Simple Joy

The world is an incredible place to be in . . . I feel alive and happy, so I decided this would be a good moment to write an entry. Clement and I just returned from our friends' house in Natenji, a green 20km South of Lilongwe. Malawi is stunningly beautiful at the moment. The hills and distant mountains transformed from barren brown to lush green with the attentive care of the rains. The maize grows thick and tall in the fields and they say this year there will be a record harvest, maybe enough to feed the entire population (usually in a good year 25% of the population faces food insecurity, this year it was closer to 80%).

Our friends are lovely. I am constantly in awe of and grateful for the people who color my life. Patricio is Chilean and works on wildlife conservation projects. Dominique, his Belgian/Congolese wife, is a nurse who now works with health outreach projects. They are a beautiful couple on multiple levels. Dominique is 7 months pregnant and they have asked me to attend their birth. It is a huge honor and will be the first birth of a friend that I will attend as a midwife.

We spent the afternoon leisurely eating a delicious meal and discussing the pieces of Malawi we love. Here is a smattering from our list: the calmness of the people, the peacefulness of the country, the beauty of the land, the beautiful women and adorable kids. Dominique and Patricio live near a village and they talked about the laughter and song of the women lilting into their yard. Patricio said, "the women here are incredible, they get up at 4am, cook, carry water, work in the fields, clean, tend their families, and then in the evening they sing. Sometimes I just want to shake them and tell them to please rest." Dominique talked about the dancing, how health messages are learned as songs and dances, and then shared by women volunteers with people in their communities. She noted that everyone, young and old, is happy to participate; everyone is equally willing to get up in front of a group and dance with the simple joy of movement and without a grain of self-consciousness.

Of course for me, many of the good moments are also birth related. I had a couple sweet birth moments recently. . .

(1) About a week ago there was one woman who was having a particularly difficult birth. Birth is painful for most women but a few women truly suffer with their labor beyond what others experience. This woman cried for hours, often calling for the nurses who could do little to comfort her; incessantly changing positions to try and find relief. I was with her when she finally delivered. At the first cry of the baby, the laboring women occupying the bed next to her let out a laugh of pure glee and began clapping.

I cleaned the woman, told her she had a boy, and arranged her and her little boy in the bed. A few minutes later the maid shouted her name from the doorway. (The patients' caretakers wait outside and will occasionally ask the maids to find out if their relative has delivered.)
She responded, "INE!" (I am).
"MWACHIRA?" (Have you delivered?)
"EI!" (Yes)
"WACHIANI?" (what is it?)
She clutched her baby happily but looked at me, completely exhausted and confused "Wachiani?"
Her neighbor, who witnessed the whole thing, laughed again between her own contractions.
"Mwamuna," I said.
"MWAMUNA!"

(2) There was a really sweet girl who came into the labor ward at the beginning of my night shift last week. She said she was 20 but looked closer to 16. Her expression was intense, focused, innocent, and fearful. Looking at her still, she looked like a normal young girl, but movement made her jerky and a bit imbalanced, maybe polio? maybe muscular dystrophy? She came first in early labor and was sent out but her contractions continued so was eventually settled into a bed in the ward. I kept an eye on her, just noticing her, and feeling a bit protective.

Another nurse attended her delivery in the early morning hours but the ward was almost empty so I stood maybe 15 feet away and watched. This particular nurse is a very sweet woman but sometimes assumes the persona of a little soldier, shouting directions and orders at the laboring women as she walks between the beds. And so she stood, shouting directions on how to push as the girl grabbed her knees, shut her eyes tightly, and pushed with all her might. Every now and then she would open her big fearful eyes, look briefly at the nurse, and then snap them shut to push again tensely and intensely.

The girl did a beautiful job. The baby was born and I watched the nurse lay it on the girl's belly, wipe it and cut the cord. But I also noticed the still blue legs remained still. At that point I retrieved the baby from the mom, gave her a few breaths until she became pink and cried. When I took her back to her young mom, the girl held out her arms with fingers spread wide, craning her neck, as though she was reaching with all her will for the most precious thing. As she took the baby from me and brought her gingerly to her chest, everything softened; her limbs and expression taking on peace. "Wamkazi," (Girl) I said. She opened her eyes - now big, soft, and warm - met my gaze and then closed them again. She was holding the most precious thing.