June 23, 2012
Of blood I mean.
We spent today volunteering at the famed Mbirikani Clinic. While our visit there was technically entirely charitable, we were all silently, and later outwardly, comparing Mbirikani’s facilities, services, and outreach programs to that of the Ministry of Health and CHS. Mbirikani provides free care for any and all members of the Mbirikani Group Ranch. Additionally, Mbirikani provides free HIV/AIDS counseling and testing, operates several mobile clinics, and provides free ARV treatment for life for anyone they diagnose. Mbirikani is a private, not-for-profit hospital, and is 98% funded by a private donor. To say that their work is incredible is an understatement. They employ a staff comprised solely of local Kenyan doctors, nurses, and orderlies. Their facilities are by and large the best I’ve seen in the region, and they are well stocked (I volunteered in the inventory/pharmacy) with all the essential medicines and materials. Mbirikani even employs its own community health workers, whose impacts, at least anecedotally, have been massive. I can’t really say more since our data analysis is underway and our various research outcomes remain murky. However, even when juxtaposed purely on a surface level it is clear that Mbirikani’s work and impacts far surpasses that of the MOH. And most of it comes down to money. Mbirikani simply has the funds and the leadership to provide the services and treatments that were long ago recognized as imperative in this region.
In a country rife with corruption and nepotism, money allocated to programs for the poor… the marginalized…. the long forgotten, discarded segments of society, is the most likely to grow legs, running to fill greedy pockets.
Mbirikani, like all the health facilities in the area, even those in Nairobi, continually experience blood shortages, with doctors and nurses regularly filling the hospital’s coffers. For trauma patients rapidly losing blood, or the severely ill with desperately low hemoglobin there are often, literally, no options. Given these dire circumstances, we were asked to give blood.
Many in my group jumped at the chance. I’ll admit something I am not proud of – I initially said no, passing the consent and screening forms back to the nurse unmarked. Numerous blood draws, several surgeries, and an acceptance of both as unpleasant facts of life have helped me overcome a once profound childhood fear of needles. Yet the strong aversion remains – especially when the destination of said needles is intravenous. I choose to avoid needles whenever I can, and as such I have never donated blood before. It has always seemed to fall in to the “avoidable” category… until now.
As I moved boxes and stocked inventory, the nagging guilt of my selfish decision grew louder and louder, filling my ears. I battled with myself.
You’re not going to miss a pint of your blood. Someone else needs it far more than you.
It’s ten minutes of your life, a tiny pinch, what is your problem?
Why are you such a coward?
You talk the talk Jess, time to walk the walk.
In short, I was irrationally and inexplicably afraid.
I thought of Baz Luhrmann’s song “Everybody’s Free (To Wear Sunscreen)” in which he says: “do something everyday that scares you.”
Okay, Mr. Luhrmann. Here goes nothing.
I forced myself to fill out the forms and join the others on the benches outside of the lab where we were having a few tubes of blood drawn for pre-testing. I sat while everyone else was tested trying to talk myself in to it. I could not, still cannot, explain why I was reacting so aversely to this but I was legitimately freaking out. Bill, a BUSPH professor, father of two, and KBC’s resident father figure, walked out holding a cotton ball over his slightly bloodied wrist. They had been unable to tap a vein in his arm. I was horrified. I very rarely have such unmasked, uncontrolled emotions. Now here I was, hiding behind a pillar laughing at myself while crying tears whose flow I could not stem.
Finally, I was the only person left. The lab techs looked outside to the benches where I sat with a few of the others and called to me. Everyone was so supportive and encouraging, never treating me as the crazy person I had become. Being that we are all public health, clinically minded individuals, they talked calm, logical sense in to my panicky brain.
Once seated in the small lab I burst in to laughter while tears filled my eyes. For someone who is very uncomfortable being vulnerable in front of others – this was an entirely new experience for me. For someone who largely internalizes and compartmentalizes the majority of their emotional experiences, this outburst was hugely surprising.
Silas, the incredibly attractive lab tech, with beautiful mocha colored eyes that belied his kind, gentle nature soothed me in to the chair and tied up my arm. He was laughing at me, I was laughing at me. Yet the hot tears still came. I apologized profusely. I tried to focus on the swirled shades of chocolate in his eyes. It worked. It was over in the blink of an eye – which made my hysteria just moments prior feel even more pathetic. I feel ridiculous even recounting it now. Silas should have slapped me and told me to get over myself, to get on with it. He should have told me of the unimaginable suffering he bears witness to daily. Instead he looked me in the face and told me could see the all the night’s stars in my eyes. Instead he put his palm on my left shoulder, squeezed gently, and smiled in a way that made me feel like he had read my mind a thousand times over.
I walked out of the lab to see Jess K. and a local Maasai man splayed across the bench consumed by laughter. To quote Jess: “That was hilarious. I heard laughter, crying, shrieks, your little feet pitter pattering, and then more laughter.” “That guy and I were both listening to you, I was holding it in. We looked at each other and just cracked up.”
