Tewane is a very small village, and as the driver of the ambulance joked to me, it's not much more than a settled cattle post. There is a clinic there, but it falls under my clinic's ultimate responsibility. Despite their size, however, they have a team in the tournament, and they were well prepared to host us. We arrived at about 9am, and already the staff was hard at work cooking and setting up for the event. We were served tea and peanut butter and jelly sandwiches. Note that those are two different types of sandwiches here- peanut butter sandwiches and jelly sandwiches. I was laughed at when I suggested putting them together. I didn't get to eat anything though, because I waited for everyone else to go first, and then was called by my counterpart to head over to the field to help set up before it was my turn. I wasn't too upset though. Tea isn't really my thing, and 9am is a little early for peanut butter sandwiches, anyway.
If I hadn't realized before what a big event the Mosadi Mogolo World Cup is before, I sure know it now. Chairs were set up for the spectators, the field was marked, and a DJ was hired to provide traditional music. By 10:30am, the tournament finally began. While the other two teams played the first soccer match, my team was the first to go through the quiz portion. The entire quiz was in Setswana, so I really don't know any of the specifics, but I do know that the questions were about HIV/AIDS transmission and the PMTCT program, that it involved a demonstration of proper formula feeding technique, and that while my team did the best they could, they definitely struggled. I believe stage fright was their excuse. The questioning took a lot longer than I thought it would, and I was nearly as relieved as my team when it was over. We watched the rest of the first game together, and then it was our turn to play. As I mentioned before, I am not quite a Mosadi Mogolo yet, so I wasn't allowed to play. Eleven of our players went out with bright green jerseys and played their hearts out. They did well despite their lack of practice and some injuries, but it wasn't enough to defeat the other teams. I, on the other hand, was fighting a small battle of my own. The day was bright and sunny, and I had realized early on that I had forgotten sunscreen. I stayed in the shade as much as possible, but between the sun and the lack of food early in the day, I had set myself up for a long day. I ate some peanuts and raisins at the start of the first game, but I knew it wasn't enough. When halftime came around, I ate an orange, just like the rest of the players. Halfway through the orange, however, I realized that the thought of one more bite made my stomach twist, and that if I didn't find a seat somewhere fast, I was going to end up on the ground. Finding no available chair, I squatted in the dirt and put my head down, and stayed like that for quite some time, willing my food to stay in my stomach and my dizziness to subside long enough for me to stand up. Eventually one of the women on the team noticed me and offered her chair, where I stayed for the rest of the two games. By the end of of the final game, I was feeling slightly better, especially because I thought that the end of the games meant that I would soon be at home. I was wrong, as usual. We stayed to help pack up, and then we all made our way over to the community center where we were served traditional Setswana food for dinner. I choked some down, and waited, feeling guilty for not mixing in with everyone else and getting the most out of the experience. Finally, it was time to go. The ambulance brought us back to the clinic, and I walked home, feeling better and better as I got closer and closer to my bed.
Sadly, my bed would have to wait a while longer. On my family compound, there are four houses- mine, my landlord's, some lady's, and one very tiny shack occupied by a young Zimbabwean couple with a brand new baby. The new mother, Shana, is a patient at my clinic as well as my neighbor, so I'd been following her case pretty closely. She came into the clinic on Monday with some bleeding, and we sent her to the hospital, sure that they would deliver the baby by the end of the day. Instead, she stayed in the hospital, and didn't deliver until they finally did a c-section on Wednesday night. By Friday, she and the baby were home. This is Shana's first baby, and she is here in Botswana without a mother, sister, or an aunt to help her out, so I was sure to check on her on Friday and Saturday, and helped with washing the baby and answering some basic questions. She was doing pretty well, so I almost didn't check on them after the MosadiMogolo match. I was feeling sunsick and tired, it was already dark, and everything seemed to be going okay for them. However, I had promised that I would check on them when I got home, so I knocked on the door. The father, Wilton, was watching television, and Shana was lying on the bed next to the baby. “She's feeling a little warm today,” Shana told me casually when I asked how the baby was doing. The one room cement house was sweltering even in the chilly winter evening, so I wasn't surprised. Then she added that the baby hadn't been feeding well, a very alarming sign in a newborn. I unpeeled the layers of blankets to find a flushed, sleeping baby. Leaving all the blankets off, I ran to my house and dug through my Peace Corps health kit to find a disposable thermometer. I ran back and stuck it under the baby's arm, and made awkward conversation as we waited for the result. The minute passed, and I took the reading-102F. I'm not a doctor, but even I knew that was too high- it would be a high fever for me, let alone a 3-day old newborn. I texted