Worst Place in the World to be a Mother?

All year, we watched Mama Sada grow.

Or, to clarify, for nine months, we watched Mama Sada's belly grow.

"When is your baby coming?!" was the frequent question from the kids.  The adults whispered predictably, "That baby hasn't come yet?"  It seemed, as it always does at 40+ weeks, that Mama Sada had been pregnant forever.  She certainly felt like it.

Her baby had a mind of his own.  Firmly bum-first, then sideways, never simple. 

Sometime around her due date, I was called to come check her out.  The doctor had told her that the baby was transverse (sideways) and now she was having contractions and didn't know what to do.  I saw her and agreed that the baby's head was under her left rib, lounging cross-ways in a position that would make labor and delivery very difficult.  At this late date and with a uterus contracting wildly, it was doubtful that the baby was planning an easy exit.

Mama Sada works at Maggie's (another teacher) house, taking care of her little guy, Itamar.  Maggie was prepared to do anything necessary to help Mama Sada and her baby have a safe birth experience. Costs and transportation were covered.  We made a plan that Mama Sada should go back to the very reputable hospital where she had been receiving regular prenatal care and ask for a cesarean section.  (Previous attempts to turn her baby had been unsuccessful.)  


Maggie and I both asked Mama Sada if she wanted us to go along with her.  Her partner is not in the picture and she was going on this 'adventure' all by herself.  Between contractions, she laughed at our silly idea and kindly explained that our mundele presence would probably just make the hospital jack up the price.  We loaded her up in a car with a driver and wished her well, making her promise to call if she needed anything.

From this point on, Maggie gave me updates on the situation...which went on, and on, and on.  Instead of "We have a baby!," the next message I received was to say that the hospital had sent Mama Sada away, telling her to come back when she was "really in labor" and "then, we will do the cesarean section."  The baby was confirmed by ultrasound to be transverse.  Another attempt to turn the baby was unsuccessful.

Mama Sada spent the next 24 hours using various methods of public and private transport, hospital-hopping around Kinshasa, trying to find a doctor who would deliver her baby safely and soon.  Take a second to picture it:  a hugely pregnant woman, in early labor, hauling herself around Kinshasa in a series of crowded, ramshackle buses, desperately trying to buy herself and her baby a safe delivery.

The strange thing about Mama Sada's story is that she had been provided with the one thing that everyone says is the reason for poor maternity care in Kinshasa:  money.   From a recently published response to Save the Children's report: "The State of the World's Mothers" where Kinshasa is listed among the 10 worst places to be a mother:

In several interviews with medical workers in Kinshasa, they all cited poverty as the main trigger of maternal deaths. Three quarters of Congolese women who did not give birth in a health facility cited lack of funds to pay for services as the reason, according to a World Bank survey.
"In some places, when you arrive [for care] and you don't have money, they just transfer you and transfer you. That is part of the reason we have such a high rate of maternal mortality in our country," says Dr. Blandine Aveledi, reproductive health manager for the New York-based International Rescue Committee (IRC) in Kinshasa. "The greatest problem is access to finances."

Mama Sada was "transferred and transferred" even though she had money to pay for the operation she desired.   I was shocked by this.  I assumed that the one thing about an incredibly disorganized and broken health system is that money can buy you what you need, no questions asked.  Not so.

Eventually, a hospital did accept Mama Sada.  She was taken for a cesarean section, and in Maggie's words, "Even her C-section was brutal. They sliced her open right across the belly-button."  Baby Vainqueur (a.k.a. "Winner") was born, healthy, huge, and sideways on April 20th.

A typical hospital stay after a c-section in Kinshasa is five days.  And for this lengthy stay, even an well-run establishment doesn't offer free diaper bags, hospital-issue baby t-shirts, diapers, soap, or sanitary pads as many of us have experienced in American, South African, or European "labor & delivery suites".  Mama Sada was not even given pain medication, food, or hot water.  

L: Dr. Laure's clinic, Kinshasa, DRC  R: St. Francis Hospital, South Carolina, USA

 On her first visit, bags filled with baby supplies and food, Maggie found Mama Sada in so much discomfort, she could not care for her baby.  The hospital staff  was unhelpful and repeatedly asked why Maggie and not Mama Sada's "family" was caring for her.  Mama Sada's biological family is in Goma.  Her Kinshasa family is her eight year old son, Emmanuel, new baby Vainqueur, and those with whom she lives and works. 

