Kpanti (pronounced Banti)

Hey everyone, I’ve got some questions for you concerning the level of involvement a volunteer should take with the people in his host community.
First off an explanation of the situation which has been pre-occupying my mind for the past two and a half weeks, it’s not a pleasant one:

There is a seven year old in my compound named Kpanti(I had spoken briefly of him a while back). His is an orphan that my host family took in a few years ago. His father has rejected him, his mother passed away over 5 years ago from an unknown disease. He was a sick child, this year was supposed to be his first in school; but he missed the majority of class due to illness. He does not speak English, is slowly learning Bassare (host families language) and yet everyone understands him, including me. That’s because he is a natural comedian (the family calls him “Wabodam”, which translates into “Mad Man”), his behavior is slightly odd, but in a slapstick kind of way he keeps spirits at the compound going strong.

When I arrived in Kpandai after seeing most of the JF’s off (myself and Stacey Gomez, a MoFA volunteer have had our placements extended by 4 months, the rest have gone back to Canada) I found out that Kpanti had been brought to the clinic with an extreme fever a few days earlier. His face had swollen shut and he was delirious. When I went to see him for the first time (the night of my arrival), he looked like death. His face had gone down to almost normal size but he couldn’t open his mouth, couldn’t speak and couldn’t eat. His right side was completely paralyzed, and he could barely move his left hand (the only thing he did when I saw him was try to rip the tube out of his nose). He was convulsing, still had a serious fever and cried when they tried to sit him up to spoon feed him juice.

In Kpandai there are no doctors. No doctors for 100,000 people. Half a dozen underequipped ‘medical assistants’ do what they can, and assisted by the nurses in the District they handle themselves fairly well, all things considered. A trip to Tamale or Accra for medical treatment is rare; it’s expensive and takes a properly timed response to the first signs of a serious illness. The last time I returned from a major EWB gathering I found that one of the girls in my compound had passed away without warning (she was always crying and rarely healthy so it wasn’t completely without warning). She was a Togolese infant here with her mother (an interesting woman), older sister (who only started smiling a week after the little sister had passed, before that she was timid and always frowning) and their drunk of a father who was working on my host families’ farm. They didn’t response quick enough and the girl died, no-one knows what killed her. When I got off the metro mass and walked into the compound the entire family was sitting on two wooden benches and some plastic chairs watching crappy western movies. They did that and only that for a few days.

I am writing this in Tamale (here for another EWB meeting), Kpanti has been at the clinic for over two weeks. I stopped visiting him a couple days before I left. I couldn’t look into his eyes; they were too intense. I believe he was embarrassed to have me see him in that situation, having me show up probably changed the way the family behaved towards him. It just stopped feeling appropriate for me to be there. The family told me he has regained some feeling in his left side and begun communicating with movements. They were hoping to bring him home from the Clinic, he was apparently requesting a bowl of TZ.

I have pushed for his transportation to Tamale, the capital city of the Northern region so he can check into a proper hospital. Of course he would have to be well enough to travel, and the money for his transportation and medical bills would have to be provided. This is where I came in, and my question about the level of involvement a volunteer should have in these types of situations. I gave them a chunk of my stipend and intend on giving them more, I do however have some reservations concerning such actions as they may create a situation I cannot handle financially and emotionally. If he passes away what will my role become; will I be held accountable if something goes awry at the hospital I transported him to? If he continues to approve, will I be looked at as the person who can provide the financial backing when someone in my community falls ill? If he continues to improve but requires specific medical treatment who will be expected to provide that treatment?

I recall a story from a friend here, he is a carrier for the sickle cell deformity(AS), and his cousin is a patient(SS). Her treatment costs upwards of 30,000 New Ghana Cedis a year. She is alive due to her father’s position as a doctor in Britain; I am incapable of providing such support. No-one in Kpanti’s life is capable of providing such support, but something needs to be done. He’s had a shitty life for a seven year old, and I can easily do without a chunk of my stipend as it doesn’t put me in any danger (EWB gives us quite a bit). But even so, as I take this level of involvement I risk the possibility of becoming ostracized in the community and ruining my placement, which means ruining the possibility of assisting in the betterment of the lives of many people in the District, not just one boy or one family. But that doesn’t seem to matter as much, his condition is more urgent and worrying about such things seems petty given the situation. I’m not a doctor; I don’t know what is going on with him. Speaking of it with my sister in Canada it seems most likely that he has Cerebral Malaria and that once his fever has dissipated he is in the clear, his paralysis may or may not lift but he will survive. But what about HIV? His mother died of god knows what; all anyone says is that she was a wild woman who died a horrible death. I want to have him tested, I want to help him obtain proper treatment but how much should I get involved?

How much would you get involved? Where would you draw the line? What is that line based on? What factors would you consider?

It’s hard to behave logically when you see a small child basically rotting to death in a run-down clinic. Laying there helpless as he is pumped full of random drugs by people without the proper medical training to deal with such situations. That’s where my head has been for the past while, when I am at work my mind is focused, when I am at the compound his absence is apparent.