Nightmare on Mom Street

Nightmare on Mom Street.... this is how a blogger dubbed Halloween, presumably because of the candy?  Getting together a costume?  But for me, the candy is no nightmare.  Each year, the American Embassy hosts a Hallowmen party at the USAID compound- and because the people at the compound are all privileged diplomats, they can order AMERICAN candy on the internet and hand it out to all the kiddies. 
Reeses, Smarties, Tootsie Rolls abound.  This is a dream, no nightmare, for a deprived sweet tooth like me. 

This year, however, there were two potential nightmares: The first was forced socializing/competition with too many type-A Americans-  at all these little gatherings, I get this deja vu feeling of the lunchroom cliques at Chaska High School...  and it just makes me want to barf all over again.  So, rather than pretending to like and mingle in the cliques that everyone else is pretending don't exist, all I wanted to do was sit under a tree reading Tina Fey's Bossypants, and chow down on Reeses peanut butter cups all by myself.  I didn't get the first part of this wish, but I did get the second part- the Reeses.  Yes, I shamelessly and pathetically went up to the American Ambassador, who was dressed as a hippie, and asked for a Reeses. 

The seond potential nightmare was getting Nalia's friend into the party.  American style, the event was well-planned, and you were supposed to sign kids up at least 5 days in advance.  While that may work in someplace like America, it doesn't work so well here.  As my Mozambican colleague says, 'in Mozambique, you can only get people to think about what to eat for dinner after lunch is over.'  So, while Nalia had promised her friend Francisca that she could go, Francisca was not on THE list.  Francisca is Portuguese and was uber-excited about the Halloween party... so I didn't have the heart to tell her we couldn't take her because she wasn't on some stupid list. 

So I told her she had to sneak in.  The problem was I couldn't figure out how to say 'sneak in' in Portuguese.  Luckily Nalia was able to explain what we had to do.  And since most of the Americans working in the Embassy here can't really speak Portuguese, we all agreed beforehand that we would use Portuguese as our secret language while the actual sneaking in was taking place.  When we got there, the community liaison officer checking the list was super-frazzled and stressed out, so Nalia and Francisa just walked in. 

The kids got good booty.  The morning after, while everyone was sleeping, I did what lots of moms do but never talk about.  I went into their loot bags. I used to feel bad about this, but don't anymore.  Maybe it's a combination of getting older and not caring what others think as much, along with realizing that some things aren't such a big deal.  I minimized hurt feelings and harm to my children by taking Whoppers from Nalia's bag (she doesn't like chocolate), and Bit-o-Honeys from Elios... what kid actually eats Bit-o-Honeys?  And they still haven't noticed.  To assuage my own guilt, I also let them eat 2 pieces of candy for breakfast. 

Nalia was a zebra wearing a black tutu. 

Elio in his homemade Batman costume...Darth Vader is Elio's friend, the one who climbed the roof with him

On the roof

Elio has a will of steel.  And until yesterday, I didn't totally realize that his stubborn head mixed with being a mischievous 4-year old can be quite dangerous.  Elio had a friend over, and they decided to play outside.  I was tired, so I thought it'd be ok to lie on the couch for 15 minutes or so before going outside to check on them. 
When I opened the door, there they were, front and center, on the ROOF of our porch.  Elio, seeing absolutely nothing wrong with what he had done, waved at me.  I implored them that they needed to get down right away... not realizing how they got up! It turned out they had opened the gate to the front yard, and climbed on a pile of rocks to get on top of the fence that goes around our house.  Then, they shimmied down the fence, and climbed the bars to the top of the roof. 
I demanded they both get down, and told Elio I would help them, but he rebuffed my offer, so I just stood behind him with my hands cradles, ready to catch any falling bodies. 
Afterwards, when I was telling his friend's dad what happened, the friend's dad asked his son, "Why did you go on the roof?"
"Because Elio told me to."
Great... I'm thinking, the authoritarian, tyrannical friend. 
Then the dad went on, "So weren't you scared on the roof?"
"Elio said he would protect me."
"And how was Elio going to protect you?"
"He told me not to jump."
I turned and looked at Elio... He nodded very seriously, affirming that he had been earnestly trying to protect his friend by telling him to not jump off the roof. 

Dubai Ninjas

We flew through Dubai on our way home from the US. There were four of us:  Nilda, my Brazilian friend, Nalia, Elio, and me.  None of us had ever been to Dubai or the Middle East, so we were eager to get to know a new place.  Our layover there was from 7pm to 5am the following morning... Emirates Airlines, presumably due to all its oil wealth, is very generous about taking care of passengers during these long layovers, so we received free hotel, free transport, and a free dinner.  Nilda needed a visa, so they also gave her a free one of those.  After the 14 hour flight from Seattle, we were all ready to move around... and the kids were very curious about being in a new part of the world.

