Judging Disadvantage

There’s an excellent book I recently finished reading, called “Mountains Beyond Mountains” by Tracy Kidder.  It’s a biographical account of Dr Paul Farmer, an American doctor who became involved with a poor community in Haiti during his medical training at Harvard.  Since then he has become a Professor at Harvard, a consultant at a Harvard Medical training hospital in Boston, and the creator of Partners in Health, a charitable public health organisation involved in providing quality public health programs to disadvantaged communities.  Particularly, but not exclusively, in Tuberculosis programs.


I don’t often recommend books to read, but I would recommend this one to anyone interested in issues of global health and social inequality.


There are many things in this book that hit home for me, but one of the strongest was the following, quoted as Dr Paul Farmer talking to a group of prison doctors in Russia when one of them asked him if America is a democracy.  Farmer replied that the rich can always call themselves democratic, because when you have no shortage of resources and opportunities, democracy comes easy, but that this is not so much democracy, as privilege.


It hit home to me because I so regularly hear people judging the disadvantaged with the same criteria as they apply to themselves, in their state of privilege.


Today I arrived home from a delightful holiday with my lovely mother, on Norfolk Island in the Pacific Ocean, north-east of Auckland in New Zealand.  It’s a tiny island lush with rainforests, clifftop views of the Pacific, restaurants, interesting history and an economy almost entirely reliant on the tourist trade.  We had a lovely week there, and I followed up with New Years Eve celebrations overlooking Sydney Harbour Bridge with a small group of family/friends, sipping champagne and enjoying the very civilised festivities.


When I arrived home, I was immediately drawn back into Alice Springs life, with Marcia contacting me asking to help her.  Her 1yo child has been removed from her care after he became progressively ill during last week.  She was in a remote community with him, and took him to the clinic every day from Monday onwards, expressing concerns for him.  When Friday came around, the nurses decided he was sick enough to warrant being transported to hospital, 500km away, and Marcia became extremely irate and aggressive, arguing with her partner (the baby’s father) and destroying some property in the clinic (apparently by slamming a door and kicking a hole in it).


I’ve worked as a Paediatric nurse in city hospitals, and I am well aware of the aggression that parents of sick children can express when they feel they have lost control over their child’s situation.  As I am not a parent, I can only imagine the emotions that evoke such reactions, but I can completely appreciate where they come from, without excusing bad behaviour.


Due to her aggravation and refusal to cooperate with medical advice for her son, Marcia had him removed from her (and her partner, who was also terribly upset), and he was transported to hospital without a carer, and has gone into state care until they can work out the family situation.


So today, a few hours after I flew in on Qantas from Sydney, I picked up Marcia from the bus stop.  She was a forlorn figure sitting on the footpath looking more dejected than I’ve ever seen her, when I pulled up in my car.  She was hungry and alone, and asking to stay at my house.  I resisted at first, and she accepted my resistance, but wanted me to help her find somewhere to “be”, where she wouldn’t be alone.  The services were full though, and as she was hungry I took her to get some food.  While waiting for her order of fried rice to be cooked, I relented, and so she is sleeping here tonight.


She ate some food, had a shower, gave me her dirty clothes to put through the wash, and has quietly gone to bed, not before telling me how worried she is for the baby, who has never been away from her before.


I mentioned part of this story to someone tonight, and it was greeted with a critical comment, that had I not come home when I did, would she have stayed at my house anyway?  I didn’t argue.  But the reply is “no, she would have found a space under the bridge in the riverbed”.


No matter how wrong she has been in her reactions, the fact is that her child has been removed from her, which is not an experience any mother is going to take easily.  She was upset with the clinic staff, that they didn’t recognise the baby’s condition earlier than they did, and I have spoken to her about how difficult it can be to diagnose illness in small children, and the way children can simmer for a while before they become obviously sick.  She understands this now, and has apparently made amends with the clinic staff.


None of this even touches on the social circumstances of living in a community where poverty and alcohol fuelled chaos reign.  I know that if I was in Marcia’s position, I would be no different, so I try not to judge her because the closest I get to understanding, is imagining how her life must be.


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