When my child is sick: Missing the promise and illusion of safety

by Lisa McKay on November 19, 2012

On Friday my fifteen-month old baby, Dominic, started running a fever for the first time in his life. We live in Northern Laos. The hospital beds here are full of dengue fever patients at the moment, and fevers of any kind aren’t to be taken lightly.

I did what any worried mama living out of reach of good medical care does nowadays … I googled. And after 24 hours of fever and fussiness, my husband and I put Dominic in his stroller and set out for the doctor who runs an after-hours clinic out of her house down at the end of the little dirt lane we live on.

Going to the doctor here is a little different than going to a doctor at home. There is no such thing as an appointment. The clinic opens when the doctor comes home from her work at the hospital at about 5:30pm, and she sees patients on a first come first served basis.

When you arrive at the clinic you take off your shoes and pick up a number outside the door. Then you wait your turn on a bench in the front of the room while Dr Payang sees people in the back of the room where she has set up a desk, a chair and a camp bed. Only a large dresser that acts as a partial screen separates the waiting room and the consultation area.

We waited our turn with half a dozen other families, and exhaled in relief when the tired doctor peered into Dominic’s mouth with a small flashlight and then showed us the source of all that heat – a throat infection. She handed over some antibiotics, wrote down the dosage instructions on a sheet of paper to make sure that we had the details right, and we headed home.

Living outside the reach of carpeted, colorful pediatricians’ offices is possibly my least favorite aspect of our life in Laos. I miss ambulances with their purposeful sirens and English speaking paramedics. I miss emergency hotlines. I miss gleaming hospitals with their bright lights and shiny instruments and reliable X-ray machines. I look at my baby when he’s running a fever and I really miss the promise and illusion of safety that all provides.

I say promise because, let’s face it, medically-speaking, Dominic would be safer if we were living in the more developed world. Malaria, dengue fever, and the tropical parasites that thrive in our garden here don’t even exist in most of Australia. And some of the more globally equitable childhood maladies, like meningitis, you really want to catch and address fast. As we learned the hard way when Dominic broke his femur at five months of age, you can’t address things fast when you live in a small town in Northern Laos.

But I say illusion because living right next door to the best hospital in the world can’t guarantee you safety or grant you total control. It just can’t. No matter how much we might want to shield our children from catastrophic injury or illness, we never erase those risks entirely. In fact, Dominic would be more at risk of experiencing something like a car accident in that situation. We don’t own a car here in Laos, so he rarely rides in one. The same could not be said if we were still living in our previous home, Los Angeles.

So the questions that I must continually confront are these: How do we calculate risk? How much risk are we willing to tolerate, and to what end? What do I do about fear? We are living in Laos because my husband is doing work we both believe makes an important, tangible difference in the lives of people poorer and much more vulnerable to the vicissitudes of life than we are. Is that a good enough reason to have my baby risk dengue fever? On average, the answer to that question so far has been yes. On average.

Now, three days after starting antibiotics, Dominic’s fever is gone. He had seemed to be much improved, but two hours after going to bed last night we woke to the sounds of retching and screaming. It heralded the start of Dominic’s first all-night vomiting marathon. This morning has brought more vomiting for him and more questions for me.

So now I’m off to consult google again, this time about oral rehydration. If only I could search out answers to all of my questions so easily.

Do you feel any tension over how your choices impact your children?
How do you resolve that tension?

——————-

Lisa McKayauthor, psychologist, sojourner in Laos

Blog: www.lisamckaywriting.com      Books: Love At The Speed Of Email and My Hands Came Away Red

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About Lisa McKay

Lisa McKay is a psychologist and the award-winning author of the memoir Love At The Speed Of Email, the novel My Hands Came Away Red, and several books on long distance relationships. She lives in Laos with her husband and their two sons.
  • We had some similar experiences when moving to S. Africa. Our oldest son began to get all kinds of “unique” sicknesses and diseases. We went to the doctor countless times in the first year till we got “used” to some of the different strains of viruses. I appreciate the way you showed both sides of the coin. The risks are higher but not limited to the field. The benefit for us inspite of more frequent trips is the cost is significantly less! Great article Lisa

    • Thanks Chris. Yeah, it does take a while to acclimatise, doesn’t it. Some people never seem to quite get there. Hope your kiddos are through that stage of picking up everything.

  • I like that you said, ‘illusion.’ That’s such an important point. It is easy to assume no harm will come if we live near a great hospital or if we have the best doctors. But what does that imply our hope is resting on?

    • Totally agree, Rachel. “illusion of safety” is a great phrase, for any parent, anywhere.

