Tuesday, 17 May 2016

Basankusu: The story of little Matthew

~ Part 1 ~ Basankusu: The story of little Matthew

Not long after my return from England, just after New Year, I went to Judith’s house to see the severely malnourished children she’d started feeding at her house on a daily basis. She’d already found a new house to serve as our new centre, but until arrangements were finalised she was quietly helping the mothers of these children to keep them alive. My students hadn’t returned from their break yet, and so I was free to visit most days.

One mother brought her painfully thin 7 year-old son bound to her back like a baby. They went to their little church first for a “praying cure” and always arrived late at Judith’s house.

“There aren’t enough hours in the day left to feed him, if he arrives so late,” I implored Judith. “Tell her to skip church and bring him straight here.” A child’s stomach can only accept so much food at a time, but they need to get as many calories as they can each day – so missing a meal each day would make it impossible for him to regain weight.

We compromised by sending her off each day with some breakfast for him, which he could eat before church, and then catch up with his eating later. I saw them there several days but eventually they stopped coming.

“The mother has taken him to her village, 30 km from here. She says she’ll feed him herself.”
I know that, in England, Social Services would take such a child into care – no such luxury here. We haven’t seen nor heard from them since.

Another little boy was handed to me. I sat him on my lap; immediately I felt how bony his body was and how tight the skin was on his face. His name was Matthew. I guessed he was about 2 years old, but he turned out to be 4 years and 8 months … not only very thin and listless, but also nowhere near as tall as other children his age.

His mother, Chantelle, came into the room and sat on the bamboo bed. A hen and its brood of chicks huddled in the corner behind us as we spoke. Chantelle was partially paralysed on one side of her face and she couldn’t use her right arm very well.

“Chantelle, Matthew has lost weight again,” Judith began, firmly, “How have you let this happen?”
Chantelle’s answer was quite dismissive. “I’ve been ill myself, haven’t I? What am I supposed to do?”

“It’s just negligence, Chantelle …” Judith was getting distressed, “You have to make sure he eats plenty, every day.”

Morning milk had been given and maize porridge was on its way – everything enriched with a little vegetable oil and sugar. A fresh pineapple lay on the table to add a few vitamins to the day’s fare … and later there would be more solid food.

I said my good-byes and made my way back home.

A few days later, Judith came to visit me at my home – Maison St Joseph – on the other side of Basankusu. She told me that the new centre was now in use – a newly built brick house just round the corner from where she lived. She wanted me to visit the next day.

“But, I have some sad news as well,” she said, “Little Matthew has died.”

I didn’t know how to react. Over the previous year, our work had doubtless saved the lives of at least 70 children; I had to get used to the fact that sometimes there would be deaths. Some parents bring their child along too late to be helped.

There then ensued a conversation with everyone and anyone – including our cook – which focused on the idea that I would pay for the burial costs. They would need a bed-sheet, and planks of wood, and nails … and then people would need food and transport, and so on.

I felt we had made little progress in trying to get people to help themselves.

“The money that people send me is to feed children,” I explained, “Burying someone is the family’s responsibility. People have been dying here for a long time before I came to live here … and they managed to bury people very well.”

The conversation ended quickly – I would not pay for the burial, no matter how heartless they thought I was. Those who were so insistent, I suggested, could take up a collection themselves. But they didn’t.

The next day I went to the new feeding centre and took some photos. Judith told me to come along to a health centre which was nearby.

“One of our children has been admitted,” she said, “Come and see.”

We made our way between the various houses, some made from kiln-fired bricks and with corrugated metal roofs, and others made from cold-pressed clay bricks with palm thatched roofs. The meandering path took us through people’s back yards, made from swept earth. Some people were cooking on wood fires, others washing clothes in plastic tubs, while chickens, goats and the family hunting dog wandered freely. We exchanged greetings with the people as we went along and eventually came to a small health centre with a few iron-framed beds inside.

The child Judith had asked me to visit was very small, swathed in a large piece of flower-patterned cloth, his breathing was shallow but steady.

“They gave him a blood transfusion yesterday,” said Judith. “He’s still very weak.”

A woman entered the room. It was Chantelle, the mother of Matthew who I’d been told had died. So who was this child? – I wondered. How is Chantelle connected to this child? I greeted Chantelle, but stopped myself from offering my condolences. I eventually put two and two together and realised that Matthew hadn’t died after all.

We said our good-byes and left the health centre staff to do their work. I walked close to Judith and discretely asked, “So, is that the child who died?”

“Yes,” she replied, “I thought you looked puzzled.”

“… and?” I said.

“They gave him a blood transfusion and he got better,” she smiled.

