Visiting Miriam

It was 10:30AM before Susan, an American nurse, was ready for the home visit. She put on her headtie, and we were off, led by two Nigerian women, Theresa and Ladi. We crossed the street from the hospital gate - which is in itself an ordeal - and hailed a taxi. (In other words, Ladi stuck her head into a parked car and asked the driver if he'd take us where we wanted to go. He agreed.) So we all four piled in and were on our way.

We didn't travel far, but too far to walk. When the asphalt road ended, the taxi driver turned around and refused to go any further. We all scrambled out and started the short trek. Susan greeted everyone we passed, especially the children: "Yara, sannu ku!" The kids were all delighted and happily answered the greeting. Goats wandered across our path, bleating mournfully.

Ladi took us to the house of a woman named Miriam (not her real name). Miriam's aunt met us at the door and welcomed us warmly. She ushered us into a bedroom and sat us on stools and the floor. Only after I sat did I notice Miriam, an emaciated woman lying across the lap of her mother. Everyone around me broke into Hausa, and I lost the conversation.

Hollow eyes. I now understand the term. Miriam - who could not have been more than thirty - was a human scarecrow, so weak she could not speak or lift a finger. Her arms and legs were just skin stretched over bone, her face drawn and pale, the eyes of a wraith. When Susan gave her a sip of water, Miriam could not swallow it. Instead, it came out her nose and dribbled out of her mouth. Susan explained to the mother that Miriam should be turned every few hours to prevent her getting bedsores.

Theresa quietly told me some of Miriam's background: Miriam was divorced with two children. Her brother and sister-in-law had recently died of AIDS, and their mother was now taking care of all the children. Miriam's aunt showed us a recent photo of Miriam and her mother, and I gasped. The woman pictured had long hair and a full figure - and a smile. There was almost no resemblance to the woman lying before me. Theresa told me that Miriam, who'd tested HIV+ only six months earlier, had come to the hospital a month before our visit with fever and vomiting. The doctor discharged her after two weeks on admission. (Because they could no longer afford it? I wondered.) Theresa was shocked at how quickly Miriam had deteriorated in the two weeks since her discharge.

All the women in the house covered their heads, and Ladi prayed for Miriam in Hausa. Afterward, we sang to Miriam, first in Hausa, then in English. I tried to pick it up as we sang: "I will go with Jesus, wherever he leads. The road will not be easy, but I will go with Jesus, wherever he leads." Miriam's lips moved as we began the song, but only slightly and briefly as her strength failed.

Susan gave a few last medical suggestions, and we got up. In the next room, Susan told Miriam's relatives she would die in the next few days, so they should encourage her and remind her that Jesus was with her. Miriam's mother and aunt walked us out and down the road a little ways. Finally, we bade goodbye and God bless you to the women, and went on our way.

"She may not even live through the night," Susan said, "and we cannot save her life with medicine. But at least we know we talked to her and encouraged her not to be afraid of death because she dies with Jesus." She was right; I knew it in my head. But my heart didn't understand. We walked along the dirt road, and I was silent.

When we returned home, I expressed myself to Susan, who told me something another missionary had said to encourage her:

"I would rather love deeply and become scarred when my loved ones die, than not love at all and go through life unmarked. I don't want to live a safe life. I want to step out and love people, even when it hurts."

After Susan left, I tried to write in my journal about our visit with Miriam, but I found I could not.

A few days later, I heard that Miriam died that same day, only eight hours after we were there. I wasn't surprised. In this place I have often seen death, and Miriam was not far from it when I saw her. Susan was right: There was nothing we could have done to save Miriam's life. But we were hardly helpless. We did what we could to ensure that Miriam would die in Jesus' arms. Sometimes that's all we can do.

Drawing Close to Goodbye

I just got here two weeks ago, and I'm already saying goodbye. I'm a missionary kid and a pilgrim. I learned to say goodbye almost before I learned hello. You would think it gets easier.

It doesn't.

