Tragedy of the Unseen

I wake up to a flash of brown and a loud hollow thud.  It takes me a second to reconstruct my surroundings.  I look to my right and see two Mozambican men seated motionless, mouths agape as if they have just seen a ghost.  We are in the cab of a shiny white open back truck.  I am in the passenger seat still trying to clear the fog in my lagging consciousness while a fat man with a self-important look on his face sits behind the steering wheel.  Between us there is a smaller meek man wearing a concerned frown on his face.  As my memory races to catch up with me, I remember trying to hitch-hike from the EN-102 outside of Tete City.  The two men, in their sparkly white pick-up truck screeched past me as they slowed down, and then backed up, rolled down the window and asked me where I was headed and how much I would pay.  The fat man was in charge and had ordered his compliant subordinate to slide over and occupy the middle seat so that I could sit down in the passenger seat of the truck.  What had followed was one or two hours of scant conversation which eventually puttered out and gave way to a long and deep slumber. 

Now I am wide awake.  I deduce from the sound and the fact that we have stopped moving that we have hit something, not an incredibly rare occurrence on Mozambican roads; dogs, goats, and chickens frequently frolic in the roads and become casualties of fast-moving and irritable drivers.  There is something leaden hanging in the air of this new truck, however, that is pushing my stomach into the ground and making me certain that the hollow thud I heard was not a chicken or even a dog.  We have pulled to the side of the road and I struggle free of my seat-belt and throw the door aside.  As I stumble desperately out of the car I look back and I see exactly what I was hoping to have imagined.  There, limbs tangled awkwardly on the pavement, is a child.  I don’t know how she got into the position she is in.  She is resting primarily on her knees, but her forehead is also resting on the ground to form a sort of tripod.  As I race back to reach her I am sure she is dead.  Her body is petrified in that position.  When I reach her I stand over her lifeless body and I don’t know what to do.   I want to scream.  I want to yell at the driver.  I want to save her.  I am now acutely aware that I am still alone, standing helplessly over a dead body.  I look back towards the car and see that the driver and his friend are still sitting in the cab.  This is turning into a nightmare.  Are they still in shock or are they contemplating their escape?  Where are the villagers?  Where are the other cars?  I feel more alone than I ever have in my life standing awkwardly and alone with this poor corpse of a girl. 

Slowly and gingerly the driver opens the door and steps out onto the pavement.  The look on his face is not one of surprise, pain, or even remorse, it is a look of minor annoyance; the kind of expression one gets when he’s been pulled over for speeding or is stuck at a long traffic light.  As the driver slowly paces his way towards me I look back down at the girl below me on the pavement and I notice her rib cage expanding and contracting slowly.  She is breathing in labored and crackly spurts.  As the driver finally arrives to survey the scene with his hands in his pockets I reach down and touch her neck for the first time.  She is warm and has a strong pulse. 

I don’t know what the protocol is in this situation.  In my mind I am a bystander; a witness with no responsibilities, but someone is dying in front of me and no one is doing anything.  Why isn’t anyone doing anything?  Someone, please, do something.  My mind is screaming at them.  Now there are a few other pedestrians that have arrived to watch the spectacle.  We form a circle around the disfigured girl, all, seemingly, waiting for something to happen.  Every heave her lungs make I imagine to be her last breath and wonder if we are all just waiting for her to die.  Finally, the driver nudges the girl with his foot and asks, “She’s not going to survive, is she?”  From the tone of his voice, you would think he has just hit a deer and is wondering if he should call the DNR or not.  He takes an almost imperceptible step towards the car and I can’t tell whether he wants her to live or not.  I imagine that he is thinking about getting out of here.  If she dies he will leave and call it an unfortunate accident, probably be in Chimoio by noon.  If she continues to hold onto life he has to take her to the hospital and get buried in police reports. 

Meanwhile, we are all still standing, watching the life bleed out of this girl.  There is a bump the size of a tennis ball protruding from the top of her shaved head and it is bleeding a lot.  She has now coughed up mucus and blood all over her dress and there are raspberry colored gashes covering her elbows and knees.  I yell, louder than intended, “well, we can’t just leave her here.”  The onlookers seem startled by my level of agitation and content to just observe.  I want to look at them and explain to them that this child is not dead yet.  I want to tell them that this is not a goat, or a chicken that we ran over, it’s a human being.  I want to say so many things.  I lean down and place my left arm under her neck, letting her swelled head rest on my forearm.  I then put my right arm under her legs and lift her fragile and broken body off of the pavement.  She may be 10 years old, but she doesn’t weigh more than a small dog. 

I lay her down gently on the dirt shoulder of the road.  This seems to be sufficient for the driver.  He motions towards the car one more time as if we should be getting on our way.  At this, as if it had been waiting for the right moment to appear, anger and emotion swell up in me like fire. I blame Mozambique for this tragedy.  I blame the narrow roads; I blame the pot holes and the reckless drivers; I blame the parents that don’t teach their children not to play in the street; I blame the parents who don’t teach their kids anything; I blame the poverty; I blame a society that allows a dead child to be less of a concern than a dead goat; I blame everyone for not caring.  I repeat, more to convince myself than anyone else, “We can’t just leave her here.”        