Perhaps things get lost in translation, but I’m sure we would have a different way of describing the situation, in English. I was disturbed by how the event had been described – but, at the same time, relieved to find that Matthew was still with us.

~ Part 2 ~œ Basankusu: The story of little Matthew

The new centre was soon up and running, welcoming children from a wide area, and for seven days per week for the more severe cases. Chantelle was now being helped by Matthew’s father; he had left her two years previously, but had come back when he heard that Matthew was so ill.

Sister Vicky, a local nun who is also a doctor and in charge of the diocesan health services, came to visit and was very pleased with what we were doing.

“We will treat you as if you are in partnership with our service,” she said. “If you need to admit a child to the Catholic hospital (Basankusu’s Secondary hospital), we will do a deal on the price – the same with medicines … we’ll sell them to you at cost price.”

We were very happy with that news; we’d been recognised for what we were doing and had been included as one of the health centres for the diocese – if only on an informal basis.

Judith, Sister Vicky, Nellie and Francis

The very next day, Matthew’s father brought him along to tohe centre, as he had started to do each day. It was two weeks since his blood transfusion. His breathing was extremely shallow and there was little response when he was spoken to.

“We need to admit him to hospital, straight away,” explained Jean-Pierre, one of our two nurses. “There’s no time to waste.”

The hospital gave him a bed. The room was bleak – cement floor and white plastered walls. The mattress was thin and split, it had no sheets or pillow. He would, however, receive the medication he needed to bring down the inflammation from his body and having him in one place would mean that we could monitor his feeding each day. We arranged for enriched milk-powder to be taken to him each day and cooked food would be delivered after midday, which could be given as several meals throughout the day. The hospital took charge of his medication and monitoring. Matthew’s parents were responsible for feeding and washing him. The hospital has a generator for operations – but after six, each evening, it sits in the deep, dark, black of night, with only the loud chirping of crickets for company. We bought them a torch.

The days went by and we saw a change in Matthew’s face. His skin regained some colour and his eyes started to sparkle. His body remained emaciated, skeletal … and must have been constantly painful. He developed a bed-sore at the base of his spine.

I visited as frequently as I could, and so did Judith – she was usually the one who brought his food along. We tried to get one of our volunteers from the centre, who lived locally to cook for him at the hospital but she found it too much of a commitment, having her own children at home, too. We continued to send the food daily. I personally called in as often as I could to see little Matthew’s progress.

After one week, I met Sister Anto at the convent; she’s the hospital administrator. She wanted me to come and look at aother child they’d admitted and was suffering from malnutrition.
“They don’t seem to have any money, at all,” she confided. “If you could help them through your centre - that would be great.”

I promised I’d go to see the child Monday morning.

Monday morning came and I met up with Judith at the hospital as she delivered milk to Matthew. She had brought her own little boy, 5 (almost 6) year-old Christenvie, with her. Alain came along, too. We soon found out that the child Sister Anto had asked us to visit had already left the hospital.

“They’ve done a runner,” she said. “They must have left during the night.”

We took the child’s name and address and set out to find where he lived. He was a little 3½ year-old boy called Mikile. He lived in a small village on the outskirts of Basankusu called Libanga, along the river. I’d never been there before, neither had Judith.

We took the Toyota Land Cruiser as far as we could through an area called Sampuka, which extends down to the river. After that the track was only passable on foot. The sun was high, and very hot, as we eventually came to Bolafa, a sleepy little hamlet next to the river. We asked directions and were told it was still quite a distance.

We left Bolafa and were soon in full forest. Christenvie walked ahead of Judith and I and showed no signs of tiring. With a wall of trees on either side and with just the occasional glimpse of the river to our left, I was reminded of the story of Hansel and Gretel. As we walked along I told the story to Christenvie … but replaced the characters with himself as Hansel and Gretel, and Judith as the parents. It seemed to go down well.

The path we were on was well maintained, with sticks standing up on each side as pegs to tie your canoe to. We realised that the river – at the moment very low – would come right up to this level, and only the path would be above water. After half an hour on this path, we came to a creek. Huge trees had been felled to form a sort of bridge, but the trees just lay as they’d fallen, so it was a matter of climbing along and over them to get to the other side without getting wet.

Eventually we saw small houses made from grey bricks, probably made from the clay along the riverside. We asked directions and came to Milike’s house.

“We’ve come to see the child who was in the hospital,” Judith announced. “We have a centre for feeding malnourished children and we’d like him to come along.”

“We buried him, yesterday,” said one woman sitting in front of one of the houses, a bubbling pot on the fire in front of her.

“But, really,” continued Judith, unperturbed, “we want to help. Bring him out so we can take him to our centre to feed him.”

Another woman appeared. “You are too late. The child is dead and we buried him yesterday. You won’t find him here now.”