      We had a friend who was a missionary in Brazil on the Amazon River. She told us once of a friend of hers who had moved her family down to work with them. The mother became really fearful for her kids of all the poisonous bugs/snakes in the region, and they quickly left the mission field because of it. The family moved to Florida, and the first week there, her son got bitten by a poisonous snake– rattlesnake?

      Anyway, not AT ALL that that was God punishing the mother or anything, but the story just underscores that idea that nowhere is really safe. And safety is just as much of an illusion in the States as it is in the Amazon.
      Great article, Lisa.

      Thanks for honestly communicating here.

    • Yes, well, that is the one hundred million dollar (or eternal, unperishable) question. My answer to that question isn’t always a good one.

  • I love what you’ve said here. As a mom I struggle a bit more with this than my husband does – just knowing a bad head injury here cannot be addressed makes me (double) cringe every time my sons climb high above our all cement yard. Our youngest had bacterial meningitis here and I cannot recall a time in my life (besides maybe the giant earthquake) that I felt so desperately alone or afraid. I don’t think I resolve the tension as much as I just compartmentalize and set it aside until in the middle of some bad illness I am forced to face it. I will say that with the most serious incidents – when our kids has had something big go on – God provided one of two close friends that are both ER docs – if you’re going to slice your leg wide open to the bone or get meningitis it is nice to do it when your parents have their smart doctor friends are visiting. 🙂 God can provide outside of our small box.

    • Oh the bad head injury scenario (in technicolour in my head, fully formed, almost instantaneously, whenever I think about it). I never thought I’d be a fearful, hypervigilant mama bear. I totally am. Or could be, if I let myself. Sometimes I let myself :). Glad you had doctor friends there for your kiddo crises!!!

  • Agree. Its an illusion. I frequently tell my friends back in America this. America is full of TV influence and materialism; not that I am in Asia to hide from those things, but in the end, I fear what would happen to my soul more than my physical body. We had dengue fever three rainy seasons ago. Not fun.

    • No, we’re doing our best to avoid that particular experience of dengue. I’ve heard it doesn’t rate.

  • Liz K

    oh, this is the part I hate the most! Not being able to communicate what is wrong with my kiddos and not knowing if we are doing what’s best health wise. We live in an area that has very good medical care, but it still is nerve wracking for me. I constantly have to ask the Lord to calm my heart about this. And I go back often to the truth that if He called my husband and I, He has called our three boys as well, and they need this time here to grow into the men that God wants them to be.

    • Yeah. I’m with you on that one. I know it’s an illusion, but I still think I’d feel better about this if we were living right next door to that hospital in our “home” country.

    • it is scary, Liz… neither being sure you’ve been understood or actually understanding what the medical professionals are saying to you. especially when were working in a second or third language. when our little girl was so sick, i thought the dr. said (in French) cerebral malaria instead of severe malaria…

      and that doesn’t even touch the whole cultural side of things, either. Here, asking the doctors to re-explain something is akin to questioning their professional capacity.

  • In light of a time travel experience with an affront as a trip to the ‘best’ hospital in town I did some googling of my own. I looked up how long people usually live in Bolivia. Seeing that number 66 blaring on the screen let a whisper of doubt creep into my 30 something year old head. I am middle aged! No fluoride in the water. Self serve ambulances. Prescriptions for medicines that my pharmacist uncle tells me to throw in the trash because it could give my kid a brain disease. All risks. Not to mention the psychological formation taking place growing up surrounded by extreme poverty and fewer opportunities than in the Western world. You ask how we resolve that tension. Usually I ignore it and power on. But when forced to face it I come back to faith in God. Loved the post Lisa!

    • Hey, denial is a tried and true strategy for helping enable perseverance :). This topic seems to have hit a nerve with people. Next month I might post directly on how I was first confronted with that tension. Thanks, Angie.

      • It may be tried and true and even effective to enable perseverance; but is it healthy? That’s what I wonder. I am very much looking forward to your post next month.

        • No, I don’t always think it’s healthy. But, oddly, the older I get the more I think it has a place. Not quite sure what that place always IS, but no longer thing denial is always and all bad.

          • So then the question is the period of time for which such denial should be permitted. Temporary? Permanent? And what are the markers to look for so that we know it is time to deal with the denial. [Don’t feel like you need to answer these questions. Just throwing them up here for the sake of thinking out loud.] Thanks for your honesty, even in uncertainty. Very refreshing.

        • I agree with Lisa. Denial isn’t always healthy…

          Yet when fear is provoked by dark powers whispering lies (like “your baby is much safer back there), recognizing that, powering on in God’s strength and denying their power over you while calling on the name of the Lord is the best… should be our only… response.

