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Mama Passes Away

9^th December 2006
An old lady who I knew only as Mama passed away last night.

Mama lives in the same compound as me. I can't say I knew Mama very well. She could not speak English and my Lugandan is non-applicable. Some token hellos and the odd nod here and there were all we managed. I remember making an effort to get to know her when I first came here, but the language barrier was too great so I just gave up.

On the night of her death, I was doing what I am doing now - tapping away on my laptop. Esther - our housekeeper - came into the lounge in a state of panic. After a few false starts she told me that Mama had fallen down and was not breathing. I said something stupid like, "Oh. That is no good. That is no good at all," as Esther disappeared outside again. I assumed people were handling it and left it at that.

Before long, Ciarra bowls in and asks me if I knew CPR. Like most people in New Zealand, I was taught CPR at school. I have also been taught it as a requirement for my engineering degree. I could remember a few basic things - the ABC's (Airway, Breathing, Circulation) and that you need to do the heart compressions two fingertips up from the base of the ribcage - but not really enough. I figured bad CPR is better than no CPR so I headed on down with Ciarra.

Mama had been rolled into the recovery position by someone - presumably Ciarra. The African folk present had not even heard of CPR and were in no position to administer it. Ciarra had previously tried to find a pulse, but had failed. I put my finger under her nose and thought I could feel some breath. I opened her mouth to see if she had swallowed her tongue - she had not. I thought I could also detect a fake pulse at her wrist. Ciarra put her hand on her chest (I was too embarrassed to) and felt a weak, but steady heartbeat.

This had happened to Mama before - her eyes would grow big and she would fall down. Brian - another Mzungu living downstairs - had once rushed her to the local clinic. Her daughter Scarlet had done something similar for Mama. She was fed oxygen at the nearby clinic and gradually retained consciousness.

This time however the clinic was closed and the local doctor (nurse?) was nowhere to be found. Esther had dashed off and found a special hire taxi that would transfer Mama to the Kampala hospital, a forty minute drive away. I helped to carry Mama into the taxi and gave Esther ush60,000 ($NZ 50) for the taxi trip - enough for there and back again and a little bit extra for any other expenses they might get stuck with.

And that was it. Mama was whisked away in a special hire taxi to the far away Kampala hospital.

I figured she would be okay. She had a heartbeat and I thought she would probably be okay.

I was wrong.

I received a phone call later on in the evening. I was told that Mama had passed away.

Hmmm.

One can't help throw around the what-if's at this point.

What if I hadn't of been so apathetic when Esther first told me?
Might I have been able to spring into action and done something more? I could of administered poor CPR and gave Mama a better chance.
What if I had given CPR with Ciarra?
I was sure her heart was beating, and was almost 100% sure that she was breathing. I don't know if that makes any sense medically, but that is what it seemed to me.
What if I had traveled with Mama to the hospital?
I could of checked her heart beat as we went - presumably her heart stopped on the way. Once again, bad CPR is better that no CPR.

I like the way I sprang into action when no one else did when the kid was bowled at a village I was visiting. I was even quietly proud of it. But then there is Mama. I wasn't the man for the crisis. I was hoping it would "all go away and someone else would sort it out".

I failed to spring into action when I heard Mama wasn't breathing. I was too embarrassed to do a simple thing like put my hand on her chest to see if her heart was beating. I didn't get into to the taxi to administer my poor - but superior to the Africans present - medical skills. I didn't want to put myself where I was not wanted.

A common theme in the last paragraph is embarrassment. I think it goes one level deeper than that though. It goes down to a central theme that was first hinted at in my stay at Ashburn Psychiatric Hospital, and then further clarified by my clinical psychologist, Tara Clark. The theme is that of Social Phobia.

I was too scared to act on things that could of helped Mama. Too scared to butt in where I could of possibly done some good.

Now, I am probably being far too hard on myself (another central theme from my poor mental health days), but the what-if's rattle around nevertheless.

Mama was an old African women. Her heart and blood pressure were not in good shape. In a way, she died quite an African death.

A taxi had to be called - there were no suitable ambulance service.
The local clinic was closed- there was no backup.
The closest hospital and Mama's only real chance of survival was - at best - a forty minute drive away
Nobody but the Mzungus (white people) had the faintest idea what CPR was.

None of this would of happened in a developed country. An ambulance would of been present in five minutes that would of administered oxygen and took her to hospital. She would of had a much better chance of surviving if it had happened in a developed country.

I know it is not my fault that Mama died. She was a frail old women. But it is hard to stop the what-if's nevertheless.

What if I had done better?

What if Africa wasn't Africa?

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