ラクの物語（英文URLを追記）

南の地域で飢えて子どもが死ぬという話がある。3秒に一人とか4秒に一人とかいわれている。

それが具体的にどういうことか、日本で普通に生活しているとあまりにも見えない。

この日本語が書かれたのが90年代、現在も変わっているようには思えないが、実際どうなのかは知らない。

このような具体的なことがもっと知られるべきではないかと考えて、本を見ながらタイプした。

以下は「いのち・開発・ＮＧＯ」に記載されているシェーラ・ザルブリック作の『ラクの物語』の要約（原作を一部改変）61-54p。実際に起こった出来事をもとに書かれたもの。

追記　英文は以下で読めます。
http://www.healthwrights.org/content/books/QTS/qts_ch01.pdf

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ラクの物語

　ラクはわが子を母乳だけで育てようとしていた。これは、長い間、村の女たちの習慣であった。しかし、一家が生活してゆくためには、彼女は地主の畑で朝から日暮れまで働かなければならなかった。何時間もの間、子どもと離れていなければならないために、彼女は赤ん坊に母乳に代わる食べ物を与える以外に選択の余地はなかった。すぐに彼女の母乳はほとんど出なくなってしまった。

　土地なし農民であり、かつ女性であることによって、ラクは二重に不利な立場に置かれた。長い間くたくたになるまで働いても、彼女の日給では家族を十分に食べさせるにはとても足りなかった。長男カナンは、７歳の頃から地主たちの家畜を預かって雑木林に草を食べさせに連れてゆくことで、家計のわずかな足しにしていた。

　ラクは遠くの畑で働いている間、赤ん坊を小屋に残し、５歳になる妹のボヌに世話を任せていた。毎朝、夜明け前に、彼女は遠くの井戸から水を汲み上げるのが日課だった。そして、少量のアワをたたいては家族のためにお粥を炊いた。家族全員の食欲を満たすのに十分なアワがないことはよくあった。ラクはいつも少量の粥を皿に残し、彼女が畑に行って働いている間、これを赤ん坊に食べさせるようボヌに言い聞かせていた。

　年長の子どもたちが働いているにもかかわらず、家族の稼ぎは少なく、十分な食料を買うことはできなかった。そこで他の家族と同様に、赤ん坊も空腹を感じることがしばしばあった。赤ん坊は繰り返す下痢と栄養状態の悪化で、悪循環に陥るまでのそう長い時間はかからなかった。ラクは具合の悪くなった赤ん坊を伝統治療師のもとに連れていった。治療師は、赤ん坊に重湯と薬草茶を飲ませた。すると赤ん坊は２、３日はよかったが、だんだん痩せてきてしまった。ある日、赤ん坊はひどい下痢をしてしまい、ラクがいくら重湯と薬草茶を飲ませつづけてもいっこうに良くならなかった。下痢は数日続き、ついに赤ん坊は干ばつにあった稲のように、しわくちゃになりぐったりしてしまった。

　そうしようもなくなったラクは、赤ん坊を病院に連れてゆこうと決心した。これはラクにとってきびしい選択だった。なぜなら、それは彼女の１日分の仕事と稼ぎを失うことを意味するのだから。家族は蓄えがないために、一日何も食べないですまさなければならない。それですめばいい方で、へたをするとラクは仕事を失いかねなかった。ラクは、それがどういう結果になるかを怖くてとても考えられなかった。賢い母親が残りの家族を助けるためには、しばしば病気の赤ん坊を見殺しにしなければならないことをラクは知っていた。しかし、ラクの赤ん坊に対する愛情はとても強く、それはできなかった。

　ラクは最後に残った財産である自分の母親の形見、青銅の水差しを売り、バス代と薬代を捻出し、赤ん坊を町の病院へ連れていった。病院のなかに入れてもらうには、門番に袖の下を渡さなければならなかった。長蛇の列のなかで何時間も待ったすえ、やっと彼女の赤ん坊の番になった。しかし、そのときには、赤ん坊は瀕死の状態になっていた。医師は、どうしてもっと良く世話をしなかったのか、どうしてこんなになるまで放っておいたのだ、と彼女を責めた。医師はラクを看護婦のところに連れていった。看護婦はラクに母乳栄養の重要性や、「衛生」といったことについて細かく説明した。そして、何よりも看護婦が強調したことは、ラクの赤ん坊にはもっと良質な食物がたくさん必要だ、ということであった。ラクは何も言わずにただ聞いていた。

