"Aiden's Story: Not 'Just Another Death'" -- by Meredith Bowen

The past few days have been some of the most joyous and the most painful of my life. And although the recent events are personal, and not work related, I have decided to share them anyway. I have decided to blog about the past few days with the hope that sharing will help me to heal.

Last Wednesday I received a call from a Tanzanian friend of mine in Arusha. He is a social worker and a village leader. People often seek him out for advice. A young couple had come to him in need of help. Both are HIV positive. Although they are not married, they are in a serious relationship. Despite their best efforts, they had become pregnant. Pregnancies are incredibly difficult on HIV positive women. In addition, this couple had no intentions of starting a family.

This is where I came in. I got the phone call asking if I would be interested in adopting their baby. As many of you know, I am planning to adopt in the coming year. So, I said that I would love to meet them and make sure that they fully understood what an adoption really meant.

I drove to Arusha and was informed that the mother – Stella – had been admitted to a local hospital with contractions. I went to the hospital and spoke with the couple. I had my Tanzanian lawyer join us and asses the situation. The couple was already incredibly informed and their decision was a conscious one.

I asked if she would be willing to transfer to another hospital in town – the “best” option - and undergo a c-section in order to reduce the risk of HIV transmission. She agreed.

I took her to this hospital’s “best” ob-gyn in Arusha and had her checked out. He said the contractions were Braxton Hicks and that he would do the c-section on Monday the 13th.

Unprepared for a newborn, I spent the weekend with friends shopping for supplies, thinking about names, celebrating the immanent arrival. I visited the mother each day and we spoke about the future of her little boy or girl.

Monday finally arrived. I drove to the hospital first thing and invited myself into the surgical room but missed the actual birth by a few minutes. It was a boy. He was born at 10am on Monday the 13th of October 2008. I named him Aiden.

Unfortunately, he came out covered in meconium. As all mothers know, that is the first stool after the baby is born. Releasing the meconium in utero is a sign of stress on the baby. He weighed 3.0kg – 6 ½ pounds – a great weight for an African baby born to a mother with HIV. The mother made it through the surgery well.

Everyone said that the baby was doing fine and that meconium is not a big deal. He was seen by Tanzanian doctors and nurses, as well as two American doctors who are doing a visiting rotation at this hospital.

The baby spent most of the day in an incubator – with oxygen – and iv antibiotics. Around 5pm I finally got to hold him. I never expected to adopt a new born. It was a blessing I thought was too rare a miracle. Holding him was one of the most joyous moments of my life – imagining our lives together.

But I had been coming down with a head cold all weekend and decided that I would return to where I had been staying with friends for the night – get some sleep and some cold meds – and head back to the hospital in the morning. I wasn’t going to be any good with a cold.

I returned to the hospital Tuesday morning. The baby’s father was waiting.

The baby had died.

The hospital form said that he died of respitory arrest at 6:40pm. Just moments after I left.

It was one of the saddest days of my life.

I have faith that I will survive this and that all of this was meant to happen - that one day I will realize why and for what purpose. In the mean time I am simply trying to breath.

In the midst of my grief, it has been incredibly obvious to me that had this baby been in the US he might have survived. There is no way to know for sure. But I am positive that the medical care in Arusha where we went was some of the worst I have ever seen. In addition to terrible facilities, the staff had nothing invested in their jobs. At 7pm when the baby died, there were NO doctors on the entire medical campus. They had all gone home for dinner. The nurses were basically useless. Even the morning I was told that the baby had died, no one seemed to care. Just another death. Just another expendable life.

We will never know what really happened, what was really wrong with Aiden, or what could have been done to save him.

I realize what a blessing it is to work here in Karatu with doctors and nurses who actually care and are properly trained. They are a rare commodity.

Please pray for Aiden. That he is resting comfortably with the angels.

Please pray for Aiden’s mother, Stella, that she fully recovers from the surgery and this tragedy.

Read Meredith's update on Stella's health on The African Orphan Education Fund blog.

Meredith Bowen is an Episcopal young adult living in Tanzania. She has volunteered in Tanzania with the Rift Valley Childrens Village (an orphanage) as well as with the Anglican Diocese of Mount Kilimanjaro and the Diocese of Tanga. Started the African Orphan Education Fund to award scholarships for secondary school and university.

