a village in the north of the country where—on a good day, when the electricity is on—a solitary bulb illuminates a dozen or so narrow beds. The room in which a baby was born the night I arrived has one birthing table that looks as if it could be on loan from Stanley Kubrick's prop warehouse. If a second woman is admitted the same night, she has to lie on the floor. Patients often walk for two days or more to get there.

Malaria is the No. 1 killer of children in Kuimba, and those with severe cases are taken to the larger municipal hospital for treatment. The road is just over 60 kilometres, but it takes three hours for even the rugged MSF four-wheel-drive vehicles to navigate the seas of mud and lunar craters. I tagged along during one of these transfers, riding in the back with a sick baby girl and her parents, another patient with suspected tuberculosis and a young Australian volunteer doctor. The baby was in obvious distress—she gasped in the heat and spit up when she took water from a sippy cup. Her father sat directly across from me, cradling his daughter, but we never exchanged a word. When the journey was over, I realized we were separated by far more than a language barrier.

At one point, the doctor noted how stoic this mom and dad were and wondered how parents in the West would behave during a three hour ride with a critically ill baby. I know I would be apoplectic. Did this father not understand how sick his daughter was? Had the mother seen so much suffering that she was no longer capable of the same parental bond as you or me?

It's easy to make that leap, but it's totally unjust. No, facing the death of a child isn't inherently easier for parents in developing countries; it's just that they're more prepared to accept it. If it happens, it's just as terrible, but there is no malpractice lawsuit, rage against God or asking "Why me?" Another MSF doctor told me, "In the West, we've come to think bad things should not happen to us, but there isn't the same expectation in other parts of the world."

Think of it like this: when a Canadian woman discovers she's pregnant, she often won't announce it for three months. She recognizes that first trimester miscarriages are fairly common and silently acknowledges that possibility. Now imagine how that logic applies in a country in which more than 15 per cent of children die before their first birthday.

That analogy breaks down quickly though: miscarriage is almost never preventable, while the kids in Angola are dying from diseases that are easy and relatively inexpensive to treat. I think of the money we spend—not wisely on disease prevention but wastefully on PR campaigns to assuage our paranoia about marginal illnesses. The same week I travelled in the Land Cruiser, people in my community were all agog because some local mosquitoes had tested positive for West Nile virus. That threat was ludicrously remote, while here was a father whose child was dying from a vastly more common mosquito-borne illness. The young woman beside him wore a mask to contain her TB—it seemed to mock the unused one in the SARS kit I had been given before leaving Toronto.

These superficial parallels drove home the fact that, despite sharing a road with these parents for 60 kilometres, I can't claim to have walked even an inch in their flip-flops. If I'm ever forced to do so, I can only hope I'll be as brave.


You can donate to Médecins Sans Frontières by visiting www.msf.ca.


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