　その間に医師は、赤ん坊のくるぶしの血管に針をさして細いチューブで点滴のボトルをつなげた。皺だらけの赤ん坊の体は、夕方ごろにはやや湿気を帯び、意識もずっとよくなってきた。下痢も止まり、夜遅く看護婦は点滴をはずした。翌日医師はラクに処方箋を私、薬局で薬を買うように言って家に返した。帰りの道すがら、赤ん坊の下痢はまた始まった。

　家に着いたラクには、お金もなければ食べるものもなく、売るものすら何も残ってはいなかった。赤ん坊が死んだのは、それからまもなくのことだった。

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シェーラ・ザルブリックがこの話のなかで語ったことのうち、私たちの短い要約のなかに含まれていないところは、ラクの赤ん坊に対する深い愛情である。赤ん坊を助けようと奮闘するラクの懸命な姿勢である。そして何よりも深く刻み込まれている事実は、赤ん坊を死に追いやった逃れることのできない原因の数々に対して、ラクがいかに無力であったかということである。

＝＝日本語、ここまで＝＝

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The Life and Death of 

One Child: Rakku’s Story

The Chain of Causes

The account below is drawn from Rakku’s Story, a book by Sheila Zurbrigg based on a true incident that took place in a village in India. (We have condensed and somewhat modified the original version.) The story vividly illustrates how a child’s death—in this case from diarrhea—is the final outcome of a long chain of interrelated causes. Links in the chain included severe diarrhea and dehydration; extreme malnutrition; crowded, unsanitary living conditions; and lack of clean water. These, in turn, had many underlying causes. Rakku’s story points to some of the many links in the causal chain.

RAKKU’S STORY
Rakku had wanted to only breastfeed her baby.
This had long been the tradition of women in her
village. However, in order for her family to
survive, Rakku had to work in the land owner’s
fields from dawn to dusk. With the long hours of
separation from her baby, she had little choice
but to give her baby other foods. Soon she no
longer could produce much breast milk.         

As both a landless peasant and a woman, Rakku
was doubly disadvantaged. For long hours of
exhausting work, she was paid too little to
adequately feed her family. Since the age of
seven, her older son, Kannan, had been helping
make ends meet by taking the cattle of several
landowning families out to graze in the scrub.  

While she was working in the distant fields,
Rakku left her baby in their wattle hut in the care
of her five-year-old daughter, Ponnu. Each
morning before dawn, Rakku would haul water
from the distant water hole. She would pound a
few handfuls of ragi (millet) and cook it into a
gruel for the family to eat. Although there was
often not enough ragi to fill all their stomachs,
Rakku would always leave a little on the plate,
instructing Ponnu to feed it to the baby while her
mother was at work in the distant fields.         

Even with the older children also working, the
family’s earnings could scarcely buy enough
food. The baby, like the rest of the family, often
went hungry. Worsening malnutrition and 

repeated bouts of diarrhea soon became a vicious

cycle. Sometimes Rakku took the sick baby to a

traditional healer, who gave him rice water and

herbal teas.                                                     

The baby would usually get better for a few
days, but soon Rakku’s baby became thinner
and thinner. One day he developed such severe
diarrhea that did not get much better even when
Rakku gave him the traditional remedies of rice
water and herbal tea. His “runny stomach”
continued for several days, until the baby was as
limp and shriveled as a rice paddy in a drought.  

In desperation, Rakku decided to take her baby
to the hospital in the city. This was a hard
decision, as Rakku had to miss a day’s work and
a day’s pay. At best, this meant a day without
food, for the family had no reserves. At worst,
Rakku might lose her job—the consequences of
which she was afraid to think about. She knew
that a wiser mother would let her sick baby die to
preserve the rest of the family. But Rakku’s love
for her baby was too strong.                              

