Gilbert and I went To Kitengela to pick up the lumber we needed to build our propagating shed. A wood frame 10′x15′x7′ which will be draped with shade mesh and used as a place to turn seeds into seedlings. It’s an election year — November 23 is the big day — and in addition to increased upheaval, you get lots of crowded trucks with crackling P.A. systems and overly enthusiastic (read — paid) supporters having a high time.

We ran into this two vehicle parade raising a ruckus on the edge of Masai land.

We put our very modest carpentry skills to work sawing

and hammering

and toting and balancing

until early evening.

I drove home and met Joyce on the road.

She took me to her house. It’s always pretty dark inside, and I could barely make out someone lying on the bed, moaning. I thought it was an old woman, sick, probably malaria. I was mostly wrong. It was a woman, and she was moaning, but she was very young and only sick if labor is a disease.

Gilbert came up from the property and helped put the pieces together.
Her name was Mbini, sixteen or seventeen years old, who had left school, she was only in the sixth grade, when she became pregnant and had come to Joyce’s, her aunt, to have her baby. (Her only being in Standard 6, was, no doubt a function of lack of money for school fees, not ability). Her water had broken some time ago and she wasn’t making any progress toward delivery. It was her first baby and Joyce was increasingly concerned about her, and really, the baby. Joyce doesn’t speak any English. She pronounces my name “deaf-id.”
“Deaf-id.” She looked right at me, “Deaf-id.” I am simply no match for Joyce. Having very little idea what exactly I was going to do, I coaxed the pick-up up the path to Joyce’s shack and signed on. Mbini couldn’t move much and couldn’t sit at all. Joyce made a bed in the back of the truck.

and we gingerly hoisted Mbini in.

and got her settled.

We decided on the Athi River Health Centre, which I had never heard of, about ten kilometers away. The Mombasa Road which I normally take to Athi River is being rebuilt, piece by piece, and now it is this particular piece, between Daystar and Athi Rver. The two diversions(detours) are two or three kilometers each and are the worst “roads” I have ever driven on. Picture softball to football sized rocks, but jagged, upright, embedded roughly next to each other, in dirt so hard you could break a shovel on it. Then add an unbroken string of huge trucks, buses, matatus and cars all scrambling over this mess in a big hurry. Blind curves, nothing like lanes, and dust everywhere, always. It is madness.

I knew Mbini would never make this, so I tip-toed over a dirt double track through the bush for five kilometers to a bad, but better-than-the-diversion road along the Stony Athi river, and then the side way to the town. It was dark when we finally got there.

The guard opened the gate. It was pretty clear what we needed. He told me there was no doctor, as though we should go away. I said get one.

We waited.

About twenty minutes later a young man walked through the gate and across the compound. He had just attended to a Muslim farmer who had attempted to prohibit two Masai guys from grazing their cattle on his land. They whacked him on the head with a panga (machete) and pretty soon his clothes were as red as theirs, but, the young doc told us, he was going to be ok.We got this report along with the one that they don’t take first deliveries here, or the sixth or higher. Two through five — ok, fine. The doctor was a good guy, but there was nothing for it. The place looked more like a deserted grammar school than a clinic, so I figured we might do better. We reloaded. I don’t drive out here after dark. It’s a useful and prudent rule, but here we were bumping along with Mbini in the back with Joyce attending to her and Gilbert and I up front trying to find out where the other clinic was.

The response you get from Kenyans you ask directions of is inversely proportional to their actual knowledge. The less certain they are, the more detailed and lengthy the answer. They never say they don’t know. You might as well be in Italy. We crept through the crowded dirt streets asking every few minutes and getting nowhere. We finally bumped into it by sheer accident and Gilbert went in. I had to stay put. The sight of a mzungu sends the fees skyrocketing.

Gilbert came out. Nothing. No first deliveries. I barely overcame my impulse to go inside, grab someone important looking, drag them outside and tell them they were welcome to go back inside just as soon as they were ready to take Mbini with them. Instead we headed for the next town, Kitengela, where Gilbert and I started the day, and a health center that Joyce thought she knew was there. Kitengela is crowded, dusty, and has a wild west feel, like a gold rush town
without the gold, or the misguided hope of opportunity, but a similar sense of lawlessness. If we had little idea where to go in Athi River, we had no idea here. Only the notion that there was a place, here…somewhere.

When it gets dark in Africa, it stays dark. No street lights, most homes with no electricity. We drove down streets with people gathered around fires, small shop/shacks barely lit by the dark orange glow of a single kerosene lamp. We actually found a sign and headed down a wide dirt road. Joyce told us to turn left, onto a much narrower, rougher dirt road. Squeezing past houses and shops, trying to navigate tire-eating potholes, people everywhere, and often only a couple feet of clearance on each side. I’m not sure I’ve ever seen another mzungu in Kitengela. We were a big draw. Here we asked directions every fifty meters or so, literally at every turn. And we had plenty of direction options to choose from. We were now nearly two hours in the truck. Frustrating for us, and what for Mbini? Unflappable Joyce was, I could tell, flapping a little inside. After a particularly unimaginable stretch of road, we found a sign, and this time, for the good of all, it was attached to the place. The guard opened the gate. Mbini and Joyce and I stayed in the truck. Gilbert went to arrange things. He came back with the news. I’m sure you have no trouble filling in the blanks. No first deliveries.

I did about ten seconds of deep breathing, “harm-no-thing” meditation, then headed in. I met Beatrice. A very nice young nurse, but firm. To round out the picture here, this was a very rudimentary “clinic.” There was no doctor here. First deliveries are often problematic here,
as Mbini’s was proving to be. Most very young women have had little or no prenatal care, so everyone is flying blind. And these places are simply not set up to deal with complications. They had no vehicle there, private or governmental to take her to a hospital if it came to
that. They had nothing to help induce labor, like pitosin or prostaglandin. And if Mbini’s labor continued to delay with her water already broken, they would be without recourse to help her, and if something went really wrong they would be in the soup. It might be helpful to think in terms of a day clinic, better for distributing malaria drugs and suturing wounds, etc. than dealing with complicated deliveries.

I talked and talked to Beatrice. A sweet, firm, No. Finally I told her that it was here or Joyce’s shack where Mbini came to have her baby, that her water had broken about twelve hours ago or so, and asked her where she thought Mbini and her baby had a better chance. “It’s here or Joyce’s,” I told her. “You can just bring her in,” she said.

I gave her my mobile number and told her she could call me if anything went wrong. That I would take her where she needed to go, if need be, but that this was our last hope for tonight. We brought her in. Beatrice examined her and said her labor was just starting. Mbini must have held a very different view.

Joyce and Gilbert and I were waiting outside and feeling much relieved. I took a self portrait of Joyce and I waiting outside the exam room.

Joyce wanted me to take a picture of her feet.

And then wanted a foot duet shot.

After Mbini and Joyce got settled and I assured Beatrice again, Gilbert and I headed our dark way home.

I’ll do my best to finish the account of Mbini’s story and get it posted tomorrow. I have to wrap up here for now.

David

Posted on October 21st, 2007 by david
Filed under: David's Journal