Dree still hadn’t left her tent.
Isaak had slithered out of the far tent, took an offered plate, and set to eating breakfast without speaking. Max remembered from boarding school that Isaak was not a morning person. Indeed, he was barely an afternoon person. A lot of fun at night, though.
“We do need to be careful how much we ask for or buy,” Batsa agreed with Alfonso, flinging his arm at the barren, stony mountains around them. “Nothing has grown here since early October at the latest. The growing season in the foothills of the Himalayas is even shorter than in Iowa.”
“Yes, we should try to tread as lightly as possible in these people’s lives,” Father Booker said in his bass operatic voice. “Is that coffee ready yet, by any chance?”
“Give me your cup, Padre,” Alfonso said. “How do you take it?”
“I don’t suppose we have milk?”
“The lady who brought the bread also brought fresh milk with her this morning. I think it’s yak milk.”
“If you please,” Father Booker said. “Maxence, do you take milk?”
When Maxence was in the field, he usually took his coffee black to conserve resources. A few times in his life, he had endeavored to mortify himself by drinking nothing but black coffee and water. He hated it. It tasted like privation. “If you have milk of whatever source, I would appreciate it. And sugar.”
Just as Alfonso was handing Maxence his cup, the third tent rustled.
Dree’s light voice fluttered in the air. “Breakfast smells good.”
Maxence and Alfonso turned.
She stood in front of her tent, blinking in the sunshine and ruffling her pixie-cut blond hair with her hand. Her puffy ski clothes camouflaged her hourglass figure, but Max could trace her shape under it with his memory.
“Good morning,” Maxence said.
Last night’s midnight confessions had not been good for Max’s soul. Indeed, he wished he’d rolled over and gone to sleep without a word. She must think he was a freak.
Alfonso crowed, “Andrea Catherine! I have saved a plate for you from these rabid dogs.”
She stretched and staggered a little as she approached the campfire. “First, you saved me from the intestinal parasites and now from starving to death in the wake of rabid dogs. I declare, Alfonso, you’re my knight in shining armor.”
Alfonso looked far too pleased.
Maxence ate the remainder of his food, stuffing himself because he’d spooned extra onto his plate to give Dree in case Batsa and Isaak ate everything in the pan.
“Do you take coffee, Andrea Catherine?” Alfonso asked.
Golden sunlight shone on her pixie face. “If you please. I heard there’s milk and sugar?”
Alfonso prepared a plate and a cup for her, which Dree took and ate. “This is good. Where’d you get eggs?”
“Powdered,” he assured her.
“Amazing.”
Maxence could cook. He should have cooked for her.
Dree elbowed Maxence in his triceps as she scooped up scrambled eggs with pieces of naan. “I didn’t even hear you get up.”
“It was early. After your impromptu medical clinic yesterday, you must have needed sleep.”
Dree squinted in the sun that was still quite near the horizon. “What time is it?”
“Just before eight. The goal for the day is to examine the sites Isaak and Alfonso discovered yesterday and take pictures of them for the charity’s board of directors.”
Max didn’t mention that he was on that board of directors, though they’d decided to fund this project in his absence. When he’d found out the idea of NICU micro-clinics had been accepted and funded without his or any outside input while he’d been sitting by his uncle’s bedside in Monaco, he’d not been happy.
Packing up after breakfast took only about twenty minutes, and they roared away on their motorcycles with Isaak and Alfonso leading the way.
Again, Maxence kept Dree ahead of him so he could keep an eye on her. She seemed to ride the motorcycle exceptionally well, but he just wanted to make sure she was all right.
The first spot the engineers had chosen to evaluate for one of the planned NICU micro-clinics was about halfway between the middle of the village and the edge, a small plot of land with a previous dwelling’s stone foundation. Maxence kicked a small piece of wood that bore the black scorch marks of fire.
Isaak said, “It’s centrally located, but again, we have the problems of no utilities, no running water, no electricity, nothing that the NICU would need to be able to function.”
“The architect and industrial engineer assure us that the solar panels and catchment cisterns will provide sufficient electricity and water.” Alfonso’s voice was a bit peevish like he’d said that too many times.
Isaak Yahontov, the electrical engineer whose company designed environmentally sustainable power sources, scrutinized the pale sky. “The sun rose above the mountains for only a few hours yesterday near the center of the village.” He spread his hand, letting the darkness of the mountains’ shadow where they stood fall on his palm. “Even though there’s plenty of light to see by, the sunlight is not direct. The sun is behind the mountains and won’t crest for a few hours. We’ll have only five hours or less of direct, usable sunlight before it descends behind the mountains on the other side of this valley. We can’t make solar power with indirect sunlight. The rays have to hit the panels. And that river that runs beside the village will slow to a trickle soon. In February and March, it won’t run. We’ll need water here, too.”
