Publicado por: Evandro Dias | 16/12/2012

Born at the Right Place

Poverty has many faces. The poor have seen them all. Those who know poverty only from media reports all too often associate poverty with “having less”. That does not even begin to tell the cruelty of poverty. I may decide I don’t need all the amenities and comfort and opt for a simple life. No car, no TV, grow my own food, no money to spend at the mall. I may choose to live “with less”. I would never choose poverty. I would never choose the cruelty of being at the mercy of others who may or may not be concerned with my wellbeing. I would never choose to watch powerlessly as my child struggles to survive.

Marian* and Manoel* didn’t choose either. Both were born in October 2011. This is the story of their first year.

Marian was born in Munich, Germany. Far from the hectic stress of a hospital, she was born in the hot tub of a birth house. Had there been the slightest hint of complications, the next clinic was only a few minutes away. But things went well and she slipped into the warm water before she was laid on her mother’s breast, where she stayed except for a short minute to weigh her. Three hours later, she went home with her happy parents.

Manoel was born a week earlier. In Belém, Brazil, the „gate to the Amazon“. His mother had arrived at São Benedito* on a Friday, three hours away from their home and twelve hours away by boat from the state capital Belém. She was in pain already and told the doctor that her first baby had already been delivered with great difficulty. She would need a caesarian section. She had given birth to the first one naturally and thus would do it again, was the response.

Only on Sunday, when he finally looked at her again, did the doctor realize that the woman did, indeed,  need a C-section. It could have been done in town, only it was too late already. The baby would need oxygen, so she was flown out to Belém. On Monday. When she finally reached the hospital, the shift there changed and the new doc in charge decided that she might as well wait a little longer. Natural birth would be possible.

It was. With all the violence and force, Manoel was finally torn from his mother’s womb. He was never laid on her chest, he didn’t feed. He spent his first month in an ICU, tied to the oxygen mask. And that was only the beginning.

When Marian was two months old, she flew to the Philippines together with her parents to live there for two years. Despite her parents’ worries she hardly noticed the flight. She either slept, laughed or fed. The mothers’ colleagues in the Philippines are crazy about Marian. She’s cuddled, caressed and carried around by everyone. The mother even finds it too much, but Marian takes it in without much ado.

Manoel travels, too. He has regular medical checkups, tests and physiotherapy in Belém.  Every trip means twelve hours on a freight ship in a hammock. Soon he has another pneumonia. Back to the hospital, oxygen mask, antibiotics, X-ray. His mother stays beside his bed. In public hospitals only one watcher is allowed per patient. So his mother doesn’t leave to eat or rest. She sleeps on a chair. The father stays back in the forest with the elder sister, three years old. The relatives say Manoel is scared when people get close to him. The long weeks in the solitude of the ICU have not prepared him for the lively affection of his family that has been waiting so long to hold him.

July 2012. Marian has to get another immunization shot and her mother wakes up sick in the morning. She hates to see her baby cry and look at her, not understanding why someone would hurt her. After ten minutes she’s ok, though. The mother decides to visit the pediatrician a few times only to play, so Marian would lose her fear.

Manoel has had a few weeks of peace. Homemade remedies keep his lungs calm and the cough down and the love of his family helps him relax. He seems to be able to see and sometimes he grasps. He never laughs, though. Then comes another trip to the city. And another pneumonia. This time he is not even admitted to a hospital. He stays at a first-aid-station for two weeks. His mother sits by his bed and cries when she sees the nurses messing up his little arms, trying to find a vein that they can prick. The night of his release he gets another fever, but it’s Friday and the doctors have gone home. The mother stays with friends in Belém. The father works even harder in the forest to pay for a consultation with a doctor.

October 2012. Marian celebrates her first birthday singing and playing on her ukulele. The midwives of the birth house in Munich send a little card with best wishes. Marian has started to walk and learned to endure the slaps of the kitten without crying. Her mother is proud of her tough little girl.

In Brazil, Manoel lies in his mother’s arms. He’s got a fever again, pneumonia, cold hands and feet and a hot belly. Manoel doesn’t cry anymore, says his mother. He just lies there and waits.

In his desperation and fury, her brother-in-law posted on Facebook about the cruelty and ignorance of doctors and bureaucrats. Don’t the poor have any rights, he asks. How can a society treat their children like this? Brazil had more C-sections in 2010 than normal births. The middle and upper class is at 82% caesarean[1]. Around 1,700 undergo plastic surgery in the country. Every day.[2] How can a country that has one of the highest rates of plastic surgeries and planned C-sections deny the most basic medical service to its poorest? And destroy an entire family.

The post goes around. Now even local politicians are upset and furious. Immediately the mother receives a call from a city representative. She should stop spreading such stories that shed a bad light on the mayor! The child’s condition is God’s will and she better remember who pays her salary as a teacher. Never mind that she hasn’t received any salary in months.

Today the mother went to four hospitals, but none wants to admit Manoel. The mothers’ legs are swollen of all the nights on hard chairs. The father is sick and thin from all the work and worry about his son. Little Maria* doesn’t eat anymore. She doesn’t understand why her mother and the little brother are always gone and her father is always sad. She is four years old now and still doesn’t speak.

Marian knows injustice when she sees it. If her mother picks her up from the ground where she played so nicely with an ant, she gets mad, jumps, screeches and slaps the father who happens to be within reach. She doesn’t know anything about public health systems or social classes. She doesn’t know Brazil yet. Next year she will move to her father’s country to live in the forest with her parents and greater family. Then she will meet her cousin Manoel, too. If it’s not too late.


*names of the children and places have been changed to protect the people involved.

[1] Conselho Federal de Medicina. Pesquisa mostra que gestantes precisam de mais informação para optar por parto natural. 26. März 2012.

[2] Jornal da Globo. Brasil é o segundo país em número de cirurgias plásticas. 30. April 2010.

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