by Katie InmanWe stand, as it were, on the shore, and see multitudes of our fellow beings struggling in the water, stretching forth their arms, sinking, drowning, and we are powerless to assist them.
-- Felix Adler
“Dad, wait; I think she thinks we are Dr. Alan with the church van. Turn around; she looks like she needs help,” I said as my father checked the rearview mirror for the young woman I thought had flagged us down. We had been in Panama for a day and half and so far had only managed to empty the clinic pharmacy of cold medications for the hundred or so toddlers with runny noses. We subsequently discovered that everything else in the clinic was either not where it should be or had expired. After this uninspiring start, I anticipated a fairly mundane week. Though we were there as a family expecting to do medical volunteer work at a clinic, so far, our tasks had consisted of a small construction job for the guys and organizing duty for the girls.
I like busy family vacations, not sitting around by a beach or seeing historical sites, but rather, messy, crazy, work-intensive ones. Medical trips are my family's specialty because we can provide two doctors and four interpreters, a “small traveling medical brigade,” or so we've been told. Peru, Mexico, wherever needed, we've worked for a week, maybe two, serving some of the poorest communities. This trip was supposed to be my choice of location and activities, as it was my last summer before college. It has been my dream to visit every country in Central and South America. So after consulting my parents on several options, we settled on Panama.
Out of the bus shelter behind her appeared a girl with a terrified loo on her face, her hands supporting a protruding belly.
We made a quick five point turn in the massive church van we had been using to run errands and asked the woman what she needed. Out of the bus shelter behind her appeared a girl with a terrified look on her face, her hands supporting a protruding belly. The woman explained that the girl, her barely fourteen-year-old sister, had been in labor since eleven that morning. Our clock showed four in the afternoon.
So young. How could this happen?
The woman offered us God's blessings and all the money in her backpack to drive the two of them to the village where an ambulance could take them to the nearest hospital 40 minutes away in the town of David.1 My father, having helped with several deliveries during medical school, knew we wouldn't have that sort of time. If we got stuck, the mother's life would be in jeopardy if she had to deliver by the side of the road. However, the clinic was locked. Dr. Alan, the director, was out with the rest of our family and there was no way to tell if we even had the necessary supplies. We could only drive to the town and pray for a miracle. I said a silent prayer as I gave the girl my hand to squeeze as she fought back her desire to scream in pain.
We did not take her money, and God's blessings were just enough to help us with the miracle. Halfway down the mountain, we spotted a familiar vehicle: the church truck. Dr. Alan informed us that the ambulance service was down for the day and that, had we attempted the drive to David coupled with the frequency of contractions, a side-of-the-road delivery would have been inevitable. Another five point turn later and we were racing back up the side of the mountain to the clinic.
Gloves? Check. Towels? Check. Needles? Check. Blanket? Check. What else do we need?
Dr. Alan asked me and my mother to help with the delivery since he felt that the girl would be more comfortable with women in the room. I timed the contractions. Two minutes; one minute, forty-five seconds; one minute; forty-five seconds between each one. There was no turning back now. With each contraction, came another howl of pain from a girl who was suffering from something she couldn't even begin to comprehend. As I looked into those dark brown eyes, I got up the nerve to ask Dr. Alan if he knew her history. He explained that the girl on the table was indeed only fourteen years of age, but had been raped by her sister's boyfriend since she was eleven. This girl had also been a great student, the only member of her family to make it to high school, the only one to learn Spanish (as opposed to only speaking the local indigenous language).
The contractions still were not frequent enough to warrant telling her to push. The anticipation and anxiety in the air were almost tangible. No one said anything and all that could be heard were the strained gasps and sighs from the girl on the table. My sister then rushed in, laughing. Unaware of the mood that preceded her entrance, she began to recount a conversation that had taken place outside the room between her and the young mother's sister.
“How old are you?”
“Sixteen,” my sister replied.
“How many children do you have?”
“Well, I'm still in high school, so none.”
“That is strange; I had two by that age already.”2
At the time, my sister may have found that conversation funny. Experiencing a mixture of anxiety for the imminent birth and shock at the story of the girl, however, I found that this new information sent me into total confusion. I could not comprehend the complexity and difficulty of this situation for this girl, or all of these girls, as now seemed to be the case. My mother chuckled. I checked my watch. Contraction separation: thirty seconds. It was time.
She isn't the only one. How could this happen?