"Self-determination, sustainability and learning the lessons of the past" -- by Reynolds Whalen

During my time abroad in East Africa, I had the unique opportunity to spend about a week with the Hadzabe people of Tanzania, some of the last truly nomadic hunter-gatherers on Earth. They spend much of their time harvesting yams and roots beneath trees, picking berries, harvesting honey, and pursuing wild game. Their impact on the environment is negligible and they live in amazing symbiotic relationships with nature that raise interesting questions about what it means to be human.

Let me give you an example.

One of the staple food items for the Hadzabe is honey that must be harvested from hives that dwell deep within tree branches. The hives are identifiable by a tiny tube protruding from the branch, visible only by a special bird that eats bees. When this bird discovers a hive, it begins calling out until one of the Hadzabe people follows the sound and uses an axe to split open the branch and grant access to the hive for the bird. After the bird has eaten the bees, the Hadzabe harvests the honey and a portion of the bee eggs, leaving enough for the hive to regenerate and start the process all over again. Pretty sustainable, if you ask me.

Unfortunately, the Tanzanian government has decided that living this way is “primitive” and “uncivilized”, and the Hadzabe people face real danger of losing their way of life. In many instances, the government has encouraged encroachment of Hadzabe land by pastoralists, who are losing their own land to the most “advanced” method of agriculture. While not all of the Hadzabe wish to maintain their current livelihoods, I firmly believe they should have the choice to continue doing so.

More importantly, I think that mandating specific land use for people who have lived in an area for hundreds or thousands of years is a terrible idea. Agriculture is simply not an effective use of land in parts of Africa.

While spending two weeks with the Maasai people at the base of Mt. Kilimanjaro, I saw this first hand. Pressure to privatize communal land has led many to lease plots for farming, overseen of course by various development programs and “experts” in agricultural production. The reality is that these tracks of land do not produce the volume or quality of crops to adequately compete in the cash economy transplanted by the West in the past century. In fact, many are struggling to survive and can only use an area for a few years before the land stops producing.

Of the hundreds of farmers we encountered, none had been on one track of land for more than five years, and few had even heard of such a situation.

In addition to the obvious degradation of converted land, agriculture has caused conflict in the area between pastoralists and farmers. This is by no means a unique situation. In fact, many of the current high profile conflicts on the continent have roots in land disputes caused by restructuring and reorganizing of land.

Consider Darfur. Most people in this arid region of Sudan have historically relied on grazing livestock and cultivating large tracks of land communally. In wet seasons, sufficient grazing land is relatively easy to come by, and pastoralists spread out over a large area. However, in the dry season, only a small percentage of land is fertile enough to provide nutrients for livestock, so everyone congregates and shares these few areas until the rains allow their dispersal once again.

When the World Bank and International Monetary Fund (IMF) introduced Structural Adjustment Programs (SAPs) in the 1970s and 80s, they provided important loans and development services that benefited many of those who received them. However, in order to receive many of these services, people were required to privatize land.

When you privatize land and introduce individual ownership, one family or group “owns” these crucial areas. When the dry season comes, or there is temporary drought or famine, conflict arises as other groups must use this land to survive. As this continues over time, these groups polarize and ethnic violence, now based largely on land ownership, becomes a major concern. Many scholars and experts on African culture and history recognize this as one primary reason certain groups are willing to join the government-sponsored militia force called “Janjaweed” and participate in attacks on villages in the region. This violence continues as I write this article.

Now, as we begin this millennium with a new development framework, we must pay close attention to the lessons of the past. When pursuing the MDGs and looking especially at Goal 1 to eradicate extreme poverty and hunger, we must be careful to pay close attention to the desires of those we seek to serve. We must continually analyze and dissect our own notions of “civilized” and “developed” so as not to repeat the mistakes of similar initiatives only thirty years ago. We should strive to be truly open to the ideas and rich knowledge of the people we are assisting and not presume to advance any agenda of our own, even one as seemingly simple as agricultural production, in an area of the world where we all have much to learn.

Reynolds Whalen is a 2008 graduate of Washington University in St. Louis and has traveled extensively in Kenya, Uganda, and Sudan. He spent fall semester 2006 in Kenya working with AIDS orphans -- read his blog on it here and has made a documentary film on that experience. He is currently raising funds to spend 2008-9 working in Rwanda for Millennium Congregation helping people in the villages of Rwanda tell their stories. You can give toward Reynolds work in Rwanda with Millennium Congregation here (be sure and put Millennium Congregation - Reynolds Whalen in the designation field)

"FAME and MDG adventure in Tanzania" -- by Meredith Bowen

I am about two weeks from embarking on a new MDG adventure and I would like to share it with the readers of this blog.