  • Frances Ross

    I totally feel the tension of our choice to be missionaries is going to impact my children, with one adult daughter living thousands of miles away from us and having three teenagers and two children and one toddler, I’m not as concerned for their physical well being as I am concerned for their spiritual! It is super hard to watch the spiritual attacks that they have to face because of our choice!!! I do love google! So glad your baby was taken care of! Thanks for your post!

    • Google!!!! LOVE google. And skype. My mind boggles when I think of what missionaries faced in this arena even 100 years ago.

  • Frances Ross

    I resolve the tension by a lot of prayer!!!

  • Oh how I agonize over this one, Lisa… on an almost daily basis. Still. We came with 4 five and under. Now we have 8… two were born here; the other two were back in Niger – one by 3 months and the other at 6 weeks… We’ve had the gamut: malaria, typhoid, both at the same time, pneumonia, dysentery (the resistant to treatment kind)… i watched one of my sweet girls lose over 1/3 of her body weight in less than a week… we almost did lose her – and refused med-evac even when everyone else was recommending because of the peace God gave that we were where we were supposed to be. I don’t have that same peace thinking about it now, though… Yet, just as you so eloquently said, it is is also very much an illusion that nothing bad will happen just because you do have access to medical care. We went home for our last home assignment and our one with asthma ended up with whooping cough (fully vaccinated, too…)

    I totally hate it when people say: “The safest place place to be is in the center of God’s will.” I know what they mean, but it doesn’t always feel safe – especially for my kids, at least not the way I define safe. It isn’t like serving God on the back side of the desert is some magic shell of protection and nothing bad is going to happen. In fact, it is everything contrary to my mama bear’s protective nature to bring these kids to a place where she knows she is exposing them to bad stuff and that they WILL get some of it. I used to think, I’d someday get used to living with the tension. It hasn’t happened yet. There’s no peace ahead of time… just choosing to trust God and His plan, whatever that may be and finding peace in choosing to trust.

    • Oh, Richelle. Thanks for sharing, though I don’t like hearing that this tension doesn’t go away when they hit two. Surely. Surely? It MUST go away??? I don’t want this for the next … forever :). PS. I hate that saying too, and several others.

  • Chris

    I haven’t figured out yet what to do about fear. We live with a much higher level of it here every single day. I pray a lot of desperate prayers, God gets us through, and sometimes I even feel my fear levels subside for a while. I think the fear is 100% attributable to the circumstances we just were never faced with living our comfortable, safer lives in the U.S. Fear is also from the enemy, so anyone involved in third world missions is usually storming the gates of hell in one way or another and will be slammed by it to varying degrees. It just comes with the territory. It may mean you are quite a threat to the darkness. 🙂

    Great post, thanks for sharing. Glad your boy is better! PTL. This blog is a great idea. I look forward to reading more posts just for us missionaries!

    Chris @ inpatagoniaargentina.wordpress.com

    • Just a quick ‘hola’ to you from your neighbor to the north, straight up in Cochabamba, Bolivia. I am glad you are here, Chris.

    • Ugh, the fear factor. It’s something that’s impacted me more since getting married and becoming a mother than I ever thought possible before! Thanks for chiming in, and hope you are having a good week in Argentina.

  • Gina Carr

    Wow. I am so encouraged by this post and all of your comments. We are still here in the states but in the process of raising support to go to Mozambique, Africa full time. We went a year ago for a month with our then 20 month old. Now we have a three year old and a 5 month old (both boys). I’ve felt so lonely in this fear thing before your post and all the others chiming in. Sickness (malaria) and poisonous snakes has been such a gripping fear of mine, and we’re not even there yet!! I’ve really wrestled with the Lord over this one, and asked the question time and again if we are we doing the right thing putting our small children at risk for these things, etc… I always come back to the thought someone else mentioned and that is this is just as much part of our children’s story and purpose as it is ours. By playing it safe, I could be robbing them of what God wants to ultimately accomplish in their lives. Ahhh, the tension! Thanks Lisa, for sharing with us right in the middle of your circumstances and everyone else too. It feels so encouraging to know we are not alone in this.

    • I’m so glad it was meaningful for you. Yeah … fear. Marrying has taught me fear. Motherhood has definitely taught me fear. Still working out what to do with those particular lessons. Also, if it’s any consolation to you with your kiddos at all … I spent most of my teenaged years in Zimbabwe and never got malaria (or was bitten by a snake). All the best with your plans.

  • Michelle Waldron

    http://bereadventisthospital.blogspot.com/2012/01/adam_01.html

    This is a post from a friend of mine in Chad who lost his son in January of this year to malaria. If anyone is interested in reading how he and his wife have dealt with this loss and the continual fight they have with malaria for their remaining twin daughter… please read his blog.