Dr. Alan stood at the foot of the bed alongside my mother, barking orders and giving status updates as if to inform some clueless spectator of what was about to happen. I, on the other hand, was more aware than I wanted to be of the situation. My job was to stand there, holding the mother's arms to the table so she would not interfere and keeping her calm by telling her what was happening. As she struggled with me and I saw sweat beading on her forehead, her nose, her chin, I looked into those dark brown eyes once more to tell her everything would be OK. I paused.
I'm lying. I'm lying to a girl I don't even know.
It would not be okay, I thought. This young mother would not finish high school; she would not be able to make her way out of poverty, out of the life of dirt floors and smoke-filled huts and shacks. She would be stuck in that muddy field owned by some lighter-skinned man with a cat and a real house up the river, doing his dirty work. She would likely send her child to school to learn just as she had, would give her hope, and then some man would smash it. Rape, pregnancy, unwanted child, life in poverty, repeat. I could sense that she did not want this child; I did not want this child either. She probably knew what it meant for her, those nine months leading up to this moment were most likely filled with the same thoughts that had just filled my mind. If I was preoccupied, she must have been driven insane with the frustration and the unfairness of it all. As the girl was sweating profusely and crying, with the worst look of pain on her face, I saw all her tragedy in that instant. She was fighting that child. She didn't want it. She was in so much pain, but none of it compared to what she would face once she heard the screams and cries of her own baby. I wanted to scream along with her, to share her pain, to lash out at the man who had destroyed her future. Instead, I continued to lie to her face, “Todo va estar bien, empuja." (“Everything will be okay, push.”)
When I turned fourteen, which high school to attend for the next four years weighed on my mind. She pondered what to name her baby.
When I turned fourteen, which high school to attend for the next four years weighed on my mind. She pondered what to name her baby. At fourteen, I started to worry about what I looked like and what clothes to wear the next day to school. She had one dress that was currently destroyed by the birth and cut open so she could breast feed more easily. I would leave for college in a few weeks. She would leave the clinic and begin her life as a mother. My sister was casually dating one of my close friends. Her sister lived with the man who had raped her since she was eleven. My biggest “job challenge”? Fishing out jammed paper from a copy machine. She would have to raise a child and make sure to tend to her crops well enough so she could feed both of them. The disparity between the struggles of our lives overwhelmed me. On top of all this, I wanted her pain to be over; I wanted her free from physical suffering. "Una empuja más y ya.” (“One more push and that's it.”)
4:36 PM, August 3rd, 2009, a girl, five pounds, ten ounces with clothes on, forty two centimeters long, dark eyes, black hair, dark skin, no name. We asked the mother what she wanted on the certificate from the clinic. She was silent. She would not even hold the child, even after we had cleaned the baby off and put clothes on her. Checking to make sure I could go out and get a breath of air, I could see my hands shaking and could sense it was more than just my hands. I had just witnessed a birth, a birth of a child to a girl four years younger than me who still seemed a child herself.
Staring out into the chilly, gray, foggy afternoon, I caught sight of one of the most beautiful natural phenomena in Panama: the daily rainbow stretching across a gray sky. It was ruined, though; this rainbow did not seem so special anymore. Of course, it was still beautiful, but this was tainted by the fact that it happened every day in a sky so bleak and miserable. I wish the rainbow was more than something that just repeats itself day in and day out in Volcancito, Panama. They say to get to the rainbow, you have to put up with the rain. This might mean that the rainbow is just the end of all the rain. For this baby girl, the storm was just beginning. Arco Iris, Spanish for rainbow--that is what I'm naming her.
Photo Credit: Katie Inman
The village is a twenty minute drive from where we were. According to a World Bank publication, Panama Poverty Assessment, the average time it takes for the portion of the population considered “indigenous” to travel to a “place of treatment” is fifty two minutes. Walking from where we spotted the women, their journey would have taken over three hours total ( World Bank, 2000).
 Nadine Gasman, in a presentation for the United Nations Population Fund notes that, “ More than half of indigenous girls [in Latin America] have had a pregnancy before age 20” (Gasman, 2000).
Gasman, Nadine et al. (2000). "Experiences with Increasing Access for Indigenous Populations in Latin America". Powerpoint Presentation for United Nations Population Fund.
World Bank. (2000). Panama Poverty Assessment. Washington, D.C.: World Bank Publications.