I have volunteered in Tanzania four times over the past four years, and in two weeks I will be heading back that way. I graduated from law school here in Ohio in May and took a job with The Foundation for African Medicine and Education (FAME) - located in Karatu, Tanzania.

Dr. Frank Artress and his wife, Susan, began their endeavors in Tanzania four years ago. Just this past spring, construction was finally completed on their out-patient clinic. Once funds are raised, an entire in-patient surgical wing will be built as well. This past May the cover of the San Francisco Chronicle carried an enormous story about Dr. Frank and his work.

Interest in FAME has exploded and potential volunteers are lining up! So, I will be heading up the Volunteer Program onsite.

I am incredibly excited about this new position and the work that awaits me. I will be blogging about my work there from my website - located on the "News" page.

Tanzania is one of the 10 poorest countries in the world and is among those with the highest rate of AIDS in the world. The leading medical concerns include AIDS, TB, malaria, pneumonia and dysentery. And with only one medical doctor for every 25,000 people, Tanzania faces one of the lowest doctor/patient ratios in the world.

I encourage you to take the time to read the San Fran Chronicle article - or check out FAME's website.

Stay tuned for stories from Tanzania!

Meredith Bowen is a recent graduate of the law school at Case Western Reserve University in Cleveland. In 2007, she spent the fall semester in Arusha, Tanzania doing an internship at the International Criminal Tribunal for Rwanda. Has volunteered in Tanzania with the Rift Valley Childrens Village (an orphanage) as well as with the Anglican Diocese of Mount Kilimanjaro and the Diocese of Tanga. Started the African Orphan Education Fund to award scholarships for secondary school and university.

"Death has a name" - by Martin McCann

On April 6th, we went with a beloved Msalato Theological College student, Ayubu Mazengo, to baptize his five-month old son, Martin Nyemo, named for me, the godfather. We meet Mollen, his mother, and the rest of the family in their village. Sandra preaches and does the baptism. It is a joyous occasion. Ayubu related to Sandra some of his dreams and hopes for Martin’s life. Martin looked just like his father, Ayubu, (Job in English) and is robust and healthy.

Click here to see a short slide show of little Martin's baptism.

Slightly over two months later on June 9th, I got a call from Sandra that Martin is very sick. After work I stopped at the local hospital to visit. He was getting IV medicine for malaria and was nursing. I was relieved and brought good news of his progress home to Sandra. No one could have been more surprised than me when the next day Sandra calls to say he had died in the morning. How fragile life is. We were devastated.

Sandra was asked to do the sermon for the funeral that day. We went back to Martin’s village that afternoon for the sermon and burial. Many faculty, students, and staff from Msalato went with us. The massive assemblage of people from the village was overwhelming. It was too much for words to describe, and we felt photos were not appropriate. Sandra’s sermon was as uplifting as one could be in such a situation.

Martin was wrapped in swaddling cloths and laid out on a kanga on the dirt floor of his home. For the funeral service, which took place on the grounds outside his home, his body was placed under a tree on a low table. After the service, we gathered at the gravesite a few hundred meters from Martin’s home. A priest friend of Ayubu jumped down into the grave and received the body, which he laid on the floor of the grave. Some men then handed down to this priest pre-cut tree branches that he wedged into the sides of the grave above the body. The result was what looked like a ladder lying flat above the body. A piece of a plastic feed sack was laid on this wooden lattice upon which were placed piles of beautiful green leafy branches followed by layers of deep red bougainvillea. (While this was happening, a priest leaned over to Sandra and said, This is the way we make our coffins.) Then the red earth was shoveled on top of the flowers after those around the grave had thrown in handfuls of dirt saying, Earth to earth, dust to dust, ashes to ashes. The gravediggers filled the grave to overflowing and meticulously molded and smoothed the heaved-up mound of dirt with sticks. Finally, they laid the handle of the shovel onto the molded earth and made the vertical and horizontal imprints of the cross in the red dirt. Men around the grave then gathered small stones and filled in the imprints producing a natural stone cross. At the close of the service- family and friends came and laid more bougainvillea on top. It was all very moving, very beautiful, and very sad.