  • It’s so good to hear from other people who battle this fear and fight to live in faith every day. In our missionary posts, we have lived through denghue and amoebas that put our two year old in the hospital for three days. Even the small things like a gaping cut on the head that needs stitches and the sudden realization that your default panic mode to throw the child in the car and run to the ER doesn’t work any more can be so scary. Just a couple of weeks ago I stepped on a fer de lance snake while out running in the evening. I have to battle anew that fear. However, I have lost one child. He died in his sleep in his crib in my large and comfortable bedroom in my home in the States. So your point about the illusion of security hits home hard with me. I’ve had to really battle the PTSD from that in this mission post. For the most part, we are in a safer area than most, but it doesn’t take the fear away. It is a lonely fear so much of the time. I appreciate seeing all the comments and knowing I am not living alone. I’d love to talk some time about taking teens in to the mission field and the particular struggle it is for them with some other missionary families.

    • Oh, Colleen, I’m sorry this post was a trigger for you – raising up sadness to confront anew. I’m also glad it helps to know you’re far from alone in that battle with fear helps. I’m tucking away ideas for future posts from this comment stream, as I’m sure others are, so teens is on the list. Perhaps one of the writers with teenagers might pick that one up.

    • Wow, Colleen,

      Thanks for sharing your story, your heart here. I am so deeply sorry for the loss of your baby. What a hard, hard thing to wrestle with. Your reality so underscores this truth that safety is an illusion, and that Jesus is the only One worthy of trust, the only One NOT an illusion.

      And, I know you are a writer– we’d love for you to guest post about that story about teens sometime! If you are interested, drop me or Angie a line at

      alifeoverseas(at)gmail (dot) com

      • I spend too much time on facebook. I was looking for the “like” button on Laura’s comment and couldn’t find it. Colleen, would love to hear your thoughts on this!

    • Shay Ballew

      I just wrote an entire reply and somehow it got erased :o( Anyway….PLEASE…I’m begging you! Let’s start a conversation about taking pre-teens/teens to the field! YES! My kiddos are 6, 11, 12 (almost 13), and 14. We’ve been on the field a year and 8 months. THIS is the real struggle/fear/tension I deal with. Would absolutely love to glean wisdom from others who’ve stripped their pre-teens and teens from all they’ve ever known to go to the mission field.

      • Yes!! We have a post coming from Colleen first week in December!!

  • Heather Horst

    This post was perfect timing for me as our family is beginning a journey of missions training and 2 month outreach to SE Asia. I lived there for 3 years without a worry and now returning with a 2 year old has been a battle with fear on a weekly basis.We are praying about whether or not to vaccinate when we felt that we were not given that direction from the Lord so far. Our Son has had multiple febrile seizures and knowing the risks and controversial ingredients make this decision even harder. I struggle with fear of vaccinating as much as traveling unvaccinated. I know immunizations do not promise ‘immunization’ and these too can give the illusion of protection or safety. Tough choice. Praying for guidance based on faith and not fear;-).

    • Heather, glad it spoke to you at this time. Hope you feel peace with your decision. In light of the seizure issues I wouldn’t dare offer any advice on the subject except this: Regardless of what you choose, get hand sanitizer and use it regularly and often.

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  • Shelly VanB

    Eesh…so timely…even though we are just short term missionaries….this hit me. http://www.thevanbinsbergens.blogspot.ca/2015/11/the-ups-and-downs-of-being-sick-abroad.html

  • The first year overseas i had this fear, every time my children were sick. “What have I done to them, bringing them here?”

    It’s my husband who’s the more sane and calm one. Every time I freaked out he’d remind me about science. You know, things like ultimately they will have stronger, more resilient immune systems because of living in different places. Everyone needs to adjust to new pathogens and sicknesses in a new place. Our immune systems tune themselves to the environment we are in. Every transition will require an adaptation period.

    So I calmed myself down. I learned to spot and treat impetigo myself at it’s earliest appearance. I know exactly what the deworming medicine is called, and what dose to ask for at the pharmacy. My kids are experts at examining each other for ticks. They apply mosquito repellant without being reminded and come in at dusk when the mosquitoes are thickest.

    Two years in we are stronger. We get sick, but not very often. Not anymore frequently than we did in the US. Even food poisoning, which, lets face it, we do get more often accepting the hospitality of our village neighbors, is something our bodies are over in a much shorter period of time than they used to be.

    • I think it also helps me that even in the west we weren’t the type of parents who relied on doctors very much. We educated ourselves, we didn’t run to the pediatrician every time a baby had a fever, we learned how to tell what is, and isn’t, an emergency. In other words, the illusion of safety thanks to doctors being present wasn’t something we relied on emotionally most of the time.
      I am thankful though that we do live somewhere that does have fairly competent emergency services, should that arise, and a short plane ride to even better access if our city doesn’t have it.

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