my own mom as well as the head nurse at my clinic, who both confirmed that the baby would need to see a doctor as soon as possible. Not knowing how to go about this on a Sunday night in Botswana, I knocked on the door of my landlady, who is also a nurse in my district. She was horrified that the baby had been home all day with such a high fever and that she hadn't known about it, and after scolding the parents, she quickly arranged for transport to the hospital. Before I knew what was happening, I was in the car holding the baby in one arm and comforting the now frightened and sobbing new mother with the other. Bed was a distant dream. Fear is contagious, and I spent the car ride anxiously monitoring the baby's breathing and looking for signs of febrile seizure. We pulled up in front of the emergency entrance, and the three of us entered with no idea of what to do or where to go. I looked to the parents for direction, but they were looking to me in the same way. Finally someone told Wilton where he had to go to handle paying and checking in, while Shana and I were pointed in the general direction of the emergency room. In the emergency department, there was no receptionist at the desk. Every bench in the waiting room was full, mostly occupied by tired mothers and small children with dull, glassy eyes wrapped in blankets. It was obviously a busy night, but no one seemed rushed, and the bright lights and beeping machines and general atmosphere of chaos and slight panic found in any ER in the US was definitely missing. Instead, the room was dim and quiet, and the atmosphere was subdued, with an air of impatient resignation. Someone mercifully made room for Shana to sit down, since she was still recovering from her c-section, but I stood holding the baby while we waited, fighting hard to push away the dizziness and nausea I had been feeling earlier. We waited and waited, and Wilton came back, and we waited some more. No one seemed to be moving, so Wilton took the baby while I ventured into the actual emergency room to investigate. A man with a chunk of his leg missing was calmly rolled in past me on a stretcher, and two nurses sat at a small desk evaluating a patient. Upon questioning them, I learned that the hospital only keeps one doctor on duty in the emergency department after 4:30pm, and they were waiting for him to return from a call. This seemed an unacceptable and ridiculous policy to me, but there was nothing to be done about it. Eventually I cornered a nurse and explained our story, and she was able to give the baby some medication to keep the fever down while we waited. Shortly after that, we pushed our way into the consultation room regardless of whether it was our turn or not, and had the baby evaluated. The fever had barely budged, and the nurse decided (surprise, surprise) that the baby would have to see a doctor. They situated Shana and the baby with a bed. No one had any idea when the doctor would be coming back, and it looked like it would be a long night. I was prepared to settle in for the long haul, but Wilton made arrangements for someone to pick us up and bring us home for the night, while Shana would stay with the baby. I didn't like this arrangement one bit, since it would mean leaving them alone, but the point was made that if they were admitted at 2am, I would have no way to get home, so I reluctantly agreed. I left Shana with strict instructions to text me with any news or developments, and met our ride outside and went home at around 10pm. Finally faced with the opportunity to sleep, I was no longer tired. Actually, that's not accurate at all. I was exhausted beyond the point of sleep. I texted the nurse at my clinic and my landlady to let them know how the baby was doing, and spoke to my mom on the phone to debrief the evening's events. I took some medicine for the headache my fatigue had burst into, made myself something to eat, and wandered around the house aimlessly. Eventually, Shana texted me to let me know that they had been seen by the doctor and been admitted overnight, and I was able to settle down and head off to sleep.
The next morning, I arrived at work hours late, having beaten my alarm clock into submission when it rang at 7am. Everyone was very nice about it, and I ended up sitting in a room with our community health educator and our community mobilizer chatting about recent events. They were concerned about the baby of course, but they had more news for me: Eva had passed away over the weekend. I was saddened, especially thinking about her family, but not surprised. We were supposed to go for a follow up home visit the week before, but when it was time to go, we were informed that she had been admitted to the hospital. She was so weak and so sick that I couldn't help but feel a little relief for her, knowing that she's beyond suffering now. I didn't know her personally, not enough to truly mourn, but she will always be with me. She was the first AIDS patient I ever met, and she will live on as my motivation for working to prevent suffering like hers.
I knew when I was assigned with work in Botswana as a health volunteer specializing in HIV/AIDS that I would see all the comings and goings of life, births as well as deaths, but there is no way to understand what that really means until you really experience it. I am still at the beginning of my service, and I still don't fully understand it, but I am beginning to see that I will not be able to observe these events as an detached bystander. I have been here at site for less than two months and I am already tangled up and involved beyond my expectations, and I wouldn't have it any other way.
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