At night I often think of Frederick Douglass. Not because my children are light brown, like him. And not because of his lionesque grey hair, nor of his eloquent speeches that still ring true after a hundred a fifty years, but of his bed. On the second floor of his white house in Anacostia, across the river from the White House, in his small bedroom. Double in width, but not in length, only long enough for his legs. It was dark, stained mahogany, or some similar type of hard wood that is now endangered. In it, he slept sitting straight up, to avoid the bronchial ailments that took down so many of his peers in those days
I think about him because that is how I should sleep, to help my almost two year old girl with her bronchial issues. If I could muster the self-discipline, I would sleep as he did, sitting up, propping my girl against me, to keep her lungs clear, so she can breathe. Here was a man who taught himself to read, escaped from the South to freedom in the North, eventually got a job as an Ambassador to Haiti, and from time to time, conferenced with Lincoln about the benefits of abolishing slavery. He walked several miles each day between his house and the executive offices of the White House, and when it was time to rest, sat up the whole night with a straight back. I hope, also, that sometimes he got to relax, laid down sideways on his double bed, and had a truly restful night.
When I am lying awake at 3 am, my face a few inches from hers, I listen to her breath. How it sucks in too quickly. I wait for her to find her rhythm, but it doesnt come. I wonder at the human capacity to sleep, without breathing, to grow, with weak lungs, to eventually outrun ones own weaknesses. In the middle of the night, my anxiety roams freely throughout my city.
I think about all the other babies in my sub-Saharan capital city who are struggling to breathe. Kids who spend their days inhaling charcoal smoke, or burnt plastic bags releasing particles that stick in your throat. Or trucks spewing diesel fumes. In the rainy season, the charcoal brazier is inside, and for an hour or so while the nshima porridge cooks, the smoke from the fire fills up the familys room.
My daughter has a whole medicine chest filled with expensive, imported drugs to help her, sprinkles for the tongue that prevent bronchial spasms and thins the mucus, an inhaler to strengthen her lungs that makes her eyes shine with steroid-infused glee, and another pumper to open the lungs when they constrict, which I pump into her mouth when she gasps for breath at night. She has a special purple contraption that makes this easier, suspending the gas so that she can get it in, even if shes crying. If things are really bad, she will use a home nebulizer. I hold her on my lap, both arms in one of my hands, so she wont bat it away, firmly grip the nozzle to her nose, one of my fingers under her chin to keep her from turning her head. The nebulizer goes for five, ten minutes, and afterwards, she sleeps better.
Somewhere else in the city is a mother watching her child, like I am, who doesn’t have a variety of preventative pills and sprinkles and nose drops and gas-blowing devices. If my nights are this bad, I think, what is happening to them?
Douglass called it like he saw it. “There is no nation more steeped in hypocrisy than the United States.” To live as a Westerner in a developing country is to wade knee-deep through it. Past mothers who, like me, gave birth two months early to their babies; who, unlike me, didnt get med-evac-ed by plane to South Africa, where a state-of-the-art ICU awaited. My Zambian friend on the next block lost one of her pre-mature triplets in the local hospital on Easter weekend. Our babies were both born at seven months.
But parenthood has made me myopic and selfish. Yesterday, I called the pediatric infectious disease specialist, a patient man from Alabama whose job it is to care for thousands of HIV infected babies, and took him away from his much needier patients to pick his brain about my own, relatively thriving girl. I asked him about the interaction of Singulair and Beclazone, and if it was strange that every night, between 2 and 4 am, she wheezes like a galloping lion, struggling with narrow airways, nostrils flaring, a dip in her neck sucking in and out.
It will not be like this forever, he assured me, but it will take several months for the pneumonia, which she had last month, to fully leave her body.
When my girl and I are awake at night, when she is really struggling to breathe, I sometimes can’t help but go there, to what would it would be like to lose her, the worst fear a parent can have. How can anyone bear to continue living when that happens, I wonder, then I stop. It is unfathomable. Without giving it a second thought, I know that I would give my own life if it would spare hers. These are the middle of the night bargains we make, in the dark, when our babies are ill. I adjust her, propping her up on my shoulder, or elevate her on pillows, but when sleep takes over, for both of us, she finds her way back to her favorite position, flat on her stomach, sideways on the bed, making an H between my husband and I, blankets pushed to the side.
I didnt think about any of this when I made the decision to have children with a Zambian man and raise them in Zambia. I did not consider that my children would get sick and there would be few medical resources on which to draw. When I delivered my son in an antiquated local hospital, it hit me like a wave on the first day of his life: the worrying isnt over it begins now! A triple-hex: more incurable diseases to catch (and I haven’t even started on malaria), fewer doctors to go to, especially on the weekends, and no state of the art hospitals to fall back on if worse came to worse.
On most days, I am grateful to raise my children here, with its lemony sunshine, barefoot year round, the gentle graciousness of the people. My son and daughter have learned to greet everyone they meet, sure that the other person will be kind in return. But as soon as my children get sick, I wish I was back in America -with its doctors and hospitals. And when I manage to get decent medical care for my children, I am triumphant first, and filled with guilt right after. They are only available to me because I have personal connections to doctors from the West. In a word, Frederick, because I am the inverse of you, an American woman in an African country.