While Nilda was picking up her visa, the call to prayer came on the loudspeaker at the airport.  Elio started a sing-a-long session, belting out along with the 'music' like it was Twinkle Twinkle Little Star.  I quickly informed him this was NOT music, and PLEASE STOP.  Next, it was on to the way people were dressed.  Elio is 4, so he's not embarrassed about much of anything.  He also really likes Lego Ninjago right now.  After watching all the women gliding around the airport in their black hijab, with only their eyes showing, Elio asked very innocently, 'Hey Nalia, are those people in black with only their eyes showing Ninjas?' 

Since were weren't tired that night due to he time difference between Seattle and Dubai (11hrs!), we decided to go on a night tour of the city... this worked out perfectly because it was still 39 deg C at 9pm... imagine what it wouldn've been like during the day?  We saw the Burj Khalifa, tallest building in the world and went to one of the manmade islands, AND we got our last hit of McDonalds right next to a beach on the Persian Gulf. 

With Grandma and Grandpa on the ferry leaving Bainbridge Island

On the biggest Ferris wheel in the world

Ferris Wheel

In front of a mosque in Dubai

Burj Khalifa, the tallest building in the world

We went hiking last week with a friend of mine from college, Jen, her son Jasper, who is in the midst of potty training, and my friend Nilda, who is from Brazil and visiting the US for the first time.  We drove and drove to the top of Blue Mountain in Olympic National Park.  When you're at the top, and it's clear, you can see all the way to Vancouver, BC, the Straits Juan de Fuca, Vancouver Island.  Unfortunately our day was not clear.  We could see about 10 feet in front of us, and we ended up temporarily losing Nilda, who as a Brazilian from near the equator, had never experienced such cold temperatures in her life.  The trail is a loop, but Nilda is learning English, and had not understood when we talked about it being a loop-she had thought we would turn around and go back.  So she sat down about half way through and waited for us.  Now she knows what a loops is. 

Jen's son, Jasper, takes a potty break, and gets a visit from a very friendly deer.

Elio the Olympian and Nalia the Nine-Year-Old

The first week of August was BIG.  Olympics time means mom, me, is glued to the TV every night, especially when swimming is on.  We were also getting ready for our big trip home to the U.S. (where we are now), and for Nalia's ninth birthday on August 3.  She really wanted a Hello Kitty cake, and since there is no pre-made icing to be found in Mozambique, I had to figure out how to make boiled white icing-- without an electric mixer.  The first time around was a syrup-y mess, but then I got on allrecipes.com, looking for some salvation.  In the end, because we didn't have an electric mixer that worked on 220, I enlisted Matias' mom and Matias to help with beating, and it worked.  All the recipes I found suggested using black licorice and Jordan almonds for Hello Kitty's whiskers and nose... but since these were at least a 3 hour plane ride away, I opted for cutting up felt and craft foam.

Elio and Nalia both participated their school's annual sports day before we left Mozambique.  Elio was very proud of his gold medal and promptly put his hand on his heart while he waited to receive it.  He then held the medal up for photo opps, just like he had seen the winning athletes in London do... can you tell his mom is an Olympics junkie?

Elio is preparing for 2024

I love that Nalia looks so HAPPY to be running...

This story won’t have a nice ending.  It’s can’t.  I don’t know exactly how it will end or when, but the ending can’t be good.  I totally understand if you don’t want to read any further.  I probably wouldn’t.  After the last few days, I have gone on all my friends’ blogs… in search of happy endings.  Birthday cakes.  Tiny muddy hands paired with smiling faces.  Strawberry patches ready for kids to pick.  Pink princesses at tea parties.

But this is a different world. 

On Thursday, I returned from Nairobi to be greeted by the glowing faces of my two beautiful children.  Several hours later I heard that our guard Jorge’s son, José, was in the central hospital.  José is three years old. 

On Sunday, Nalia, Matias and Elio left to visit Matias’ family in Chimoio.  Knowing that Jorge also has a 3-month old daughter, who was now not breastfeeding very often because her mother is in the hospital taking care of Jose, I asked Jorge to come over with the baby and try to figure out a plan.  I didn’t understand why Jorge couldn’t stay at the hospital with his son so his wife Lidia could go home and breastfeed the baby.