I saw an article about desperate Greek maternity hospitals recently.  Apparently, the new revenue strategy for these institutions is that if the mother can't pay, the hospital keeps her baby until she can.  Shocking, right?  

That idea is old-school in Kinshasa.  Hospitals have been holding babies hostage in exchange for payment for a long time.  Maggie and Mama Sada both report that this hospital threatened to keep baby Vainqueur multiple times until they received payment - and payment well in excess of the "regular" fees.  In the end, it cost over $1000 for the hospital to release Mama Sada.  A "regular" patient price for a cesarean section in Kinshasa is around $250 - which is still a good month's salary.

Mama Sada brought Vainqueur to see me yesterday.  He's strong and bright-eyed at 5 weeks old.  Mama Sada is lively as ever, clucking concernedly over her baby.  We talked about all the normal, lovely things he is doing.  We marveled at his head control, discussed his bowels, and complimented his full head of hair.  I asked how he was nursing and we talked about the wonders of breastmilk.

But Mama Sada shudders when talking about the hospital.  And this is a shudder far beyond the painful memories of childbirth.  This is the memory of childbirth in Kinshasa.  "Oh, mama, it's terrible.  But it's over now. And look what I got." 

Guest Post: Swatting Mosquitoes? Sign Me Up!

It's Guest Post time again! Here's my lovely sister writing about the road ahead for 2012 graduates:

I’m not a Mama…thank goodness. And I don’t plan on being a Congo Mama. Especially after reading most of the stuff on this blog. But Sarah and Jill have asked me to write something, so here’s what I’m thinking about these days.

I graduated from college a mere 20 days ago and unlike most of my friends, I’m not looking for a job. Nope, not me. I was even interviewed by a radio station because I’m such a novelty.

I have my goals set on something more fascinating, more prestigious, and more sought-after. Living in one of those “Third World" countries. Or really, a “developing” country as the post-Cold War world has taught us to say.

Developing world.

Okay, so maybe it’s neither more prestigious nor more sought-after than a full time job complete with salary, benefits, and job security. But who wants that anyway? Well, most everyone I know.

Most of my friends think I’m one-of-a-kind. I’m the only one they know who is satisfied with a part time job (that’s relevant to my degree, I might add), who wants to go to graduate school in Africa, live there indefinitely and in the interim make my bridesmaids wear crazy pagne in my wedding.

(Don't worry, not the final product.)

The secret is, I’m not very original. My friends who have been in my life more than seven years (which coincidentally is the same amount of years Sarah has been MIA from the States) know this trajectory is more genetic than imaginative.

My part time job? Yep, Sarah did the same thing, at the same place, with the same job title. Grad school in Africa? Yep, Sarah went to the American University of Cairo. Live and work in Africa someday? Yep, Sarah’s clearly been there, done that. Have crazy looking bridesmaids dresses? Well, thankfully Sarah didn’t put me through that for her wedding, but the African fabric for my bridesmaids was definitely her idea.

Sarah & Charlotte

But the good news is, Sarah is pretty much the only person I know who has done those things. So while I may not be the first Sensa-something to move to Africa, it’s the last place most people want to go. So while everyone else is scurrying to find a full time job, I’m trying to find the fastest avenue to Africa. And there shouldn't be much competition, right?

Not so fast. While I wish I could just go on a travel visa, and then somehow magically turn that into a work visa, or a student visa, or any other kind of visa that will let me stay more than a month, that’s not the most realistic thing in the world.

So I’ve spent hundreds of hours applying for scholarships to work, study, and do research in Africa. I’ve even applied for the Fulbright Scholarship. If you've never ventured into the Fulbright process, don’t. It requires a full 9-month-long research proposal, three letters of recommendation, and an intense interview where Africana scholars poke holes in your research proposal. Oh and then I have to establish an affiliation with a university in Africa.

As it turns out, connecting with someone in Africa and convincing them to write a letter saying they’d be happy to host you for a year and cater to all your needs, isn’t so easy. Even though I check my email 27 times a day, it seems folks on the other side of the world don’t. Or they’re ignoring me. Who knows.

After months of staring at an empty in-box, I eventually found an awesome professor willing to write an affiliation letter. But he was two weeks late. Don’t worry, I convinced the Fulbright committee to extend the application deadline that was set over a year ago.

At the end of all this, I ask myself, why do I need to spend months and months trying to get to the one continent most don’t want to visit?

Because I’d still rather be in that proverbial “Third World” country facing weird diseases, apocalyptic downpours, and pet-sized insects, than applying for jobs in the States that I probably wouldn’t get, and sitting in a cubical for the rest of my life. And since most people I know are focusing on the latter, I’m still going to consider myself original. And hope someone else agrees enough to help me get there.