The death of a child in the West is no less traumatic for the families involved, it is just so much less common. Worldwide there are 300-500 million new cases of malaria annually. It is the most deadly vector-borne illness, causing 3.5-5 million deaths annually. Many of these deaths are in children 1-4 years of age. It is estimated that in Africa a child dies of malaria every 30 seconds. Treated bednets are a priority of the World Health Organization’s program, Roll Back Malaria.

A fellow priest wrote to Sandra after hearing of Martin’s death: Guess we need to preach more about sleeping under mosquito nets and making sure that we destroy all breeding places than preaching about soul winning and going to heaven! A lot also needs to be done to reduce the delays and shortcomings in delivery of treatment. A major problem has been the emergence of Chloroquin resistance in Plasmodium falciparum (the major killer and commonest form of malaria in Africa). Millennium Development Goal #6 is to combat HIV/AIDS, malaria, and other diseases.

In our grief, Magi Griffin, the other Atlanta missionary in this diocese who had gone to Martin’s baptism with us, reminded us in a sweet note: Death has a name. Precious Martin. How easy it is for us to fall into the terrible trap of thinking that because death is so common here that it is not as traumatic for them as for us. Martin’s death has certainly brought this home to us. Although we have watched his family cope in a very heroic and stoic fashion, nevertheless we have witnessed the picture of deep grief etched in their faces; we have seen their silent tears; we have heard the quiet groans of grief that only a mother could make.

I have heard many people from abroad say: Death is different here. People just accept it. It is just a part of life. The latter is a true statement, but the fact that it is common does not in any way reduce the particularity or the pain. As Magi so aptly reminded us, Death has a name.

One of the hardest things to accept about Martin’s death is that we do not think that this would have happened in the West. Poor village families are late to get to a hospital because of distance, lack of transport and money. And even after getting to a hospital, we find ourselves wondering if treatment is appropriate and timely. I think most of the missionaries feel that if malaria were such a huge problem in the US or Europe that even if a cure or vaccine had not been discovered, we would have found ways to successfully control it. We are grateful for the NetsForLife program. We tell Martin’s story not only because it is the one we know but also in the hope that it will encourage you not to forget that it is individuals with names who are make up those overwhelming statistics which can make one’s eyes blur over.

Dr. Martin McCann set up a histopathology laboratory in the Mackay House Anglican Mission Clinic in the Diocese of Central Tanganyika. In addition, he is working as a consultant and teacher at the Mvumi Anglican Mission Hospital in the same diocese. He and his wife, the Rev. Dr. Sandra McCann, are living in Tanzania as appointed missionaries of The Episcopal Church. You can read more about their life and work at www.mccannmission.org.

"How Much is Enough" -- by Meredith Bowen

This past weekend I hosted a fundraising event in my home town - in order to raise awareness and funds for the orphanange in Tanzania where I have volunteered. At the beginning of the evening a gentleman approached me and asked "How much?" "Excuse me?" I replied. He wanted to know how much was "enough" - he had a check in his pocket, he had come prepared to donate - I appreciated that. However, I was thrown. I had never been asked how much before. And I have been fundraising for years now. I didn't have an answer for him. I suggested that maybe he come back to me later in the evening, give me some time to think it over.

Why was this such a difficult question? More important, why did it upset me that this man had asked? As the evening began to come to a close - having been bothered by this encounter all night - it came to me.

There is no answer. At least not one that I will ever give. The answer is personal. If I give an amount I have basically let that person "off the hook" of having to decide themselves.

At the end of the evening I spoke briefly about my love for the orphans that I had been so fortunate to love over these last four years. I was frank with the crowd, encouraging them to write checks to support this endeavor. And I said, "If you are wondering how much is enough, "enough" would be the amount that you hope the person sitting next to you will make their check out for, especially if these children were your children. Because they are all of ours."

Meredith Bowen is at law school at Case Western Reserve University in Cleveland, spending the fall semester in Arusha, Tanzania doing an internship at the International Criminal Tribunal for Rwanda. Has volunteered in Tanzania with the Rift Valley Childrens Village (an orphanage) as well as with the Anglican Diocese of Mount Kilimanjaro and the Diocese of Tanga. Started the African Orphan Education Fund to award scholarships for secondary school and university.