First thing Monday morning Joe intercepted me. He exclaimed I had to visit an infant he saw over the weekend.
“What’s happening?” I asked.
“A child,” he replied. “It’s not good, I can’t explain it. You just have to see it.” I didn’t press him. We hurried to a small village next to Sirigu. Word spread. People said it was a spirit child.
The Nankani mother emerged from the traditional women’s room limping and carrying a child wrapped in a bundle to protect him from the wind, believed to be carrying spiritual and physical causes of sickness. A grandmother came out to help her and ensure he kept covered and soon returned to seclusion. Apoka, the mother, told us the child’s name was Azampana, a generic name used until the child is older. She brought him closer and removed the careful layers of Dutch wax cloth around him.
Azampana had bilateral cleft pallet and spina bifida. His obstructed, labored wheezing was loud and upsetting. His eyes were swollen shut.
Joe told me to photograph him. We needed documentation. I hesitated before capturing three photos of his face. Joe then asked Apoka to flip Azampana over to show the infected opening at the base of his spine.
“How old is he?” I asked family members.
“He’s eight days old today,” someone responded. When we were finished looking, Apoka covered him and slipped away to her room.
“What causes this?” I asked.
“Actually, I cannot tell,” said the family head. “It’s the first time I’ve seen something like this.”
Another man remarked, “I think it could be sickness. Maybe the woman got an infection when she was pregnant and through it [the sickness] the child has those deformities.”
“Is it a spirit child?”
“No. There are no misfortunes in the house.”
The parents were stoic. The local nurse was not optimistic. She taught Apoka how to feed Azampana with a spoon since breastfeeding was impossible. It is hard to keep the utensils clean, she said. She was reluctant to help the family, and I got the sense she felt that anything adding to her heavy responsibilities was a waste of time. He would not survive. Even if surgery was available, the nurse said, they must wait several months before they can operate on him. What would happen in the meantime? More infection? Malaria?
In developed contexts, the surgeries and services needed for Azampana are routine. The likelihood of survival is over 90%. In Northern Ghana, such a child has little chance. This inequality is one of the more appalling failures of humanity.
The following day Joe and I took Apoka and Azampana to the hospital. We felt the need to do something. A physician from a British charity and two local doctors happened by and stopped to examine him. We chatted and they admitted Apoka and Azampana into the maternity ward to stabilize him, treat the infection, and consider transferring the child to a hospital in Accra for the required surgeries. The British doctor was positive his charity would fund the expenses. Hope propelled Apoka. After mother and son were in the hospital’s care, we returned to Sirigu.
Two days later, Joe and I were in a group meeting in the shade outside his office. We noticed Azampana’s father standing in the distance. He approached the periphery and waited for us. He explained that he received a message delivered a few hours earlier saying the child had died. He was well-composed considering the loss. The Nankani discourage overt expressions of profound emotions in this setting. I offered to bring Azampana’s remains and Apoka home that afternoon. The father voiced his appreciation.
There is diversity in how Nankani parents respond to child misfortune, illness, or disability. Much of my work focuses on families that view sick or disabled children as spirits sent from the bush to cause misfortune and kill family members. I show how parents, when confronted with a chronically ill or disabled child, react with fear and aggression, and do not mourn their child’s death. I’ve written less of “common” deaths of children destined for the house. When a child identified as a part of the family dies, parents experience and express a set of responses that can appear to be, to outsiders, either familiar, unexpected, or both.
It’s easy to construe parental fatalism, stoicism, or impassivity as a lack of concern or love for a child. Too often we interpret common human experiences of parenting, love, and death as universal. We think it’s natural that parents will always love their children. This is not always the case. A few decades of research have cautioned against universalizing parental sentiments. Sometimes what we consider natural comes from assumptions and research based on wealthy, white, and industrialized societies.[i] In the 1970s, Maria Piers, a psychologist who worked with poor mothers, showed how infanticide, child maltreatment, and neglect were consequences of the underdevelopment of women and the oppression, emotional starvation, and negative life experiences of mothers. Not that maternal love does not exist, Piers argued. Rather, a range of social problems interfere with the motherly drive. In Death without Weeping, Nancy Scheper-Hughes contradicted universal maternal scripts by showing how love and maternal practices around the selective neglect of infants without a “knack for life” were socially and culturally produced.
Human responses to critical life events are complex, involving interactions between our biology and a range of impinging contextual forces, cultural and moral worlds, and internal dynamics.
Taken for granted, and less discussed, are the meanings behind people’s affects and expressions and, in this case, the nuances behind the words and behaviors surrounding child mortality. The terms used to define and describe love or loss are difficult to interpret across cultures or even between individuals sharing a culture. The experiences, bases, and objects of affection and attachment can differ from one person or group to the next. That leaves us with the question: what are we talking about when we talk about love?[ii]
I think a challenging task as an ethnographer involves interpreting people’s experiences and emotions. This is not just a translation problem; it is semantic and moral. When speaking with families who lost a child, I needed to shed my assumptions and expectations associated with love and other constructs. It was an interview with Anaba, a father of a deceased toddler, that challenged my interpretations. I asked him how he felt about the death. He was sad and distraught. But when I probed, Anaba described how his distress was not around the death of a unique family member or losing a close attachment. It was in the unrecoverable loss of his family’s efforts for the child. Anaba mourned his investment; it took emotional precedence. An American psychologist remarked that he seemed like a psychopath. He wasn’t. Anaba was empathetic, loving, and generous with the children in the household. He fit the local model for being an ideal father. He suffered over the child, but the object of his loss differed from Western expectations.
Anaba’s clarification helped me realize that if parents said they were sad and mourning a loss, I still misunderstood what made up their experience of sadness, what their suffering indexed, and what dimensions of the loss, if any, they were mourning.