Anyone? Anyone?

Katie.

Cooking with the Mamas: Pili-Pili Sauce

Johan has always been on a quest for the perfect hot-sauce. (A clichéd goal, perhaps...) Something powerful, yet neutral.  Good on everything, from breakfast to dessert.

He was a Sriracha man for awhile, but it didn't pack the punch that he wanted.  He tried various boutique brands with names including the adjectives "atomic" or "blow-your-brains-out." But, they have always fallen short.

This is what he says he looks for:

"In a hot sauce, I want a lot of heat and a bit of flavor.  Just a couple drops should be enough to wake up the dish -- I shouldn't have to use it like a sauce just to get the heat, and I can't abide too much vinegar or sweetness".

(Sorry, but,  "I can't abide"?!)

Until Mama Vida came along.

The first week we were here, we had a life-changing chicken dinner at Mama Colonel's.  These incredible vinegar half-chickens came with mayo and pili-pili sauce on the side, for dipping.  Johan loved the chicken, but was possessed by the pili-pili.

Later, he picked up a bottle of Nando's brand, Peri-Peri Sauce, hoping to recreate the magic at home.  He was incredibly disappointed.  Seeing the bottle in the refrigerator, Mama Vida casually mentioned that she could make a hot sauce...if we wanted to try it.

She arrived the next day with this bag of beauties:

And Johan's life has never been the same.

He puts this stuff on everything.  Mama Vida can barely churn it out fast enough.  We've already devised a plan for next week's massive pili-pili making extravaganza...so he will make it through the summer vacation.

Like most perfect things, this sauce is incredibly simple.  Here goes it:

Carefully stem and de-seed (how many seeds you leave in determines the sauce's final heat) a whole bunch of extremely hot peppers.  Mama Vida doesn't wear gloves, but I might suggest that you do.  The peppers that she uses to make pili-pili look an awful lot like Scotch Bonnets to me...so we're talking very hot.

Place peppers in blender/food processor.

Pop in a few cloves of garlic.

Add 1 onion, chopped.

Then, whirl.

 At this point, you can do one of two things:  

1.) Leave it be as a lovely puree.  Add water if needed.  Douse all your food in this loveliness.

OR

2.) Cook the puree down, until the water is mostly gone.  Then, add a small amount of oil to achieve desired consistency.  This will make a longer-lasting, hotter, sauce.

Pack your sauce into a jar.  An old olive jar works just fine:

And prepare to be enlightened - or at least invigorated - at every meal.

10 Mama Fears Before Departure (real and imagined)

This morning I had my first cup of coffee on our porch (out of a daily average of 50) while Ani happily swung in her swing beside me. After she fell back asleep, I snuck inside to pour another cup when I heard Mamicho arrive.

As soon as she found Ani alone(!) on the porch I heard her say, "Anifa!" (No idea why she calls her this.) "Why are you out here alone?! Who left you here? Are you sick? Did they make you sleep here all night? Is this what they're going to do with you in the United States?!"

And then I was reminded of all the fears Mamicho and Mama Youyou have shared with us over the years before our Stateside departure. Here they are in no particular order:

1: Charlotte will return to Congo and immediately be terrified of everyone because there are only white people and no gens noirs aux États-unis.

Nope, no Congolese here.

  by  shoothead 

2: The girls will get bitten by mosquitoes on their faces right before we leave and everyone will think they're neglectful Mamas. (In reality, chances are this would happen on our watch, not theirs.)

3: I will forget to sort through my clothes and give them what I don't want anymore.

4: I will forget to sort through my shoes and give them what I don't want anymore.

5: Charlotte will be miserable because we live in an apartment building in the States and she won't have easy access to her favorite place, the outdoors. (Mamicho has since learned that we don't live in New York City, as most assume all Americans do. And has seen many pictures of our homes in the country. She feels a little better about Charlotte's access to grass this year.)

Yeah, pretty opposite of the Shenandoah Valley.

  by  Bert Kaufmann 

6: In Ani's attempts to start walking she will fall and bang her head and end up with a nasty bruise right before her return. (Most days her forehead is black and blue from this awful stage of learning to walk.) Therefore, Mama Youyou has vowed to carry her everywhere right before we go so this doesn't happen.

7: I will rely too much on the Ergo to carry them around and no one will carry them au dos avec pagne, the girls' preferred method.