We talked it over and Jorge explained that men aren’t allowed to stay at the hospital.  There have been problems with abuse.  I agreed to ask Elio and Nalia’s nanny to sit with José the next day so Lidia could go home and feed her baby.  Jorge had been bringing the baby to the hospital once or twice a day to feed, but it wasn’t enough. 

Next, I offered Jorge a ride to the hospital to see his son.  I pulled up by the gate.  We both just sat there.  ‘But don’t you want to go in and see José?’

 After what happened with Oscar, I was trying to distance myself from this.  But I could tell Jorge really wanted me to go so I relented.  We ran up the stairs because the baby was now screaming to be fed. 

I wasn’t prepared for what I saw next.  I had met José before but I didn’t recognize him this time.  His whole body was swollen, head to toe.  The doctors had tried to insert an IV, but struggled to find a vein because of all the swelling, so they had shaved the sides of his head to look for a vein.  I brought one of Elio’s cars for José to play with, but his eyes were swollen shut; he couldn’t see.  ‘Tia trouxe um carro para ti… I’ve brought a car just for you,’ I told him, but he couldn’t see it.  I pulled out his small bloated hand and placed the cars inside.  He didn’t grasp it, so I closed his hand.  He sat up and started spinning the wheels around.  This was good.  There was blood coming out of his nose, and his eyes were completely bloodshot.  His mother said he had been vomiting blood, and also pooping blood.  He had had two transfusions in 2 days.  I kept asking Jorge and Lidia what the problem is all they could say was ‘anemia.’ 

The atmosphere in the hospital during visiting hours was like another macabre party.  It reminded me of Oscar’s funeral.  All these sick children lying listlessly on beds surrounded by relatives toting food, juice, and chatting and laughing.  I told Jorge that he needed to give José as much carinho as humanly possible…. To help him recover more quickly.  Carinho is love, affection, sympathy all rolled into one, but Jorge didn’t seem to know what to do.  He just looked overwhelmed.  Later, Lidia told me that Jorge had broken down from the whole ordeal and cried.  Mozambican men never cry. 

I know that I need to distance myself from these things… I can’t save the world, nor can I help everyone.  I am fully aware of this. But I can’t watch a child suffering when there’s something I can do to help. So I talked to some Mozambican friends who are nurses and doctors.  They told me I had to talk with José´s pediatrician. 

So I went this morning.  I wasn’t expecting much… I was expecting a curt, cold doctor, numb to all the suffering-- if I was able to see the doctor at all.  Not having the força, the strength, to go at it alone, I asked a friend to come with me.  Ask for help when you need it. I am learning slowly.

  

We had to wait for Dr. Simple (sim-play in Portuguese) for awhile.   She was giving a visiting doctor a tour of the ward.  The visiting doctor looked American, and when I got a closer look, I read UCSD on his jacket… a doctor from the pediatric department at the University of California, San Diego. 

‘This is where we treat with chemotherapy,’ Dr. Simple explained.  When they left, I looked inside the room, and there was nothing.  Nothing.  Just two beds with sheets. The California doctor looked totally shell shocked… from everything.  He was barely speaking.  If you have been to a hospital here and also in Europe or the U.S., then you will understand why.  The disparities are too wide to be described in words.

Then Dr. Simple called me in.  She was warm and attentive right away, but professional. She asked if I was a relative to José… I told a bleached-white lie.  Because I knew I had to.  ‘José’s mother is from Chimoio, where my husband is from…they are distant cousins.’  Not so much a lie… we are all related, right?

She sighed and opened the file.  First she told me that José is severely anemic.  His hemoglobin was 2 when he was admitted to the hospital.  I have seen blood smears with hemoglobin of 6 and the blood was so light that it looked yellow when I put it up to the light.  I can’t imagine that José´s blood was even red.  I gasped. From what I know, many people with hemoglobin this low are dead.  She then asked me if I knew what platelets do.  I had to admit that I had forgotten my biology lessons.  ‘Platelets are what keep the blood coagulating, and stop us from bleeding to death.  The low range for platelet count in a child is 150,000.  When José was admitted, his platelets were 1000. We almost lost him the night came in.’ 

‘So this is why there is blood streaming out of him all the time?’  ‘Exactly,’ she explained.  ‘I need to give him platelets, but we have a shortage of platelets in the hospital now, so I do a five day plan and ask for 2 times as many platelets as I need.  Usually I can get him platelets once a day. Yesterday his platelets were up to 70,000.  His hemoglobin is up to 8. The swelling is kwashiorkor.’

I know what kwashiorkor is.  It’s a form of severe malnutrition.  The body swells up, becoming incredibly edemic, and the child usually gets scaly open wounds around the body, especially on the limbs.