Some Nankani mothers’ expressions were familiar—they said they loved the child and grieved the lost attachment. But many mothers explained how their emotional response centered on the useless suffering involved in carrying, birthing, and raising a child that dies. Some acknowledged both sentiments. Men also bemoaned the unseen or spiritual reasons for the child’s departure, instead of the child herself. Was witchcraft responsible? Both mothers and fathers lamented the loss of a future—their child could have become an important person, even the president of Ghana.
A set of cultural practices shaping relationships, care(giving), and attachment can partially explain their responses. The Nankani prioritize reciprocity and define and live relationships in terms of exchange. Being human, becoming a person, attaching to a relative, and strengthening one’s status is not a given or a priori. Individuals cultivate these throughout their life by engaging in forms of economic and social exchange. When children reciprocate, they establish and strengthen their bond with family members. Parents anticipate the day when resources and affection flow both directions.
When I first encountered Azampana’s family, I expected them to be impassive or even looking for ways to be free of the child. I had seen this in similar circumstances. But their response to his condition differed from other families.
There was confusion when Joe and I arrived at the hospital. After a thorough search, we could not find Apoka. The nurses claimed ignorance, saying they didn’t know where she was, but Azampana’s body was still at the hospital. They would not let us take his body until we paid the bill and had a doctor sign the death certificate. One was not available until the next day, so I phoned the doctor I met earlier in the week. We stumbled through the bureaucracy, paid, and returned to the nurses’ station to claim the body and find Apoka. We searched again but Apoka was nowhere to be found and neither was Azampana. The nurses then sent us to the morgue.
We walked behind the hospital, near its boundary, and approached the well-kept house of the mortuary man.[iii] He was shirtless, plump, and had an authoritative presence. The master of the dead is an unenviable position. It’s one that requires, like the traditional village gravediggers, protective medicine and the right disposition. A green monkey (a Chlorocebus) sat on a log near him and the other visitors. This was fitting. We greeted the mortuary man and the others. I made to shake hands with his monkey. He grabbed my finger and yanked me toward his spot in the shade, sharp monkey teeth bared. I shook free and jumped back. “Asshole monkey,” I muttered. Everyone laughed. Only then I noticed the ample buffer around him.
The mortuary man said that he didn’t remember seeing a baby arriving that day, but we better search the morgue to make sure.
A dissection table was near the entrance, its channels set to enable fluids to flow to the drains. Counters and refrigerators in various states of repair lined the walls. “Maybe you can identify him,” he said. He unlocked the chains and opened the stainless-steel doors to a compartment containing several rows of body-length shelves. I glanced over the ten bodies stacked inches apart. He extended a few of the racks. Most were young and middle-aged women. He approached another cooler. “Some have been here for weeks,” he said. “Their families are arguing and still trying to arrange the burial.” Azampana was not there but my eyes were seized by the bodies of two other newborns, wrapped in scraps of cloth, limbs drawn in, resting on the breasts of their mothers. I couldn’t look away. The image forever rendered the sterile mortality statistics tangible in my mind.
We again returned to the nurses’ station and pieced together what happened. After Azampana had died, Apoka refused to surrender him. Hospital regulations would not allow her to take the body home until she paid her bill. Apoka had little money and no phone. The nurses left her alone with Azampana for a brief time, but later she remained inconsolable, refusing to concede, clutching the body to her chest. They eventually let her take Azampana home knowing we would pay her bill. Although the nurses covering for Apoka sent us across the hospital in a wild search, I admired their cunning.
After she left the hospital, Apoka wrapped Azampana onto her back and carried him to the central taxi stand to find a minibus going to Sirigu. After two hours—with frequent stops on rough, dusty roads—she walked the final hour home alone.
I try to imagine what Apoka was experiencing while in the hospital, refusing to surrender her child to the morgue and the afterlife. I wonder about her journey home. Did the others on the crowded bus notice her baby? Did she hide what happened? What did Apoka think of the mothers and children present? Did anyone try to strike up a conversation? What did she say?
The family buried Azampana the next evening after sundown on the edge of the farm near their compound. The internment was brief. His mother and father remained placid. Perhaps they struggled to hold back their tears.
Sometimes families bury infants in a semi-domesticated or a transitional place like farms, trash heaps, and other locations between home and the wilds of the bush. Burying the child here—instead of beneath an old household with established family members—ensures regeneration. Their remains will transform into something productive. Burial locations are not indicative of how a family feels for the child. Neither is the parent’s extent of expressed emotion.
A stoic presentation does not mean parents are callous. To cry after the death of a child will interfere with its passage to the afterlife.[iv] If the mother or father weep during the burial, the child enters a cycle of return. It will be reborn to its mother only to die again.
The questions surrounding universal parental love and responses to loss are not an all or nothing, either/or calculus. Family reactions are diverse and dynamic. Sometimes we recognize experiences of loss like Apoka’s. We project our feelings or empathize with her suffering and refusal to surrender her boy. Another parent’s experience can strike familiar or unexpected sentiments within us. A death with or without weeping. But for reasons sometimes different from what we imagine.
Interested in more? Spirit Children: Illness, Poverty, and Infanticide is available. Read other essays here.
[i] See Henrich et al.’s collection of work discussing WEIRD societies (White, Educated, Industrialized, Rich, and Democratic).
[ii] The similarity to Raymond Carver’s What We Talk About When We Talk About Love is intentional.
[iii] I never learned his name. Everyone just referred to him as the Mortuary Man.
[iv] See Nations & Rebhum’s Angels with Wet Wings Won’t Fly (1988). Countering Scheper-Hughes’ research in N.E. Brazil and her book Death without Weeping, they describe how mothers are discouraged from crying upon the death of a child and how this behavior cannot be interpreted as maternal detachment.