Joyce - €14.50/kg

“It is a melancholy object to those who walk through this great town or travel in the country, when they see the streets, the roads, and cabin doors, crowded with beggars of the female sex, followed by three, four, or six children, all in rags and importuning every passenger for an alms….” Imagine a poverty-stricken country, population living from hand to mouth, and children being born in ever-growing numbers but in fact unprovided for. Could well be Benin. But this passage in fact refers to Ireland at the beginning of the 1700’s. So begins Swift’s Modest Proposal for Preventing the Children of Poor People in Ireland from being a Burden to their Parents or Country and for Making them Beneficial to the Public.  His proposal is as ingenious as it is modest: I have been assured by a very knowing American of my acquaintance in London, that a young healthy child well nursed is at a year old a most delicious, nourishing, and wholesome food, whether stewed, roasted, baked, or boiled; and I make no doubt that it will equally serve in a fricassee or a ragout. The flesh of yearling children as an export product: think  of all the advantages!

How much is a year-old child worth? Joyce, in this case. We first met her about three weeks ago at the centre in Madjre, strapped to the back of her mother, one of the mentally ill there. Or so we thought. Not her mother at all. For it turns out that the father, background and domicile unknown, had come visiting a relative there, with Joyce in his arms. Joyce’s mother, he said, could not care for the child. And then he departed, leaving Joyce behind. I’m not sure how he managed that, but there she was. To all intents and purposes orphaned. Another mouth to feed, though  true, it is a very small one. Joyce must be about a year old, looking at her dentition and her motor skills; but at her four kilos hardly the size of a year-old. Sadly, in Benin that is hardly rare. Malnutrition, even for children who have not been abandoned, is rife.

This morning we saw her again, still strapped to the same back. Marijke was the first to spot it, and Mariette immediately agreed: Joyce looked like she was dying. Her fingers, which should be brown-black, were a pale pink; the whites of her eyes were whiter than they ought ever to be. And dull. Like her general skin tone. And the slack apathy of her face. Extreme anaemia, there could be no doubt. This girl needed hospitalization without delay, if she was to make it through another night. I phoned Raoul: we need to talk, I said. The baby is dying.

You should understand that there is no professional care at this centre. No-one trained in doing diagnoses. No nurse, psychiatric or otherwise. There is a lot of love and a lot of commitment, a few volunteers (mostly ex-patients) who help with the cooking and with supervision, and there are Raoul and his wife. The latter two decide on and dispense medication, assign tasks to volunteers and to patients, and try to keep the centre financially afloat. Not easy to do. We had arrived that morning around eleven o’clock. It wasn’t until I opened the children’s Bible to the story of Jesus’ multiplying of bread and fish, that we discovered how hand-to-mouth existence is. I asked, by way of introduction: Avez-vous bien manger? In Benin that question is a courtesy question, like  How are you?  in English. No-one expects to hear: Non, in response. But that is what I heard. No-one had eaten at all this morning. There was no diesel to run the flour mill. No corn flour, no boullie, no pâte. No-one had eaten. Which means that Joyce hadn’t eaten either. And even if she had, there would have been little nutrition in it for her. All the love and commitment in the world doesn’t provide a malnourished little girl with what she really needs.

Raoul arrived 15 minute later, harried: he had been on his way from Azove to Lokossa, trying to ferret out where the funds for the centre – which had been wired to Ecobank – had ended up. Yes, he said, he knew the baby wasn’t doing well.  But everyone was hungry, and there wasn’t anyone who could look out for her better than the girl who was playing mother. I said: we’ll take her, but there’ll need to be some authorisation, won’t there? Do you have any papers saying who she is, or who is responsible for her? He looked at me as if I was speaking in tongues. No, he said. Just take her, if you will. I’ll find someone to go with you, and to stay with her at the hospital. (That bit didn’t surprise us: at the hospitals here the staff do not do more than strictly, strictly medical duties. Washing, cleaning, cooking: that’s what the family is for.) One of the kitchen volunteers was asked to go along. Time came to go: but not before Raoul and Mariette and Marijke had been able to almost convince the girl whose baby Joyce had been for the last few weeks that we weren’t taking her away forever.

We arrived at Gohomey: the hospital where Joyce would most be most likely to survive, Mariette was convinced. The hospital is run by Catholic sisters and is reputed to be clean and able to do blood tests and transfusions. The verandas were lined with mothers and fathers awaiting their turn. Mariette, very assertively, managed to negotiate a consultation well ahead of most in the line. Second, actually, right after a baby with extremely high temperature. The nurse did what nurses do: Joyce was temped, examined and a chart was opened. We were sent to another veranda with another door labelled laboratory. Where a very kind technician did very unkind things to Joyce, trying to extract sufficient blood from veins virtually impossible to find. We were all in tears by the time she succeeded.

The test results were ready 15 minutes later. Blood count almost off the bottom end of the scale. This baby needs a transfusion, right now, the doctor said. But we don’t have any blood. He shook his head. I do, I said. Same blood type: 0 positive. And if that’s not enough, Marijke has lots more… There was a lot of relieved joking on the veranda after that. A man we did not know offered blood of his own. No, told him, yovo blood is much stronger. Mine is what she gets… Another blood test followed, this time to verify that I was indeed 0 positive. And not long afterwards I was lying in an ancient recliner, watching myself fill a 400cc blood bag. Don’t forget to have some soft drink afterwards, I was told. And then the bag was detached, brought over to the other veranda, and Joyce was taken to the ward.

We stayed until the drip was regular, and then we left. The kitchen volunteer remained. Joyce was semiconscious, but there was no more we would do.

Tonight we went back. She was still attached to tubes, but now just receiving saline. She was sleeping. Her colour was amazingly normal. Fingers, eyes, lips. Joyce was back. All four kilos of her.

Some time later we were back with food. Which she refused to eat, incidentally. Because her right hand was still attached to the immobilizing board and the tubes. And her left hand: she never eats with that. And no one, no one else but Joyce herself gets to feed her face.

Back to my question: how much is a year-old child worth? Well, I don’t know that. But I know what she cost us today. A pint of blood. And FCFA 38.000 or €58,00 all-in: from syringes to analysis to hospitalisation to a bag full of medicines and vitamin solutions. That makes about €14,50/kg. A bargain.

(And that in times when aid to developing countries is being decimated… May I make a modest proposal?)