But what is causing all this? This is the question that kept burning circles through my head. I knew she was getting to it, but I knew to be patient. 

She flipped the page in José’s chart.  ´José has AIDS.´

I couldn’t contain my tears.  José is THREE years old.  He will be on medicine the rest of his short life, if he’s lucky.  He will never have children, probably never fall in love.   So many nevers.  It was too much for me.

‘We should get his CD4 counts back tomorrow,’ Dr. Simple explained, ‘and then his hematology report.  After that, we will know if we can put him on antiretrovirals (ARVs).  I am pretty sure he can start on ARVs soon.’ 

My mind immediately shot to the baby.  If José is HIV positive, so is Lidia, and the baby is breastfeeding, so at risk of contracting HIV through Lidia.  But formula is beyond the means of most people here, and when that is the case, the advice is to exclusively breastfeed up to 6 months… but Lidia could not do this because she was taking care of José. 

‘Does Lidia know that she and José have HIV?’ I asked the doctor. 

‘She knows that José is positive, yes, but I did not discuss her own status with her.’

I talked it over with my friend.  I didn’t mention to Lidia all I knew.  I will explain tomorrow what the doctor said about the platelets and the anemia and malnutrition, but will not mention HIV.  Matias, because he is a Mozambican and a man, will talk to them about the HIV.  That is the best way to go. 

Tomorrow Jorge is coming over and I will show him how to make formula, cleanly and hygienically, and explain that the baby should be weaned to formula, but not abruptly, over about one month.  I will buy the formula.  My mom wrote me an email asking what I wanted for my birthday yesterday.  All I want is formula.  That’s what I’m going to tell her.

I am praying with my entire core that someday I will see José smile.  I have never seen him smile.  He is three, but he looks like he’s not even two.  I have never heard him speak, but his mother says he does.  I have visions of the day he comes to our house to play in the dirt and eat cake and chase the dog with a stick… of the day he can be a child.  

Sushi in Nairobi with Abigail

This week, I was invited to a conference in Nairobi. I don’t get out much, especially to bigger cities, so I was pretty excited about this one.  Usually, when I go on work trips, I sleep in health posts in the middle of nowhere, and I get to eat gazelle meat, because that’s the only thing available on the menu.  When you live in a place where you don’t have much access to the usual elements of American life, you tend to yearn… obsessively …  The exact definition of these yearnings is pretty indiscriminate, and in my experience, depend entirely on the person.   For me, Nairobi is the big city, so when I woke up the night before with something threatening the chances of making my trip to the land of plenty, I was pretty freaked out.

The night before we left, we all went to Matias’ cousins’ graduation party, and I must have eaten something…  really, I have no idea, but I woke up in the middle of the night, and the whole left side of my face was swollen.  There was no pain. Allergy?  But I have never had an allergic reaction to anything in my life.  Stress? Hives?  Maybe.   The left side of my face swelled up so much that  it looked like I had cached a gigantic gumball in my left cheek 24/7.  It was pretty bizarre.  But, as usual, Matias was not worried.  Há de passar.  This is the Mozambican answer to every problem.  ‘It will pass.’  When I woke up in the morning, it was at least getting better and not worse, so I decided to go to Nairobi.  I took an antihistamine, prescribed by Matias’ cousin… everything is bought over the counter here (valium included), turned into a zombie on the plane, and arrived in Nairobi pretty much a-ok. 

And tonight I was having sushi at the West Gate mall with Abigail.  Imagine.  Abigail is the Maternal and Child Health Specialist for PSI (Population Services International) in South Sudan, and she and I ended up enjoying salmon and avocado rolls, and salmon sashimi over a nice glass of wine in the mall in Nairobi.  My Mozambican colleagues were talking about going out for chicken, and had even discussed a trip to Carnivore, the Nairobi restaurant where you can eat ANYthing (ostrich, alligator, gazelle, kudu) and I just couldn’t stomach it.  I felt like another dose of chicken and chips would be the knife in my heart. I told them I was sorry to be a non-conformist, but I had to have sushi.  Sorry.  Over dinner, we found out:  Abigail grew up in a military family just like me, and her parents now live in Germany, where I also have family.  She’s the oldest of four, like me, and her sisters live in Utah, where I was born… not many people are from Utah.  We shared all of this over our sumptuous Nairobi sushi (a critic would scoff at calling sushi sumptuous, but its true).  The food was like going to heaven and back, but the best thing was just talking with Abigail.  Sometimes the most comforting thing in life is finding someone who has something in common with you.