At this point, five minutes have passed since we stopped and word has spread to the neighboring village that a child has been hit on the road.  Parents emerge from the stores and the fields beyond sweating and covered in dirt from their mornings spent in the fields.  They are looking for their children, making sure that their families are still complete.  The increase in the number of eyes now beholding the spectacle seems to have a distinct impact on the driver and other people previously standing and watching.  There are now 15 or 20 villagers around who know the child.  One man shouts, “You have to take her to the hospital!”  His spirit and sense of urgency seem to finally light a fire in the rest of the stagnant crowd and they nod eagerly and approvingly.  Despite this no one seems to have the motivation to actually take action.  We find ourselves, yet again, standing and watching the blood pool under her hair and run off the side of the road. 

A thought now occurs to me.  I am the only white person within miles of here.  In their eyes, I am the driver of the car; it was my car and my wealth and my carelessness that are responsible for this innocent girl’s death.  At this, I lean down once more, and lift up the child in the same careful manner I had before.  With a crowd of Mozambicans parting like the Red Sea to let me pass I march the remaining 20 feet back the car alone with the girl in my arms.  She is now heavier than I remember when I first lifted her up.  With help, I manage to place her in the bed of the truck and rest her head on a few sacs of corn.  There is still blood flowing freely from the wound in her head and I use the only first aid technique I know of: I pull a filthy piece of cloth from the bed of the truck and wrap it twice tightly around her forehead, covering the tennis ball sized lump and the oozing gash in her head.  I think the driver has finally received the message that this is also his burden to bear and he hurries to the driver’s side to start the car and ride to the nearest hospital.

As the engine revs and we pull away a small muscular man jumps into the back of the truck with the slumped over girl.  He seems distraught and I deduce immediately that he is the girl’s father.  I look through the back window of the cab to see him lift up his daughter’s head and let it rest gently in his palm.  His body is that of a farmer – undernourished and miniature but taut with sinewy muscles.  He wears a brown shirt, the color of the earth and no shoes.  As he holds his daughter despondently in his arms I see the sadness pouring out of his eyes.  I look through the glass of the cab window and I feel his sadness as if it was my own.  It starts in my stomach and swells into my lungs, my throat and then my eyes.  I can’t hold it in or keep it out. Her head is the size of a large grapefruit and it fits perfectly into his palm which now is covered in red.  The father looks briefly into my eyes as I peer back through the impenetrable glass of the cab window.  I try to project all of the empathy and remorse that I possess into him.  Direct it through his eyes and push it into the empty pit in his stomach.  I know, however, that all he sees when he looks back at me is pity.  There is nothing I can say or do to help a father who has just lost his daughter.

When we reach the village clinic only a two minute drive away the driver honks to summon the nurse from his post within.  No one comes; we wait a few minutes and still no one.  It occurs to us that today is Sunday and at a small village clinic like this there will likely be no nurse here until Monday morning.  We decide to take the next best action.  We will drive 40 kilometers down the road to the next large town, Vanduzi, where there is a full-service health clinic that we can take the child to.  We jump back in the car and drive South.  Another relative of the girl has now jumped into the back with her and is urging the driver to step on the gas.  “She is still breathing,” he shouts.  “Move quickly!”  For the entirety of the 20 minute drive to Vanduzi I don’t take my eyes off of the father and his ailing child.  She has vomited and is now writhing back and forth letting out brief shrieks of pain.  Every time she yelps, the anxious relative bangs on the driver’s side window imploring the driver to have haste.

When we arrive to the clinic in Vanduzi it appears to have been abandoned.  There are three buildings which form a courtyard around a small pavilion for waiting patients.  As we pull the pick-up truck into the courtyard there appear to be no patients, no doctors, no nurses, no staff.  The driver honks the horn and a large man holding a clipboard and wearing a white nurse’s uniform finally emerges from a door with the inscription “Socorro” or “Help.”  There is no gurney, no flashing ambulance lights, in fact, the nurse doesn’t even look at the child sprawled out in the back of the truck.  He keeps his eyes firmly fixed on his clipboard and merely flicks his chin towards the door to indicate that we should bring the victim into the room inscribed with “Help” that he had appeared from and wait for instructions there. 

Another 10 minutes pass and I’m ready to put the gloves on and start treating this girl myself.  The nurse is still outside asking questions to the driver—name, vehicle number, registration, description of the incident, identification.  Meanwhile, the girl, I don’t even know her name yet, is lying on the hospital bed and I am standing at the foot of the bed as her father sits by her side.  The room we are in is a small operating room with a desk, two beds, a sink, and a small counter full of surgical tools.  The hospital bed the girl is lying on has white Mickey Mouse sheets.  Where is the doctor, I wonder?  She is still bleeding from the wound on her head and now the Mickey Mouse sheets are becoming wet with her blood.  I expected her to be dead by now and I don’t know whether seeing her now in a semi-conscious state, writhing and moaning in pain is heartening or not. 

