For Lack of a Quarter...

Irene G. Brammertz

Death never lacks its ironies, especially avoidable death.

She was lying, half propped up against her husband, on the bench in the back of the Land Cruiser. It was the only transportation they had found since she had fallen ill two weeks ago. Tata Daniel had yielded to pressure to give them a ride when on an errand delivering a message.

All eyes were on Lusadusu, who had just examined the woman. “She is very ill,” he explained to me, the PCV along on the trip. “She has a liver abscess from years of suffering from malarial and other parasites: It has made her extremely anemic.

“Mama Irene,” he requested, “we have to transport this patient with us to the hospital. There is no medicine or equipment here. Can you sit in the front between the driver and me?”

I looked at the stricken woman: She does not appear very old, maybe late twenties. “But of course, no problem, I’ll squeeze in the front with you and Tata Daniel.” My mind wandered, remembering: These trips are always dramatic. Last time we transported a woman who was in labor, and I thought she was going to have the baby right there in the back of the truck. I suppose we have to bring this one, too, in spite of the rules.

“All packed up and ready,” Tata Daniel, the driver assured himself of this by looking in the rear-view mirror. He started to back the truck up the narrow path and toward the dusty road. He worried aloud: “I hope we make it all the way to Kimpese without a hitch, or I’ll get blamed again, since I took it upon myself to accept this ailing woman passenger.”

While still backing, there was shouting from the rear: “Stop, stop, she is having a seizure!” Nurse Lusadusu got out and walked around to to re-examine the patient. Lusadusu now yelled for a blood pressure gauge, the most high-tech item available. As usual, excitement caused him to stutter. After a couple of minutes, he explained, “Irene, we cannot take this woman to Kimpese to die.” Then he turned to the village nurse and commanded: “Send one of your helpers to the Seventh Day Adventist clinic and see if they have an IV and some fluid. It would be embarrassing to lose a patient with the villagers watching.”

Just then the woman had another convulsion. Lusadusu asked the nurses’ aides to carry her into the mud-brick Health Center. Besides my co-workers—Nketani and Matumona and me—a crowd of curious villagers had gathered. Just as the aides were passing, carrying the woman by her feet and shoulders, her body went limp, releasing her fluids. I looked at the wet trail on the red earth. Oh, my God, the poor woman just died, right in front of my eyes. She is so young. Life isn’t fair! These people suffer so much. Damn politics! Damn these people for being so complacent. They die for lack of a quarter...the fare for a trip to the hospital. Life is too cheap here, worth less than a quarter....

Lusadusu came out from the room where they had taken the body. Apprehensive, he made an announcement. His mind was busy looking for the right words, but there were none. “Everybody must think I am incompetent. I must save face. How do they expect me to do this job—an IV could have stabilized her to get her to the hospital in Kimpese.” He looked up and, instead of commenting on what had just happened, said to his crew: “Let’s reload the truck; we must get home.”

Daniel, Matumona, and Nketani, were talking on the side of the path.

“Lusadusu, this wasn’t your fault; it’s the system. They should have tried to find a ride on a produce lorry two weeks ago to take her to the hospital. They didn’t want to spend the money for the ride on the lorry. They waited too long to get help. There is nothing you could have done to saver her.”

The woman’s husband huddled in the dust beside the path, next to a neat little pile consisting of their cooking pots, reed mats, and other meager belongings. He covered his face with his large calloused hands, trying to hide the tears. “How will I get her body back to my village now?” he pondered. “She deserves a decent burial in the ancestral cemetery. How will I justify these additional expenses to my other wives? I should never have brought her here. I would not be faced with this dilemma now.”

Irene Brammertz immigrated to the United States from Switzerland in 1964. After her children were grown, she served in the Peace Corps in Zaire (now Democratic Republic of Congo) in the Public Health Program from 1988-1990. Her service in the Peace Corps was the catalyst that inspired her to further her education. She holds a master’s degree in Public Health, International Health Management, from the University of South Florida in Tampa.