8: Charlotte will try to speak French (or worse, Lingala) with other children, and they will think she is crazy.

9: Charlotte will have only me to speak French with her and she will return to Congo with my American accent or she will have totally forgotten everything. --Okay, I made this one up, but they're probably thinking it.

10: They will miss their "real" Mamas so desperately that they will pine away for Congo and have a miserable time. --I made this one up too, but I'm sure they're thinking it. And we'll just let them continue believing it because at least once a day Mama Youyou or Mamicho reminds me that two months is a really long time. "Deux mois? C'est un temps trop long, Mama."

Friday List!

JILL'S LIST:
  
I'm such a sucker for magazines.  I had high hopes for iPad glossies, but alas, Internet woes have prevented much of that fun.  However, during a burst of good bandwidth the other day, I was able to download two exquisite new magazines.  Both are travel-with-families oriented.  Both feature overly-expensive luggage and scented candles.  I can't get enough.  (via Design Mom)

And, as I have the luxury to write about magazines and prepare for vacation, things really heat up in the East . 
Jason Stearns writes:

 While the M23 rebellion is taking up most of the Congo news in Congolese and foreign press, a series of largely unconnected massacres has been taking a far larger human toll in the area of Bunyakiri and Ufamando. According to United Nations reports, over 200 civilians - and possibly many more - have been killed in tit-for-tat massacres between the Rwandan FDLR rebels and the Raia Mutomboki militias since the beginning of the year.

Photographer, Phil Moore, shows:

I'm considering options for replacing some of our circa-1970's U.S. Embassy issue furniture with stuff made out of shipping pallets. Seriously!  (When in need of furniture, we also love the items at Artisanat et Développement, of course!) I just had a big talk with our school maintenance manager, convincing him of the intense brilliance behind my plan (and enlisting his help).  He promised to scope out a place on Avenue de la Justice for pallet hookups.  He was semi-convinced when I showed him these pictures:

Interesting Congo-centric project.  Interviews with real people.  (As opposed to fake ones.)

SARAH'S LIST:

Part of the reason I like writing for this blog is how reckless I allow myself to be with punctuation. And I get to start almost every sentence with "and." I also put commas wherever the heck, I, want,. But here's a good piece on proper placement.

Today's Christmas for the Kimbanguistes. Remember the fascination with their orchestra after the 60 Minutes episode? They'll spend today parading all over town playing instruments and singing. It sounds like one non-stop marching band is passing outside all day.

Okay, so we've already seen this all over Facebook. But it makes a lot of sense to me. The #1 thing I notice as soon as the plane lands in the States is this fascination with phones. Adam and I left before the dawn of the smart phone and then never caught up. I use a Nokia that's so old, I couldn't even find a picture of it. So here's to being hands free!

A fun chart to figure out How Common Is Your Birthday. I'm assuming this is based on American births. I can't quite imagine other countries avoiding giving birth on July 4, Halloween and Christmas as much as we do.

  by  Aih. 

Babies Around the World. With a nice photo of a Congo Mama.

We've been blessed with fertility. Here's an article about that awful Two Week Wait for those who are not. With #2, there was no two week wait because we almost missed the entire first trimester...but that's another post about the idiocy of not knowing you're pregnant.

  by  euthman 

How to Take Photos of Newborns. And not look like Anne Geddes, bless her heart. There are actually some great ideas here. I just happen to live next door to everyone's favorite photographer, so I don't need to worry about these tips. But for the rest of you...

  by  Nina Matthews Photography 

And a final link for one of our favorite fans. You know who you are. Pretty much the only reason I would ever make myself read an article entitled: Pro-Wrestling, Senegal Style.

Guest Post: Mama Linda Saves the Day...and the LEGOs

I met my future cousin-in-law Ted the day before he and his family moved to Tanzania. He was 8. A few weeks ago he graduated from college. (But miraculously I've stayed the same age.) Here's the first in what we hope will be a series of guest posts about other mamas around the world. 

To Mama Linda!

When I was 8 years old, my family moved to Tanzania so my parents could work with Mennonite Central Committee (MCC) and Tanzanian artisans. The move brought many abrupt changes: in climate, in language, in culture. It also brought a new person into our household: Mama Linda. Mama Linda helped keep our house in order and cooked many meals, doing her best to satisfy two kids who'd long ago decided to evenly divide all edibles between them; I hated anything that my sister Justine liked and vice versa.

One of Mama Linda's more surprising culinary experiments was feta on pizza because we were out of other cheese. After returning to Tanzania a decade later, I realize we were lucky to have cheese of any kind; dairy products (other than milk straight from a cow) are rare indeed in Tanzania.

