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 McKay – author, psychologist, sojourner in Laos