Companionable silence



I’ve come to the end of a 24 hour shift and am reflecting on the day that has just passed, here in the DTC. 



I spend much of the early part of the night with a seven year old girl who needs to be treated with diphtheria antitoxin. She has a significant pseudomembrane and will be at risk of severe complications if left untreated. 



She is terrified when she arrives, scared of the treatment she was about to receive, unable to understand why she needed injections to treat her. At home, I would be able to reason with most children her age but not speaking the same language prevents this. My rudimentary grasp of the language allows me to say hello, thank you, make a basic assessment of pain and specific symptoms of diphtheria, to understand when people are asking for water. It does not extend to this level of complexity. Even with the help of an interpreter it’s not the same; subtle nuances are impossible to grasp. 



I set about finding other ways to build trust. My colleague draws pictures (I am no artist!) and  we provide her with pencils we found in the local market. We sit together colouring. We find a few sweets and give them to her. She calms enough for us to be able to start the treatment. 



Over the course of the next few hours, I am beside her bed constantly, monitoring for early signs of a reaction to the treatment. Her mother is close by, sharing her attention with her three small children. 



I know from some of the stories I have heard around he camp that this child is likely to have seen some horrific sights, will have endured more in her seven years that most will in a lifetime. Now she has a potentially life threatening disease and I don’t want her to suffer any more. 



We find ways to communicate: it’s possible to tell whether someone is smiling or frowning, even behind the masks we wear to prevent the spread of infection. It’s all in the eyes. We use thumbs up and thumbs down to good effect. Her arm hurts where her drip is sited; periodically she holds it out to me and I stroke it gently. It seems to comfort her.  My colleague described a feeling of companionable silence. She’s right: that’s exactly how it feels. 



A few hours in, she is restless and I try to think of a way to amuse her. I find a piece of paper and some scissors, fold the paper and start cutting. She’s curious and watches with interest. After a couple of minutes I hold up the paper and unfold a string of people, holding hands. The look of  pure delight that illuminates her face is something I will never forget. I fold the chain of little people a couple of times and hand it to her. She handles it as if it’s a precious jewel. 



So much of what we do here relies on making do when we don't have quite the right thing, being innovative with not much in the way of resources. I love the simplicity of it all and I know that in that moment, for that little girl and for me, what we had was enough.