Mama Linda joined our life at the beginning of what I might call my contentious phase. Ornery, disrespectful, rebellious, whiny: all are adjectives that applied to me at that time. I wouldn't have dared yell at Mama Linda of course, but I remember telling my mom to tell her not to clean my room. That was also the age of LEGOs covering the floor, and I didn't want any little bricks accidentally swept away or any projects disrupted. I have a clear memory of Mama Linda looking incredulously at me, probably for this request. I think mostly she just chuckled.

Photo Credit: Jill Humphrey. Lego Credit: Eli.

My clearest memory of Mama Linda is actually pretty self-centered (as most memories are). In fifth grade, at age 10, I tripped while running down our hallway (to read The Fellowship of the Ring) and hit my head hard on my concrete doorway. Bleeding profusely, I screamed, and my mom immediately knew that I needed to see a doctor but my dad had our only car. Luckily, Mama Linda had called a taxi for her ride home and quickly shoved us into it. I remember a look of concern and her clucking noise.

My memories of Mama Linda are likely corrupted by the decade that's passed since I've seen her. She has been jumbled up, too, with my fresher memories of my (depending how you count) 3 or 4 host mothers on my Study Service Term in Tanzania last year. They all showed the same incredulity at anything I did, whether I succeeded or failed. I was a constant source of amusement for them, but in the way an infant is. I was completely reliant on those women, for food, drink, and shelter.

I owe those women a great debt of gratitude. Asanteni sana Mama Linda, Mama Michael, Mama Abel, Mama Albert, na Mama Johnson. Ninawashukuru sana!

Okay, am I the only one tearing up? Thanks, Ted! Really there are two universal truths: Little boys will tote their LEGOs all over the world and Mamas will always cluck at them. 

Anyone else have a Mama story to share? Let us know. 


You can read more about Ted at his excellent blog: http://gebani.blogspot.com
 

Merci! 10,000 times.

Thanks, everyone! (And by "everyone," I obviously mean our family members who we bribed to click on our link 10,000 times.)

We have surpassed 10,000 views on this blog.  Nice.  I think.  At least, it gives Sarah and me an excuse for a celebratory glass of Tembo.

Tchic, Mupwa, Mama Vida, Mama YouYou, Mama NouNou, & Mamicho will all be very impressed.  And maybe a little terrified.

To 10,000 more!

To Do List.

We leave Kinshasa for the Virginia summer in just a few short days. Two months Stateside.

So, I present you with my To Do List that has been developed based on a year living in Africa, having two kids, a cat, and plans to fill 8-10 trunks with stuff during a visit to the land of Target and Ikea.  I really like reading other people's To Do Lists.  Especially when clipped to a refrigerator door.  It's totally revealing, usually funny, and provides a fabulous snapshot of the ins and outs of daily life.

So, be entertained:

1.) Inventory remaining medications and medical supplies.  Make list of what to buy in bulk (Especially Ibuprofen & Cold Meds.  Local versions don't seem to work as well.  Is that for real, or just in my head?)

2.) Go to 30 Juin Pharmacy:  buy home malaria tests and Coartem cures for whole family.  Try to avoid becoming malarial right after stepping onto American soil.  Oh, the drama!

3.) Take stock of bug spray and sunscreen.  (Need to spend hours researching mosquito repellent again.  Even after 9 months of daily application, I can't decide which is best.)

The Continuum.  From L to R:  #1, #2, #3, #4

4.) Wash and maybe re-treat mosquito nets (right before we leave).  They are a sickly color of grey right now.

5.) Talk to NouNou, Mama Vida, & Mupwa about optional projects around the house while we're gone:

• Cleaning weird parts of the house that we don't normally care about (fan blades, screens, etc.).  
• Make sure both sewing machines are working.  Have them worked on if necessary.  Mama YouYou and Mama Vida will be sewing for extra money this summer.
• Talk to Mupwa about his big plan for "hunting down the cockroaches where they live during the day."  See what this is all about and if it involves loads of toxic chemicals.  Maybe do it anyway.
• Will they please take care of the cat?

 6.) Make list of books to buy in U.S.:

• New version of Lonely Planet "Healthy Travel Africa"
• Picture French Dictionary (give back stolen versions to neighbors).
• French kid's books.
• The newest "Where There Is No Doctor."

7.)  Make list of products to look at at the pharmacy in the Brussels Airport.  (This is mainly a self-indulgent activity.)