ENCORE

The staff of the surgery center have just left. I have the cover off a portable air conditioner and I'm trying to figure out why it's not working. I hear the sound of an incoming text message on my phone. I glance nonchalantly at the screen.

"Nous sommes a la pediatrie avec le bebe." It's from Antoine, the new business manager for Adventist Health International here in Chad. I just informed him yesterday of his nomination and I started his orientation in that same afternoon. Now his child is sick, hospitalized in pediatrics at the local government hospital since we still haven't gotten our authorization to open our center.

I remember well the day he called me in early January to tell me his wife had just delivered. Antoine and I have been friends for several years since I started this project in Moundou. He's been my right hand man, completely on a volunteer basis, until yesterday. His lined face, constantly in a grin from ear to ear belies his inner strength of will but well reveals his compassion and dedication. I rushed to the hospital and was privileged to give the new mom and proud father a ride home. They have two children already but have been struggling for several years to have more. Now a tiny, wiggly boy is on his way to brighten their home.




It was less than two weeks after my son, Adam, died that Antoine's boy came into the world. It was a bittersweet moment.

When my dad came to be with us in our time of grief, the church asked him to preach and it happened to be the day that Antoine and his wife wanted to dedicate their son so I found myself standing alongside my dad next to Antoine and his family. I translated as my dad encouraged the church to help raise the child to put his trust in his Creator and dedicated the parents and child to God.

I quickly text Antoine back to ask him what's going on, is it malaria as I fear? Antoine's wife had brought the child to see me two weeks ago. He had diarrhea and fever. The mom had been giving him water from an open well along with breastfeeding. I encouraged the mom to breast feed only and prescribed a treatment for malaria and amoebas. Now, I question whether I should have hospitalized the boy. I know that IV Quinine is the best and really only efficacious treatment for malaria but my soul was still smarting from losing my own son as a complication of that same medicine.

Antoine writes back. "Il n'y a pas du sang, ils veulent le transfuser." He's anemic and they're going to transfuse him. I decide to call and we carry out our conversation in French.

"What's going on? Have they done labs? What's his hemoglobin?" The dialogue drags a little as I try to explain what the hemoglobin is and he tries to figure out the abbreviations on the lab slip. Finally, I find out it's 8.3 which is not too bad.

"Don't transfuse, it's not necessary. He needs a malaria treatment. He needs IV Quinine."

"Doctor, they've already taken the blood. It's here in a bag ready to transfuse."

"Have they found an IV? Did you pay? You know that emergencies, including severe anemia and transfusions is supposed to be free?"

"Yes, but you know how the people are here, we had to pay or they wouldn't have done anything." "Bring the child here, he'll be better..." but I'm interrupted. I hear cries in the background and Antoine starts yelling at someone in Ngambaye. I don't understand. Finally, I hang up. I figure there's some relative who's come or the nurses are wanting something or whatever and I'm wasting my phone credit.

Antoine calls back in less than a minute. "L'enfant est expiré." His son is dead. I don't know what to say. Antoine continues. "Can you come take us home in your car?"

"Our car hasn't got it's registration yet. It's illegal. I can't. Sorry. I'm so sorry...I don't know what to say." We hang up.

I call back 30 minutes later after my initial chaotic thoughts simmer down. "Antoine, where are you?"

"We're back home already."

"I'm coming over."

"Merci."

I close up the clinic, go home, shower and walk out with Justin to the main road where we flag down some taxis. As the moto taxi pulls up to Antoine's little hut I see a group of people outside already. Word travels fast, especially concerning the ever present death here in Africa. There are a few chairs outside but the majority of the crying is coming from inside the courtyard. It's subdued, though, and I hear a voice in Ngambaye that sounds like someone is praying. I enter the courtyard and the bowed heads of the women crowded barefoot on the mats and the men squeezed together on the one bench confirms that they are communicating with God. I stand behind the bench. After the prayer, someone gets up and motions me to sit on the bench in his place. I look across and see Antoine sitting next to some of the leaders of the church who are giving a eulogy. His face is blank. The lines are there, but the smile is gone.

Behind me, I hear sounds of digging. There is a three foot opening between the wall and one of the huts that leads back to an open pee hole that drains into the septic tank outside. In front of that is a two by one foot rectangular hole with fresh dirt piled to the side. I see a bundle held gently by an old woman who softly rocks and cries. The women feel it more than the men, at least it shows more. Of course, they are closer to these little ones than we are. They've carried them inside their bodies for nine months and nursed them and cleaned them and cared for them as no man will ever understand.

At the end of the sermon, they ask me to pray. Chills come over me and my voice cracks as I try to express something of my sorrow and hope before God to these people who's grief I know only too well. I then accompany the body to the hole. I am determined to participate. I grab one end of the bundle and two of us lower the cadaver gently into the fresh grave. Kneeling down, many hands push and pull the dirt into the hole. Then, two of us grab rods and sticks and push the earth into it's place to pack it in. Everything is done quickly and efficiently. We've all seen and done this before for our own children. After we've tamped the grave and packed it down with our feet, someone brings a bucket of water. We wash our hands, the water trickling onto the grave to help pack it down more. No marker will note where this child awaits his wake up call.

Then the men go outside where a circle of chairs has been set up in the early twilight under the mango tree. I finally get to greet Antoine. I clasp his hand but he'll have none of it. He draws me into an embrace. We sit there for several minutes not saying anything, just hugging. I go and sit down. We all sit in silence for about 10 minutes. Finally, small conversations spark up around the circle. I go over and sit by Antoine.

"Antoine, you've entered the fight and our enemy doesn't like it. He prowls around seeking who he can devour because he knows his time is short. I've buried two children here in Chad, side by side in Béré. The other doctors in Béré have had their son sick for over a month and finally them mom took him back to the US. Now, you are under attack as well. Bon courage. Let's be like Job who said 'The Lord giveth and the Lord taketh away, blessed be the name of the Lord." God has put your son to rest for the night, he'll wake him in the morning." We continue to chat as he tells me the whole story of how his child ended up at the hospital and all that went on until he died suddenly as we were talking on the phone.

"I'd like to see the mother of your son and then I should get home." It's dark already as Antoine accompanies me into the unlit courtyard. His wife is lying on her side as another woman wails and moans, rocking back and forth in grief right beside her. She reaches up as I kneel in front of her and extend my hand. She clasps it in an iron grip and we sit there for at least 10 minutes in silence as little by little my tears fall and run down my cheeks as I sniffle in sorrow. The woman has ceased her wailing and Antoine comes behind me and grasps my shoulders.

"Doctor, ça va, ne pleure pas." he comforts. I then express my condolences and that Sarah also sends her's from Denmark and try to comfort her with a few of the many words of comfort that I received after my son's death.

Then I walk out alone into the dark. I head towards the main road where I can catch a taxi. I almost stumble several times in the obscurity, but then I look up. The moon is at half strength, but bright and the stars are bursting as can only happen in dark places like Africa where man has not intruded too much with his artificial things. I somehow feel at peace. Morning will come.