delivering death

I’ve been thinking about my time in africa a lot lately. maybe it’s because I started using the same brand of shampoo again as I did then but almost every time I wash my hair, I ride this wave of nostalgia. recently the waves have become so frequent that I’ve simply begun floating in an ocean of memories. as I stood in my southern california shower letting the water trickle down my face, I imagined the peeling blue paint on the walls of my own shower stall back in cameroon. some days I would pick at it but most times not because there was never hot water and my goosebumps always told me to hurry out of the shower.

I don’t usually talk about my time in africa because of how much it parallels with death. at eighteen, I thought I wanted to be a nurse and decided to spend a few months as a nursing volunteer in a small village in the extreme north of cameroon. a few weeks in however, I realized I could never be a nurse. watching children die everyday wasn’t something I wanted to normalize in my life and though hospitals in cameroon are far different than america, death in general wasn’t something I wanted to routinely experience. I applaud nurses – my mother, my husband, my best friend – because it’s a necessary profession and one that I’m unable to do. I naively thought that nurses and doctors always restored people back to perfect health but cameroon showed me the reality of the circle of life and how deeply wrong I was.

today’s shower brought me back to a specific moment: my first baby delivery.

before going to cameroon, I didn’t have any medical experience except for the stories that my mother would bring home as a nurse and while the hospital staff knew this, they decided to take me in anyways. when I got to the hospital, I started off doing triages. at first I made educated guesses of where people were supposed to go and a week in, I started to get the hang of it. with time and experience, the staff allowed me to administer pre-natal shots to pregnant women and eventually I was able to do blood transfusions. I worked my way up until they allowed me to assist in their delivery rooms.

at the time, there weren’t any american doctors as there had been in the past and the hospital was being run by cameroonian nurses and aids. after a month of volunteering at the hospital, G, the head delivery nurse asked me if I wanted to deliver my first baby. I had watched the team perform many deliveries before and foolishly thought that I was ready.

I scrubbed in and saw that the girl was about fifteen years old. she eyed my suspiciously and for good reason as we both looked the same age. the young girl looked angry, scared and in pain. she was only four inches dilated but acting as if she were nine. she walked a few laps around the room and then started jogging. G sat there chatting with the other nurse paying little mind to her or to me. I hadn’t seen anything like this in previous deliveries and asked G if this was normal. annoyed that I had interrupted him, he nodded his head and went back to his conversation.

as she continued to jog around the delivery room she started to scream and in response, her mother, the only other person there with her started to yell back. though I only knew a few french words and phrases, I knew enough to know that the older mother was yelling at her daughter to stop acting like a baby – a baby that she was about to give birth to. the girl began to run around again but this time faster. I stood there almost dumbfounded trying to soak up all that was happening. she scooted up onto the delivery bed and started yelling at G that she was ready to start pushing. he called me over and instructed me to stick two fingers into her vagina to see if she was 10 inches dilated, to which we found that she was not. she started pushing and panting and G yelled at me to grab a tin bowl as he helped her off the bed. in french, he told her to squat over the bowl and a few minutes later, I saw little pieces of feces. she then stood up and started running around again. after maybe ten minutes of yelling and running she sat back on the delivery bed.

I asked G if they were going to give her anesthesia and he replied half jokingly, “in cameroon, our women our stronger than your american women.” checking to see how far she had dilated, we saw that she was ready to start pushing. the mother started stroking her daughter’s face and told her to push. G then instructed me to put both my fingers on opposite sides of her vagina to stretch it out and keep from tearing. after about fifteen minutes of the girl pushing and me stretching, I started to see a tuft of hair. after another fifteen minutes, little to no progress was made. G then jumped on top of the delivery bed and stood over the woman and started pushing her stomach towards me while yelling at her to continue pushing. over her screams, he started to yell at me, asking if the head was being pushed out. I told him that with each one of his pushes, the head was becoming more visible. with this confirmation, he continued to push at a more frequent pace and finally jumped down to see how I was doing. he told me to reach inside of her and grab the head and then jumped back up to push again. I remembered thinking that this couldn’t be right and when I told G, he yelled at me to stop questioning him and do as I was told or else I could leave his delivery room.

the baby’s head finally pushed through and though still attached to its body, it remained lodged in the vaginal canal. inspecting the face, I knew that the baby was dead. if I had let go of the head, it would have gone limp hanging from its mother. I started to panic thinking that it was my fault for pulling his head out but G kept shouting at me to keep pulling until the whole baby was out. I screamed at G that the baby was dead but he ignored me and kept telling me to pull the baby out. it was chaos with the girl screaming in pain, the mother screaming to keep pushing but also G screaming at me to pull the baby out. when the girl and G gave their final push, I grabbed the baby with both hands and held it in my arms. staring at him, I started crying. this was the closest I had ever been to new life but instead had delivered death. the head nurse told me to cut the umbilical cord and place him on a cloth on a table while he went to pull out the placenta.

staring at the baby, time stood still. I was in shock of what had just happened and began to stroke the baby’s cheeks. when G saw my tear-stricken face, he told me to clean myself up and go outside. I did what I was told, finding a bench under some shade to sit on. reflecting on that past hour and a half, I began to cry uncontrollably. I was mad at myself for accepting the offer to deliver the baby and also mad at myself for listening to G when he told me to keep pulling, aiding in his death. I sat outside for about twenty minutes hyperventilating before G came out and sat down with me. he asked me why I was crying so much and I told him that I hated myself for assisting in the death of an infant. at first he scoffed but when he realized that I was serious, he looked me in the eyes and said, “caitlin, you didn’t kill that baby. that baby had been dead for days, you delivered a stillborn.” trying to process his words, I sat there stunned. through tears, I asked him that if he had known it was a stillborn, why didn’t he tell me. further, why did he allow this to be my first delivery? G was silent for a second and replied, “I wanted you to see the reality of life here. we don’t always get to be the heroes – death is very real. being a nurse or a doctor isn’t just about healing patients but also empathizing with them during their times of crisis. watching you this past month, I can tell by the way you interact with the patients that you’ve never experienced death before.” his words acutely stung my soul because looking back at that moment, I knew it was true – I subconsciously wanted to be the hospital’s american savior.

to further explain, I know that I didn’t want cameroonians to bow down to my ‘selflessness (giving up a semester of school)’ but to know that a piece of a developed country was there to help them in the form of presence. I realize that this makes my eighteen-year-old self look like a terrible person but it was a subconscious yet embarrassing truth during that time period of my life. fortunately, it became a lesson that has since then changed me. a role model of mine, zainab salbi once said,

“those who give [to third world countries] should not confuse their giving with love or respect. giving… is kind and generous but there is one more step needed to complete the process of reaching out and building bridges of peace in the world to look past that person’s victimhood and see their personhood.”

as an american, I think there is a danger in going to third world countries with this ‘american savior’ mindset. we grow up being told that we are the greatest nation in the world and while that may be true, it isn’t a pass for treating others as inferior, subconscious or not. the most valuable lesson that I learned while in cameroon was empathy. in america, we also learn this lesson but with other americans or immigrants trying to assimilate. how can we truly empathize with people who are different than us if we pompously waltz into their country and continually treat them like damsels in distress?

for our humanitarian efforts to reach its full potential, we have to be proactive about changing our conscious’ narrative. those of third world countries may be victims of oppression, poverty, and corruption but our course of action should not be to ignore their personhood in the name of help. with each country I visit, I continue to learn new lessons but for cameroon, I will always associate it with empathy.