They called the boy’s father, a young, quiet man. “We were at the hospital for four weeks,” he said. “They told us there was nothing else they could do and we came home. Then our little boy died.”

They brought out chairs and we sat down to talk. It was a very peaceful place. Only the sounds of nature. The people were gentle … quiet … and the houses well set out, with the area in front of each house clear and well swept. In Basankusu, people would call out to me and demand money – they played loud music and were generally more gregarious. The people here, of the Ngombe tribe, were calm, working hard at their crafts, and didn’t seem to treat me as different to anyone else there.
Judith told them about our centre for malnutrition and that they should tell others so people would know in time if any of their children should lose weight.

Milike’s father realised that we’d walked quite a way and was impressed that we’d made such an effort to help them.

“I’ll take you back by river,” he said. … and at that we made our way down to the river.
Travelling back by canoe I saw the beauty of the river, but siting in such a small canoe – on a little stool – felt precarious as each little wave wobbled the canoe from side to side. Milike’s dad stood tall at the stern of the boat with a one ended paddle, paddling slowly on one side – and then on the other. Other canoes – family members and friends – paddled alongside us. The river is very wide but we stayed fairly close to the riverbanks. My only worry was, that if we fell in, my camera would be damaged.

“Are you worried?” Judith mocked.

“I’m not worried,” I replied, “because I can swim. What about you? Who will save you if you fall in?”

“You will save me,” she replied.

“And who will save your little boy?” I asked.

“Alain will save him,” she said.

Sitting precariously in the canoe
Neither Alain nor Judith can swim. There are no life-jackets – but fortunately we didn’t fall in.
After about three-quarters of an hour we came to Sampuka, where we’d left the car. Judith really impressed me as we walked back – she stopped and asked people if there were any malnourished children; here and there a discrete word would lead her to a house and she would talk to the family about our centre.

“Your baby needs help,” she’d say.

“No, my baby’s fine.”

“I can see that your baby is very thin; come along to our centre and we can give him milk – don’t worry … it’s free.”

“I’ll think about it …” – and then we’d move off to another house.

(Three mothers came along to the centre the next week from Judith’s efforts.)

~ Part 3 ~ Basankusu: The story of little Matthew

After many days of visiting Matthew and his mother, and sometimes his father, at the hospital, our visiting Belgian eye-doctors arrived and installed themselves for two weeks at the same hospital. Matthew had been moved to a ward with ten beds in it, but with only a few other people sharing the room.

I visited them on a Friday and Matthew’s eyes continued to sparkle. By Monday morning, however, he’d gone downhill again.

“Where is Matthew’s dad?” I asked Chantelle. “He’s supposed to be preparing his solid food while we bring along milk powder.”

“He got some paid work,” she said, as if it wasn’t a problem to leave his sick child for a couple of days without food. I gave Chantelle money to buy something locally, so that he would have something more than the enriched milk we were sending.

The next morning, Tuesday, I arrived early to check on their progress. Chantelle said that she, herself, had become sick during the night and she had a fever. Matthew was staring at the ceiling, the cotton cloth he was wrapped in soaked in urine.

I knew then that I had to get Matthew away from his parents – they were not helping the situation in the least. I left the hospital and walked 4 km to our nutrition centre to talk with Judith.

“We’ll have to get them to agree to Matthew sleeping here,” said Judith. “If they sleep here at our centre – where I sleep – I’ll be able to see what they’re feeding Matthew, and make sure they don’t miss anymore mealtimes.”

Alain arrived, and so I sent Judith by taxi-bike, a form of transport made popular several years ago by visiting Ugandan peacekeepers, and Alain and I followed on foot. Half an hour later the three of us arrived back at the hospital. Chantelle lay on the bed next to her emaciated child.

“Come on”, I said, “Let’s go and find a change of scene. The hospital is not doing you any good, Chantelle. We can go to Mama Modeste’s house, which is near here, to wash Matthew’s clothes and have a chat about what we can do next.”

Chantelle agreed. Perhaps by now she was depressed. The people at the hospital said they’d treat her fever and put the costs on our bill. I leant over Matthew and picked him up. We emerged into harsh sunlight; I wrapped the faded, patterned cloth over his head. Because so many people were at the hospital to see the eye-doctors, a few more stalls than was usual had sprung up on the other side of the dirt track outside the simple hospital building. People turned to stare at me carrying this small frail child away from the hospital.

“Where are you going with one of ours?” they called out. I ignored them and continued on. With Matthew’s bony frame against me, I talked to him about where we were going, that his mother was coming along, too and that we’d have something nice to eat. Without saying anything in reply, he accepted my words and remained relaxed as I carried him across the empty plot opposite the hospital. After about six or seven minutes, we arrived at Mama Modeste’s house.