Rakku sold a bronze pot she had inherited from her
mother—the last of her remaining possessions of any
value—to pay for bus fare and medicine, and took her
baby to the city hospital. She had to pay a bribe to the
guard to let her in the hospital gate. After hours of
waiting in long lines, at last her baby was seen. By then
the baby was on the verge of death.                            

The doctor scolded Rakku for waiting so long, and for not
taking better care of her baby. He referred her to a nurse,
who carefully explained to her the importance of breast-

feeding and something the nurse called “hygiene.”
Above all, the nurse emphasized, her baby needed more
and better food. Rakku listened in silence.                    

Meanwhile, the doctor put a needle into a vein in the
baby’s ankle and connected it by a thin tube to a bottle of
glucose water. By evening the baby’s shrunken body
filled out a bit, and he seemed more alert. The diarrhea had
stopped, and the late night nurse removed the needle from
the baby’s leg.                                                                 
The next morning a doctor gave Rakku a prescription for
medicines to buy in the pharmacy and sent them home.
On the way home the baby’s diarrhea began again. 

Arriving back home, Rakku had neither food, nor money,
nor anything left to sell. Her baby died a short time later.

One characteristic portrayed in the story as told by Sheila
Zurbrigg, but lost in our short summary, is Rakku’s deep
love for her baby: the enormous courage of her struggle to
save his life, and her clear perception of her baby’s basic
needs. What also comes across strongly is Rakku’s
powerlessness to do anything about the inescapable
underlying causes of her baby’s death.                   

What Caused the Baby’s Death?                          

If someone were to ask What caused Rakku’s baby’s
death?, what answer or answers might be given? The
death certificate—had there been one—would probably
have listed “gastroenteritis” (diarrhea), or possibly “dehy-

dration” (water loss). But, clearly, diarrhea and dehydra-

tion—and even “severe malnutrition”—were only the final
links in a long chain of causes: physical, biological,
cultural, economic, and political.                                

Most doctors, like the doctor in Rakku’s story, would
probably define the baby’s life-endangering problem
primarily as a medical one, and fail to fully take into
account the crucial underlying social and economic
factors. This narrow viewpoint made the doctor’s medical
intervention in some ways counterproductive—even
deadly. As we could see, the expenses Rakku incurred to
obtain this medical intervention worsened her economic
plight, aggravated her baby’s already weakened state, and
became one more link in the chain of causes contributing
to her baby’s death.                                                      

Similarly, the nurse in the story at once recognized that
poor nutrition contributed to the baby’s illness. But
instead of exploring the situational causes and helping
Rakku find ways to address them, she put the blame on
Rakku. The nurse’s health messages—aimed at solving a
problem defined as behavioral and educational—were
more humiliating than helpful. They did little either to
empower Rakku or to avert her baby’s death.             

As Rakku’s Story documents, it is essential that those of
us concerned with the health needs of Third World
children take a fresh look at the causes of high child
mortality and morbidity—death and sickness rates—
within the context of poverty and underdevelopment. As
Carl Taylor (a pioneer of primary health care) and William
Greenough point out, “Few health problems are influenced
as much by multi-causality as the diarrheal diseases.”2

Typically, a child who is healthy and well-nourished
recovers quickly from a bout of diarrhea; the illness is
messy and unpleasant, but not life-threatening. In
communities where children’s health is already
compromised by malnutrition, poor sanitation, and
repeated infection, diarrheal diseases become a major
killer.                                                                      

In this book, we will discuss in detail a whole network of
factors that contribute to the unacceptably high death
rates of children, focusing particularly on childhood death
from diarrhea. The list of causes ranges all the way from
specific disease agents (bacteria, viruses, parasites) in the
individual child, to environmental conditions in the home
and community (such as lack of sufficient food, clean
water, and toilets), to social and political factors at the
local, national, and global levels.                                 

In trying to explain the poor state of health of the world’s
children, different observers tend to focus on different
causes. Which causes capture our attention, and which
we tend to overlook, depends to a large extent on our own
social background and world view. And yet, the way we
define the causes of human ills often determines the
solutions we seek.                                                    

引用、ここまで。

英文でよければ、以下でも読めます。
https://static1.squarespace.com/static/5373a37ae4b0bbcc0ca38e64/t/569c695adc5cb42985863c2e/1453091164481/1A+Rakku.pdf