Mentally fabricated crisis averted – I returned to my respective volunteer position, waiting for the test results. I am pleased to report that all 17 of us are HIV, hepatitis, malaria, and syphilis free.
I offered to help set up for the impending donations. We walked through the small hospital, to a neat, newly emptied row of four beds that faced the windows of the isolation room. Where an older man, heaving chest caved with advanced tuberculosis, rasped and wheezed under a breathing mask. Somewhere in the hospital another man moaned in pain, over and over. None of us inquired about him, and I trust that the doctors were giving him the very best care possible, but from the meeting of eyes that occurred with each piercing cry I knew we all shared concern and morbid curiosity.
Another man, in a bed adjacent to us, stared woefully as I passed. His eyes were sunken in above painfully hollowed cheeks. The sharp planes of his face framing the whites of his eyes in a way that struck me at once as beautiful and tragic. A stiff white sheet was pulled up, tucked around him just below the chin. But even that didn’t hide the bony points of his skeletal frame. In spite of his state, his youth was apparent. The sheet breathed rhythmically, with labor, ever so slightly. Had it not I would have been sure I was looking in to the eyes of a corpse. We locked eyes. I realized I was staring. I realized I had stopped moving. Remorse and shame smacked me across the face and I shuffled away staring at my feet. I have no idea if he actually saw me staring, or if he just saw through me. Perhaps death was wrapped too closely around his neck, too crowded in front of his eyes, to let the living in. Often, this is a final gift granted to the dying before they are released of their suffering. I truly hope he was one of the lucky recipients.
The hot blush of shame spread down my neck and across my face as I set down a jerry can of water and sodas near the beds where I would soon lie. Ashamed I had been so fearful of a mere needle, for even toying with the idea of not donating, for crying so needlessly only moments ago, for being so healthy by comparison, for having so much…
When the four beds were prepared and the nurse readied with bags and needles, we lined up against the wall as the first four lied down next to their assigned blood bags. The next few hours had us rotating in and out of the beds and around one another’s bedsides. Alternatively caring, and being cared for. The camaraderie and affection was incredibly touching. Mere strangers a month ago I now squeezed the hands and rubbed the foreheads of newfound friends. Everyone knew how scared I and the other newbie blood donors were and let us go in the first or second shift to get it over with. An act of grace.
When it was my turn, Michelle, Nicole, and Jackie crowded around me. In spite of myself, again laughing, tears sprang to my eyes. I lied there squeezing a ball of tissues to fill the pint bag lying on the floor beside me, calming and crying alternatively each time one of my friends did something kind. A simple gesture, like holding my hand or patting my arm lovingly sent a babbling brook down my cheeks and chin. I’ve gone soft. I told them, taking futile swipes at my tears with my free hand.
Tara and Corrie went last. They wanted to race to see who could fill up their pint bag faster. I held Tara’s hand and told her stories about my travels in Morocco as Nicole timed them and hollered developments like a Kentucky Derby announcer. Tara laughed while grimacing. I’d be lying if I said the needles they used were small, or that they didn’t hurt. But pain is relative, easily paled when true pain lies all around you.
Afterwards, two of the doctors came in with huge smiles on their faces. They walked among us, shaking hands, saying thank you over and over. They picked up the bags of our blood, labeled with our blood types and names, cradling them gently as one would a beloved infant. Beaming. It would have been an odd sight. Two large white coat clad figures gingerly cupping stacked pints of blood in their hands had their faces not been so earnest.
When in your lifetime do you ever truly get to say that you directly saved a life?
Later that day, our blood was pumped in to veins of numerous individuals whose hemoglobin was at 5.1 or BELOW. There was a man with an HG count of 2. I had no idea that one could even be kept alive with such a low red blood cell count.
As I type this my blood is coursing through the veins of someone who desperately needed it far more than I ever did. Perhaps a hemorrhaging new mother or a severely ill child afflicted with malaria. Perhaps through the veins of the frail white sheet shrouded body that was once a man as alive as I am right now. If I… if we… accomplish nothing else here in rural Kenya, we at least have done this.
I am so grateful. For my health and my family and my friends. For all I’ve ever had and for all I will have. I am so grateful. For the immense understanding and kindness showered upon me today in torrents. I am so grateful. For the Mbirikani Clinic, for the woman whose willpower and wallet has created such a place, for this beacon of hope, stuck in the middle of the sorrowful sea.
I am so grateful I was able to do this small thing. Which to someone else is no small thing at all.
Ten minutes to save a life. A pinch. A slightly sore arm. An excuse to eat a few sugar cookies and take it easy for the remainder of the day. That’s all it took. The magnitude of this is seemingly minor act is so massive I tear up just thinking about it.
… hopefully whoever gets my blood will not inherit the emotion inducing, inarticulate rendering bug that’s bitten me lately.
(To read more about Mbirikani Clinic: http://www.aidforafrica.org/member-charities/africa-infectious-disease-village-clinics/)