Modeste wasn’t there, but I was welcomed by other members of her family, and just after I got there Judith, Chantelle, Matthew’s dad, and Alain arrived, too. We were given a place to sit in their small house.

“You go home, Francis, and come back later,” said Judith, “We can do everything here.” She’d laughed at me earlier when I’d said that I would wash Matthew’s clothes myself because nobody seemed willing to help. She would arrange everything, she would wash his clothes and cook everyone something to eat.

I returned at half-one to find them all sitting together in Modeste’s house, waiting for the food to be served. Matthew’s faded cloths were hanging on a clothesline and already dry. The air was already sweeter and everyone seemed relaxed again.

Matthew’s dad spoke up. “I can see that I need to be at the hospital more and that Chantelle is finding things difficult. If you leave a little money with me each day, I will buy and cook Matthew’s solid food at the hospital. I will do it all – don’t worry.”
Chantelle with Matthew in the hospital

We all went back to the hospital feeling better about the situation.

As Matthew lay again in his hospital bed, I noticed he had a high temperature. The nurse confirmed it and said they would give him something to help.

Things were looking up – Matthew’s parents were starting to take more responsibility and we were all able to go home.

~ Part 4 ~ Basankusu: The story of little Matthew

The nutrition project continued to do well; several more children got to their target weight and were dismissed from the project. We would monitor them at home to make sure their parents continued to feed them properly.

Alain arrived at Mill Hill, early one morning, looking distressed.

“They’ve gone,” he said. “Matthew, Chantelle and Matthew’s dad – vanished.”

“Well they’ve done it before,” I replied, “but last time they said they’d been looking for traditional medicine and later on they returned.”

Alain went to find Chantelle’s family home – which is quite near to our feeding centre. He’d ask there to find out where they’d gone. Then, we’d have to persuade them to either go back to the hospital or install themselves at our centre.

It was the next day when Alain came to say he’d finally tracked them down. Matthew’s father had taken Matthew to his uncle’s house in the west of Basankusu. I jumped into our Toyota Land Cruiser and we set off to persuade them to come back, collecting Judith on the way. Basankusu’s so called roads are horribly eroded mud and sand tracks, with huge crevices and holes in them caused by heavy rain. Some show signs of gravelling and the severe erosion allows patches of brick paving from the Belgian era to be revealed here and there. They are, in essence, dirt tracks. I made my way cautiously along these roads.

The uncle’s house was nicely presented, with kiln-baked bricks and a corrugated metal roof.
“They’ve had money at some time,” I pondered, “I wonder why they find it so hard to care for someone in their own family.”

Neighbours across the dirt track stirred and then wandered over to our car. “You’re too late,” said one woman, “he’s already dead.”

We were stunned. All our work, all our encouragement, all our support ... for nothing. Why didn’t they ... ? Why did they ... ? Questions raced through my head, but the finality of death I knew was irreversible.

I decided to go into the house to give my condolences. There, in a small room, on the floor, was a bamboo bed, which is just a platform of thin bamboo sticks framed with larger bamboo sticks – a small form wrapped neatly in patterned colourful cloth lay at one end. It was Matthew’s lifeless body. The cloth cocooned his body, his face visible from the folded cloth. All the worry and pain, all the discomfort and fear – had gone, his face clear, relaxed, in death.

His father sat next to him – head in hands, grief-stricken. I laid my hand on his shoulder. “Please accept my condolences,” I said. He made a small movement with his head to acknowledge me and then I left.

 The uncle was waiting for me outside. “You have a car,” he said, “and their village is 20 km from here. You can carry them to their village for the burial.”

I’d made it clear on several occasions that I wouldn’t pay for funerals. It’s hard, but my work is for the living and – tragic though it was – I felt that Matthew’s death could have been prevented. On the other hand, he may have been too sick to have been saved from the beginning, and the blood transfusion had only, perhaps, given him a few extra weeks reprise before his ultimate demise. We’ll never know. Certainly, his parents had been overwhelmed by the commitment to keep him alive and felt a failure - as did we ourselves.

“This car isn’t in any condition to travel along that road,” I told him. “It really is not our responsibility to bury Matthew – it’s his family’s. However, I will give you a contribution to help with the costs.”

The uncle went with me back to Maison St Joseph, where I live, and I gave him just over $20, and his fare for a taxi-bike to take him home again.

It was more than a week later when Matthew’s father called by our house. He told me that his uncle had given him only $15 – he had apparently taken $5 for himself! Unfortunately, this type of thing happens frequently...

While he was there, Judith phoned. “We have just received another severely malnourished child who needs hospital treatment,” she said.

“I’m on my way,” I replied...

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