Four of my doctor friends are moving away this week, and I'm already starting to say goodbye to them. This afternoon I attended a "send-forth" for the doctor friend I've known the longest (pictured with me above). I was only there a half hour, and yet it was still a struggle not to cry. The rest of the week will mean saying goodbye to the others - not just a spoken farewell, but the unspoken: realising this is the last time I'll go on rounds with Dr. So-and-so, the last time I'll be on call with Dr. Such-and-such, the last time I'll hear them laugh. The Last.

No, saying goodbye doesn't get easier. At least, with the assurance of heaven, it's only goodbye for a little while...Thank God for that.

John Mark

It all happened so fast. Monday night we received a call to see if we could foster an HIV baby, and by Wednesday, he was gone.

Gone home, that is.

I met John Mark in the Special Care Baby Unit (SCBU) of the hospital on Tuesday morning. He seemed simply huge (at 2 kg - about 4-1/2 lbs) compared to the babies in the other incubators. And he slept peacefully, healthy and quiet. I fell in love with him, as I'd fallen in love with all of the other babies in the room, including the one who was only 800 g (1 lb, 12 oz) at birth. He didn't have a name, and the nurses refused to give him a temporary name since they thought he would be confused when he got a real name later on. I laughed at this and called him John Mark.

John Mark's mother was HIV-positive, and so he would be taken care of by a local Christian organization that works with those affected by HIV/AIDS. A representative showed up on Wednesday to pick him up and take him home. John Mark's mother wanted to pray for her son before she gave him up, so we all waited outside and chatted.

At last, the chaplain, Justina, emerged from the SCBU and told us that the mother couldn't give up the baby.

So John Mark went home with his mother. My heart broke. I know that in general, the best place for a baby is with his mother. And that is probably what was best for John Mark. But... what will happen to him when his mother dies of AIDS in a few years? Will his extended family care for him or abandon him? Will his mother give him the drugs he needs in order to conquer HIV? Will she agree to give him formula instead of breastfeeding? If we're to be honest, what are his chances of survival?

I can't answer any of these questions. And I never will be able to. John Mark will change names and likely be passed from home to home, heart to heart. But I won't forget John Mark. And I pray he will live an abundant life.

What am I doing here?

What am I doing here? Ha. Sometimes I wonder that myself. Here I am, a young geek with aspirations of becoming a doctor, in Africa in the rainy season. Actually, it's home. I grew up here. But this time I'm back to do my own work.

I'm here in Jos working with an HIV/AIDS ministry... I hope. So far, there hasn't been much to do, but I'm keeping a look-out. I'm just learning in any case. I'll sit in on some counseling sessions, visit clients and patients who are HIV+, ask questions, and write about it all.

There may also be some writing about being at the hospital where my dad is a paediatrician. I just can't help myself: the hospital is my second home. But I'll try to keep my focus on the ministry.

I'm here until August 2006. Who knows what can happen between now and then? I guarantee I'll be excited and depressed - some days probably at the same time. But come along for the trek, and I promise it won't be boring!

A Path Through Tall Grass

Here I am in Jos, Nigeria, once again - at home. And this marks the beginning of a new journey, a path through tall grass. Here in Africa, we're taught to watch out for the tall grass, for that's where the snakes live. And it's true. But sometimes you have to go straight through the tall grass to reach your destination. You may have a machete to clear the grass; you may not. But you have to get through. Beware the snakes!

AIDS is real in Africa. Oh, I know it's real in the rest of the world, but here... Here you can talk to anyone on the street, any single random person you like, and he will tell you someone he knows who's died of AIDS. It's that simple. No one is left unaffected.

Here, I walk through tall grass. I spend time surrounded by needy, hurting people, people living with HIV, people dying of AIDS. I have just begun to clear my path because I know, gosh darn it, there is something - something - for me deep inside the jungle. I'm not sure what yet, but my heart and soul tell me I need to push through the grass. I know that death lurks in this tall grass, preparing to strike. And I have no machete to clear the way.

But I have faith.

And I will make a path, if it means trampling through like an elephant, snakes or no snakes. I have been brought here for a reason. I need to know what that reason is. And in the meantime, I must throw caution to the wind and plunge straight into the grass, embracing those most in need of God's love.

I am terrified.

...And did I mention I hate snakes?

But here I am, in Jos, Nigeria, and my path begins here. So help me, God.