Lunch at the small office where I work in Kigali, Rwanda, usually consists of pleasant conversation and lots of laughter. One day, just a few weeks into my Global Health Corps fellowship, two young female coworkers and I began a casual conversation about what we dreamed our futures to look like. We shared how many children we each wanted and imagined what it would be like to one day have a family of our own. We talked about our hopes of sharing parental responsibilities and creating a good life for our children.
But our pleasant lunchtime conversation suddenly took on a serious tone when one colleague recounted a story about a good friend of hers who had recently died after giving birth. Sadly, her baby died too. But this incident did not occur in some remote village with limited access to health care services. These deaths occurred in Rwanda’s capital of Kigali, a developed and prosperous city known to have some of the most extensive hospital and health care facilities in the country. The tragedy struck the community hard, and my coworker even harder, when it turned out that an error on behalf of the hospital staff was to blame.
After a long and profound silence, my other coworker shared a story about her family friend who lives in a village about an hour away from the city. The woman had a 2-year-old son who became suddenly ill with a respiratory infection. She took him to the nearest hospital but the wait to receive care was too long and the boy died. Refusing to leave him at the morgue, she carried him on her back all the way back to her village, where she waited for her husband to return from work to deliver the news in person. Another contemplative silence followed. I had nothing to contribute, only my condolences, as maternal and child death is essentially unheard of where I come from in the Unites States. I had read countless articles and statistics on maternal child health globally, but having these conversations firsthand brought my awareness to another level. I allowed the stories to sink into my mind, imagining the pain and sadness of those affected by the deaths. What had started out as a conversation between three young women, fantasizing of the family life they one day hope to have, was interrupted by the harsh reality of maternal and child deaths.
This conversation stuck with me, and it was only several weeks later when I received news that a good friend of mine had lost her sister who had just given birth to her third child. The mother had apparently felt ill about a week after delivery and sought medical care, but was not treated in time and passed away suddenly. The shock to my friend was powerful, and a few of us attended the funeral to support her.
As my first funeral in Rwanda, I wasn’t sure what to expect and I selfishly worried about standing out as a Westerner. When we arrived that morning, there were hundreds of guests already crowding under the tents. I couldn’t help but notice that they were the same tents that were used on the joyous occasion of a friend’s wedding I had attended only weeks before. We were motioned into the house and welcomed into the living room where the family was crowded around the adorned casket. It was a very emotional scene, with women sobbing and wailing over the open casket, lights flashing as photos were taken at rapid fire. I froze, staying in one spot near the corner, my eyes fixed on the face of my friend standing across the room with her sister lying in the casket next to her. I will always remember the expression on her face. She wore a beautiful long white dress, as did all of the women in the family, with a small white bow pinned to the chest. The casket was brought outside and we followed, finding a seat on a bench under the hot sun. The ceremony was filled with beautiful songs and speeches and although I couldn’t understand much of what was being said, the grief was unbelievably palpable.
“Pregnancy is not a disease,” my friend often says, a seemingly simple statement yet one that I find to be so profound. Yet despite all of the incredible progress that Rwanda has made, these stories are a sober reminder that maternal and child death remains a major issue. Statistics become a harsh reality when you witness the pain that numbers signify firsthand and the jump from reading about maternal and child deaths to attending the funeral was particularly jarring. I didn’t know this young mother personally, but I now know her story and it is one that I will forever be marked by. In the end, this experience has been but a catalyst in my devotion to improving maternal and child health globally.
Lara Heskestad is a 2015–2016 Global Health Corps fellow at Health Builders in Rwanda. All GHC fellows, partners and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. Join the movement today.
