Nathan’s little boy died of nothing. The seven year-old got a boiler in his nose. It was painful, but nothing a course of antibiotics couldn’t fix. Nathan dutifully brought his boy to the island hospital, and requested treatment. As usual, there was no doctor present, but a nurse gave him some medicine. The pills were past their expiry date, but they were better than nothing.
The inflammation subsided, and the boy was able the sleep again for a while. The infection, however, didn’t disappear. Once the under-strength antibiotics had run their course, it came back with a vengeance.
To look at the boy, there wasn’t much wrong. A little swelling around one eye and nostril, but otherwise nothing. What you couldn’t see was the constant, excruciating pain as the infection moved into his sinuses and began to press against his brain.
Nathan brought his son back to hospital. There was still no doctor, and Nathan himself had to go back to work. He left the boy there with his wife to wait for the doctor, who actually wasn’t a doctor at all, but a medical student from overseas getting a bit of practice in a place where mistakes don’t count as much.
Much was lost in the translation from Bislama to English and back, and Nathan’s wife was more than a little intimidated, so all the ‘baby doc’ did was prescribe another course of antibiotics and more bed rest.
The boy was back in two days time, burning up with fever and hardly conscious. Finally he was flown to the district hospital on Espiritu Santo island, his mother at his side. On arrival, they were shuttled into an overflowing ward and told to wait for the doctor to come. Once again, language and timidity meant that the little boy was largely ignored. The doctor saw nothing but a sleepy child with a bit of a swollen nose, and the mother would never dare gainsay an expert.
The boy drifted into a coma, and it took hours before people realised that he wasn’t simply sleeping. By the time the med-evac plane arrived in Santo, he was already dead.
Shortly after the news of his son’s death reached me, I encountered Nathan in the space outside his office. In the Vanuatu fashion, I offered my condolences quietly, with few words. Nathan just stood there in front of me, rudderless, smiling as people do when there’s nothing to be said, nothing more to be done. His own life, his future, was gone.
Dead of a boiler. Dead of nothing at all.
Death is everywhere in Vanuatu. Not that it’s more common; it’s more – shall we say, present than in societies where family has shrunk to sub-atomic proportions. It’s unusual here for anyone to go a month without being at least peripherally affected by someone’s passing. Everyone knows their duty at such times. The one hundred days of mourning are respected and understood by all.
To an outsider, it’s wildly incongruous to watch the mourners as they approach the deceased’s house, chatting quietly, even laughing amongst themselves as if on some innocuous errand. The only clue about their destination is a cloth draped across one shoulder, to wipe the coming tears.
At the very instant they reach the gate, the wails begin. They are contrived, it’s true, but utterly heartfelt. The display of pain and sorrow at a funeral is more than most people of European descent have ever seen. To hear women moaning and weeping during the vigil and the burial is an uncanny and deeply moving experience. Though ritualised, the depth and sincerity of the emotion is starkly undeniable.
And then, as quickly as it begins, it is done. Life goes on, there’s food to be cooked, children to be tended to, and laundry to be done. The laughter, the scolding and the storian start up again, as they always do.
Everyone in Vanuatu understands the place of things, and the need for everything to be in its place. Respect for public display and private observance of all of life’s events is universal. If someone smiles and jokes with his friends and colleagues just days after his first-born son has died… well, that’s as it should be. The funeral is over, and though there will be other opportunities to look back and mourn over the next hundred days, life goes on, whether one wants it to or not.
Nobody needs to mention the emptiness behind the smiles, the agonising gap between life and living. They know it’s there. Many – too many – have felt it themselves when loved ones died of illness or accident. But the life of the community takes precedence over all else, and its joy, its happiness is paramount. So we smile and laugh and live life lightly.
I can accept the necessity, even the appropriateness of this. What I struggle with every day, however, is that our acceptance of the form of things keeps us from actually doing anything about the problem.
Nathan’s boy died of nothing. But the shape that custom places on events never allows our anguish to transform itself to passionate fire. The loss of a loved one is felt as keenly in Vanuatu as anywhere, but the sense of time and place forces us to tolerate that such suffering and loss will happen again.
Intolerance of tragedy requires that we change, and change exacts a price from the community. As a result, those who have devoted their lives to achieving change in Vanuatu have little choice but to hide their candle under a bushel. There are countless such heroes throughout the country, doing what they can in their own small way.
There may yet be upheaval and radical social transformation in Vanuatu. But when change comes from the inside, it comes quietly, unnoticed by many. Most of us, we just accept that our children will die of nothing. And once the hundred days are over, only the angels will cry for them.
What can be done? By you, by the community, by those of us far away? How can we slow down the waste of life lost over nothing?
Mostly, we need to make it okay to lead, to say that things are not okay, and to propose change.
None of those are easy, or even simple. Communication, education and social reform – in that order – will give us the opportunity to start changing expectations. The opportunity, mind you, for there is nothing inevitable about it. Vanuatu society could break in about half a dozen different ways due to external pressures, brought about by the very tools that people like me are trying to integrate into daily life.
Someone recently told me that my challenge was not to prove the technology, but to understand its effects, and to prove they’re worthwhile. People in Vanuatu, he said, are almost unique in the world in that they still know the purpose of life, and everyone’s place in it. He’s right, of course. This essay was about the costs of this certainty.
I could only reply was that these changes are inevitable, and all we can do is make sure the good guys (the ones who know what’s liable to happen and how to turn it for the better) are in control.
Sorry, I missed the obvious in my first reply:
– Find those people who are doing good things right now, and support them as well as possible.
– Integrate with the local communities and become one of those people quietly working to keep life boring and uneventful.
1. Doing.
2. Doing.
I guess it is never done, is it? You left out
3. Remember to cry with the angels….
This is a very touching piece. The poor little thing… We will never know what he died of but a few possibilities come to mind:
i)sepsis due to the boil on his nose which might have responded to antibiotics
ii)Brain infection / blood clots in the brain, again precipated by the infection and worsened by dehyhdration – if so, there is a very high risk of death, even in industrialised countries
iii)cerebral malaria – the boil on the nose could be a ‘red herring’ and not the cause of his fever. If malaria was considered at the second visit, when he did not respond to the antibiotics, malaria treatment might have helped.
Children in Vanuatu are tough and can usually withstand minor infections without much difficulties, so I find it difficult to see how a relatively benign boil on the nose could cause the death of a little boy. How old was he?
Les
Thanks for your comment, Les.
The little boy was 7 years old.
You’re right that most children here are very robust – probably more so than the majority of Australian children – but I’ve also seen several cases where lack of adequate basic care by family and health care professionals has resulted in chronic illness and significantly poor health. I’ve intervened in one or two cases where a visit to a private clinic was enough to turn things around within a couple of days.
I understand that i) or ii) would be most likely in this little boy’s case. People on his island[*] are commonly tested for malaria whenever they present with a fever.
[*] Please forgive my vagueness, but I don’t want to draw undue attention to the family, who have already gone through enough.