Health in Chad, a family affair

We report the testimony of Sabrina Atturo, MAGIS project leader, currently in N’Djamena for an initiative in support of the University Hospital Center Le Bon Samaritain.

Eveline is not a fancy name but the name of my new friend who will be staying for a while at Le Bon Samaritain Hospital in N’Djamena. Eveline is a wisp of a woman in her twenties, very tall and proud, from the Sao ethnic group. She weighs only 38kg because HIV has entered her body violently and has severely debilitated her.

I met Eveline thanks to Carlos, a young Jesuit and Spanish doctor who examined her and had her hospitalized urgently. Eveline belongs to a fragile and vulnerable family. Her parents are gone and her brothers and sisters make many sacrifices to feed her. But they are there and have never abandoned her despite the difficulties. Of course, they can only guarantee her the minimum: one meal a day with bouille, rice with chicken or fish. The State guarantees her medication but her diet is poor so her body cannot recover its strength properly.

When Carlos introduced me to her, my maternal sense prevailed and so, touched to the core, I made a commitment of my own: to spend a few hours of my day with her. Needless to say, I came to her with all my background on HIV-positive people, made of loneliness, stigma, exclusion, her alone in the room, casseroles always empty of food, the two usual shirts that alternate every day. If I had stopped at a quick hello every afternoon I would still have my convictions.

Instead, something happened in the depths and I took the right time but above all I let myself be touched in the depths by her eyes full of life. So a new social reality manifested itself in my eyes: I met an older sister of hers who works all day long at the market but in the evening, before going home, she comes by and brings her a bite of bread for the evening and the morning (in hospitals in Chad there is no canteen service, it is the family that brings the food). Eveline is so nice and chatty that she knows the whole ward, as soon as she hears footsteps she turns to the door and greets, she says something in Arabic that I don’t understand but all the relatives of the hospitalized patients come in and greet her. In the morning and afternoon she goes out for a walk outside the ward and someone invites her to sit on her “family carpet”. If it’s mealtime and she has nothing, everyone shares their “five loaves and two fishes” with her.

Surely outside the hospital Eveline’s life is not easy, she suffers from social stigma, she cannot work, she is not fully integrated in the social life, she is a poor and HIV positive woman. But here in the hospital she is respected, she is welcomed, listened to and supported, as much as possible, by her family and by the Chadians themselves… and this solidarity fills my heart despite the material poverty.

In Chad, the right to health is not guaranteed; you have to pay for everything, there is no national health service that takes care of the poorest. Everything is paid for by the patient and every day I listen to the difficulties people have in accessing care… but what I learn from them is that if you are sick, a social network always tries to support you, with the little they have, because your health is a family affair.

A Chadian doctor who lived 12 years in Italy told me one day over coffee: “Dear Sabrina, here in Chad health is a family affair, unlike in Europe where it is increasingly an individual affair. When I visit someone, it’s not the patient who answers my questions but the family member who is always present during the visits: the husband for his wife, the older brother or father for his son. And when someone is hospitalized, the family gets together and organizes shifts to be next to the sick person, at least two-three at a time.” The women prepare food for everyone; they go to the hospital in the morning, roll out the carpet in the common areas, the patient comes out and sits with them (no one here can stand the enclosed spaces of a hospital – in Chad you live outside the house not inside the walls!) and you share a meal, chatting with your carpet neighbors. From time to time, men also pass by, who are busier with work, but friends and relatives never fail to pay a visit. A living, simple and concrete social network that supports the sick!

But what about us? We don’t even have the time anymore to visit our hospitalized relatives and friends. We increasingly entrust the care of the sick to insurance companies and voluntary associations. Are we really masters of our time or are we just victims of it? Michael Ende’s novel Momo comes to my mind: “you have eyes to see the light, and ears to hear the sounds, you have a heart that perceives time. But alas, there are blind and deaf hearts that, though they beat, do not hear…”

And so, in the simplicity of sharing, Eveline and I say goodbye to you from Chad, together with our mutually donated time in which we listen to music, see every day the photos of her trusted doctor Carlos (who meanwhile has returned to Spain), silently I massage the most painful parts of her body, she relaxes and my life here is enriched with meaning.

Photos: Fondazione MAGIS