The Arrival of Zara Egbe

Warning: The following post is graphic and kind of depressing.

Right now, somewhere in Cameroon, there is a baby named after me who I saw delivered. It's really weird. But for the whole story lets go back to the beginning, to Etoko.

Etoko is a small village 20 miles from Mamfe, but 2 hours away because the road there is in such horrendous condition. (See below.) I went to Etoko (pop. 1,200) to evaluate and redesign its small, barely-functioning health center, which was currently being kept afloat by the NGOs I was consulting for. I was accompanied by Sharlotte, my wonderful, amazing, cheerful assistant, who is also an excellent (but currently unemployed) nurse. Etoko is a village of farmers, most of whom never went to school because the nearest one is four miles away. We spent four days living in the health center, which consists of four bare, concrete rooms, with the incompetent nurse, Rebecca. We hung out with local women, played with children, toured the lush countryside, fetched water from the nearby stream, and cooked some delicious porcupine. Overall it was an enjoyable but uneventful trip. Until the last day.

On the morning of June 17th, a Tuesday, Alice came into the health center. We had spent a few evenings chatting with Alice (or at least Sharlotte had done most of the chatting in the local dialect and I nodded politely) and she was quite funny and cheerful. always laughing about something. She was also 9 months pregnant and pretty uncomfortable given the extreme heat and humidity. Although rather articulate, Alice had stopped school after 6th grade because her parents wanted to marry her off, which they did, to a local farmer about 15 years her senior. Since then, she had spent most of her time helping with the farming and child-bearing. According to her health record, Alice is 20 years old, but she already has three children- a boy and two girls. This was her fifth pregnancy- one was a miscarriage.

When I woke up Tuesday morning at 7am Alice was already there, having come in as soon as her water broke. She was pacing, wincing, and chewing a stick which people use as a toothbrush. Her good friend, also named Alice, was with her. Alice2, age 22, was also pregnant, with her fifth child. While Alice2 swabbed the floor (being pregnant doesn't excuse women from physical labor in Cameroon), Sharlotte, Rebecca and I ran around the health center, preparing supplies for the delivery. This was only Rebecca's second birth and she was clearly nervous but luckily Sharlotte, all of 25 years old, is extremely competent and was helping her out.

At 7:30 Alice and Alice2 went outside to the outhouse to give Alice an enema, which Cameroonian women believe speeds up delivery. After they came back in I got trapped talking to a crazy old woman who wanted to take a picture with me while Alice was delivering in the next room. I go there just as the baby was coming out. It was incredibly messy because the enema clearly wasn't complete and the plastic mattress, scrap of sheet, and Alice herself were covered in shit, blood and various delivery-related fluids. The baby was out by 8am, a girl with a fair amount of hair and seemingly healthy, except for her eyes, which were red, puffy and swollen. It is recommended, especially in Cameroon where the prevalence of STIs is high, for babies to be given antibiotic or silver nitrate eye drops immediately after delivery to prevent blindness caused by chlamydia or gonorrhea infecting their eyes. But because this was a rural health center with such a lack of supplies that only two sets of gloves are allocated per delivery, there were no such medications.

In fact, the health center was so short on supplies that in order to clean off the amniotic fluid, Rebecca rubbed peanut oil all over the baby. She was then wrapped in a set of hand knitted clothes- shirt, pants, booties, sweater, hat, blanket. While all this was going on, no one asked Alice how she was doing, if she needed anything. She was simply left to soak in the mess on the bed. When she was given any help by Rebecca she was manhandled, and yelled for wincing when she was roughly given an injection of ergometrine (to stop post-partum bleeding). Alice asked no questions about the baby nor bothered to turn and look at her, check how she was doing.

Because there is no scale at the clinic, the baby was not weighed and measured, just given a once over to make sure she was alright. She barely cried, just giving a plaintive wail every now and again. Once she was wrapped up, I suggested that we give Alice a chance to see and hold her. Sharlotte tried to give Alice the baby but Alice just turned her head away, refusing to look at her. It was clear then that Alice was not happy about the baby being a girl. After all, Cameroon is still a place where girls are considered unecessary and expensive, since they must be married off and are less useful on the farm. Boys are highly valued and mothers are judged on the number of sons they produce. Alice now had 3 girls and just one boy, and she clearly upset about that. Women in Cameroon believe that the sex of their baby is determined by them, rather than their husband, and thus blame themselves if they have a girl.

Watching Alice refuse to hold, or even acknowledge her child, I had to conceed that this was definitely not the happy occassion that we, in the West, romanticize childbirth to be. This was a baby who was quite literally born into shit, was likely going to be blind, and had a mother who didnt want her. This was not a cause for celebration for Alice, but rather an extra burden for her to carry. Looking at the disappointment and resignation on Alice's face, I was both frustrated and heartbroken. I was frustrated with her for not loving her baby the way I expected her to and frustrated with the culture of girlchild hating that exists in so many developing countries. But my heart went out to Alice, who while three years younger than me, had more responsibilities and fewer opportunities than I could ever imagine. Her attitude towards her child was a product of history, culture, sexism, economics, and politics, and she was only responding as she was conditioned to. All she and millions of other women have to define themselves is their identity as a mother and they want to fulfill the ideal their society creates for them.

Eventually Alice got up and changed and went into the next room, which been decorated and prepped by other women to serve as a maternity room. It appeared that every woman in the village had come to the health center as soon as she heard Alice was giving birth and had brought some supplies for her. They were extremely efficient and everything was brought in and set up in a highly systematic way, which should not be surprising given how often they probably do it, as Cameroon as a birth rate of 4.5 children/woman. Everyone fawned over the baby while Alice sat, ignored, in a corner. No one congratulated her or asked her how she was doing- it was all about the baby. The mothers and their children all sang and danced around, clearly enjoying themselves. Alice's 35 year old, toothless, raggedly husband came in, smiling. He hugged Alice proudly, but got no response from her. Oddly enough, he wasn't dissapointed about having another daughter- he actually seemed extremely happy about it, but he may have been putting on a front for me.

While we cleaned and packed up, a friend of Alice's came in and told me that it had been decided that the baby would be named Zara Egbe, in honor of the 'white man' in town and the two nurses who delivered her, Sharlotte and Rebecca, both of whom have the Cameroonian name Egbe in addition to their Christian names. Alice herself clearly had had no say in the matter but didn't seem to care either way. She was in slightly better spirits as we departed and had agreed to hold the baby, which we considered great progress.

A few weeks later Rebecca came to Mamfe and I ran into her. I asked about Alice and baby Zara and found out that they had stayed in the maternity room for 5 days but left without paying a single franc. Why? Because the baby was a girl and not worth paying for.