The nurse walks in casually and sits down at his desk.  I look up at the father sitting helplessly at the side of the bed holding onto his daughter and follow his eyes back to the nurse sitting at his desk.  The nurse has yet to take his eyes off his clip board and address the child bleeding to death on his hospital bed 10 feet away.  Finally, the nurse rises and saunters over to the girl on the bed with his clipboard in hand.  He begins his next line of questioning, this time directed at the father—name, age, birthplace, identification, education, profession.  This is not as simple of a task as it should be.  Her father doesn’t know exactly how old the girl is or what her date of birth is; neither the father nor the daughter have identification of any kind; and the father can neither read nor speak Portuguese, making the entire interrogation last five times longer than it should.  Each question must be repeated three times and each time there is no answer they must make something up to write into the nurse’s clipboard.  For the second time today anger boils within me and I want to scream.  Will no one acknowledge the fact that there is a child bleeding from the head lying untreated in this hospital bed?  I’m sure now that she will bleed to death and it will be my fault for not saying anything. 

Just when I have reached my boiling point and am ready to grab the gauze and begin wrapping her head myself the nurse looks up for the first time and approaches his patient.  I want to hold the girl’s delicate hand and ease her pain, but I feel my feet glued to the tile floor underneath me.  My mouth hangs open primed to speak words of comfort and encouragement but I feel my mouth fill with cotton and my words become muted.  The nurse calls an assistant over and they prepare to put an IV into the squirming girl’s arm.  The assistant appears nervous and botches the injection of the needle four times in a row.  They can’t seem to get the liquid to flow down into her veins.  They have tried her elbow and wrist on both arms, each time having to untie and retie the rubber band on her upper arm. 

Another 10 minutes go by fumbling around with the IV and the ring of blood staining the Mickey Mouse sheets beneath her head is expanding.  There is no sense of urgency.  The nurse and his female assistant are laughing about the IV.  They had forgotten to turn the valve under the bag to allow the liquid to flow down.  I know nothing.  I wonder, however, if there is any doctor in the States that would let a dying child bleed onto a hospital bed for as long as we’ve been here without wrapping the wound and stopping the bleeding.  Why can’t I move towards her?  Why can’t I tell the nurse to do his job?  Why is the life of a poor child not even worth the effort of saving her?  Finally they get the IV flowing and the nurse looks at her head for the first time.  Perfunctorily, he rotates her head to get the full view of it and remarks, “Head trauma, we can’t treat that here.  She’ll have to go to Chimoio.”  Thus, after the assistant wraps her head in gauze, and only minutes after they had successfully inserted the IV, they pull the IV out and send us back to the car.  “We’ll take her to Chimoio in the ambulance.” 

The girl is placed in the back of a different pick-up truck, the so-called “ambulance,” and it disappears from view.  The driver, his friend and I get back into the truck and continue on our way to Chimoio.  It is as if nothing ever happened and I wonder if it was all a dream.  I look over at the driver and he wears a concerned frown on his face.  I imagine how I would feel if I had been responsible for a tragedy like this.  We spend the rest of the drive back to Chimoio playing through the events over and over.  I feel the sadness in his voice as he recounts the details.  There were two girls playing in the street, oblivious to the approaching truck.  As the truck neared, they tried to run off to the right side of the road, but, at the last second, changed their mind and went left to avoid the truck.  As they did this, the driver was forced to swerve right veering off of the road and onto the shoulder.  He avoided the two frolicking girls in the street, but there, on the shoulder, was a third girl waiting for the car to pass.  I imagine she did not see the car coming and did not have time to be afraid.

In Chimoio, we now go to the hospital where we were told the girl was taken.   This hospital is much larger than the Vanduzi clinic and appears to have doctors and nurses working at it.  I see the girl lying on a hospital bed through a crack in a door to one of the general rooms.  They will not let me go into the room.  The same wiry father is sitting on the bed next to his daughter.  I don’t know if I make eye contact with him or if it is my imagination, but when I look into his eyes one last time I have no words or emotion for him.  I try to show genuine concern and not pity.  I want his daughter to survive more than I have wanted anything in my life.  As I’m peering through the crack in the door and nurse approaches me and tells me that I can leave.  There’s nothing more the police or the hospital need from me.  I feel awkward leaving without knowing what’s going to happen to her.  I ask one of the nurses how it looks and he tells me that the child suffered a serious head injury, and there’s no way to tell yet whether she will survive or not, but it doesn’t look good.

Slowly, and shamefully, I retreat from the hospital room and exit the premises.  I give the driver my phone number and tell him to call me if he hears any news about the girl.  I know that I will never hear from him again; he is ready to put this episode behind him.  Meanwhile, the girl and her father sit in the hospital waiting to see whether she will survive or not.  There will be no organ transplants, no transfusions, no fancy machines to keep her alive.  If she lives it will be a God-given miracle; if she dies it will be her God-given fate.  They will mourn and cry for a week, but she will be buried and the corn will need be harvested for the next season.  I have never felt both so ashamed and blessed for the privileges I have been given in my life.