Batsa scratched the side of his cheek, where even two days’ growth of beard was beginning to look luxurious. “If I remember right, and I’m pretty sure I do, it doesn’t rain in Nepal like it does in the States. In Iowa, it rains steadily a few times a week all summer long. Here, there’s a monsoon season, like much of Southeast Asia. India is just south of here. A great deal of rain falls during the monsoons, though I think we are on the dry side of the Himalayas and thus in a rain shadow. The problem is that very little precipitation falls during the rest of the year. They have a problem with water supply as well as safe drinking water in these villages. The catchment cisterns would overflow during the monsoons and run dry a month afterward, and there wouldn’t be any more rain for months after that.”
Dree frowned and glared at her feet.
Maxence sighed. The board of directors hadn’t considered this situation, and that was the problem with sending outsiders in to do pre-determined charity projects.
While the intention might be good, the outcomes could be harmful.
He had lived in The Congo for four years. This project would have worked in Rwanda or The Congo, both with lush, verdant farm fields that produced crops much of the year due to a consistent supply of rain and long hours of direct sunlight.
While the six of them were musing on the inherent problems, they mounted their motorcycles. They rode over the rough roads to the next village they’d planned to evaluate, which was eighty miles farther into the Himalayas and a few thousand feet higher in elevation. His ears popped dozens of times under his helmet.
The eighty miles took four hours, guiding the bikes carefully around small boulders that had careened down the mountain.
Again, even though they rolled into the center of town as unobtrusively as they could, people ducked out of their houses to observe the commotion.
Isaak and Alfonso already knew that they were tasked with assessing locations for NICU micro-clinics and setting up the camp, so they rode off on their motorbikes. Father Booker, Batsa, Dree, and Maxence dismounted to peruse the village’s general situation.
Maxence removed his helmet and breathed a deep draught of the crisp air, which was colder as they climbed higher in the mountains. The chilly breeze slid through his hair and over his scalp, and he unzipped his black leather riding jacket to cool off. Riding the motorcycle in leathers with an engine burning gasoline between his legs had overheated him, even though the cold air had essentially b
ecome a wind that had howled between twenty to fifty miles an hour as he rode.
Beside him, Dree twisted off her motorcycle helmet and flipped the gray veil over her hair. Almost immediately, she spotted a boy with a skin infection crawling up the side of his neck and commandeered Batsa to translate to his mother what must be done.
Maxence saw the proverbial writing on the wall, so he appropriated a house with a sizable kitchen table for her makeshift clinic. After that, he assisted her where he could, wiped down the table with lye soap between patients, and made sure Dree had lunch when the time came.
People crowded into the “waiting room” area, which was the rest of the small house. Each patient had not only a parent or other caregiver, but also several aunties, uncles, grandparents, or older cousins with them, as the mother should not lack for moral support nor be lonely in her errand.
Such camaraderie and community cohesion were similar to the way of life where he lived in The Congo, and Maxence missed it anew. He missed his people there.
Father Booker prayed with people who requested it and looked after the other children of the mothers who brought their small children to be seen by “Lady Doctor Dree,” as Batsa called her.
When Dree had demurred that she wasn’t a doctor, Batsa had shrugged and said it was easier to translate that than to define the difference between a physician and a nurse practitioner.
Max and Booker triaged patients as best they could, bringing to the front a small girl gasping for breath while telling people with superficial scrapes who just wanted to see Lady Doctor Dree to wait.
In the early afternoon, three young women arrived at the clinic, kicking the door open as they carried in a fourth young woman wrapped in a blue and orange paisley bed sheet. The long black hair of the woman they carried trailed on the floor as they struggled with even her light weight.
One of the women called out, “Doctor! Doctor,” and then a long explanation in the Nepali language.
Batsa hurried over to them and spoke for just a second before he called back to Dree and Maxence, who were over by the table, “Lady Doctor Dree! It’s urgent.”
He urged the young women toward the table with hand motions and short, insistent words as he grabbed the young woman under her shoulders. “Father Booker! You are needed here!”
Father Booker was already on his way to help. He reached the group of women carrying her. Despite their worried protests, he gathered the sheet-wrapped woman up in his arms. Her arms and legs trailed limply as he dashed for the kitchen.
Dree handed the child on the table to his young mother and ran.
Maxence reached across the kitchen table and lifted the young woman from Booker’s arms so they could place her gently on the table. The young woman, barely more than a girl, fluttered her eyelids and rolled her head away from him. He met Father Booker’s frightened gaze as they started to unwrap her from the sheet.
Her friends began yelling at them, slapping their hands away.
Batsa said, “They are saying that they promised her they would preserve her modesty.”
Maxence lifted his hands from the girl’s arm, but he didn’t step back. Giving into protestations of modesty seemed ridiculous when this young woman might be dying right before their eyes.
Dree crowded past Maxence and began shining her penlight at the young woman’s face, pulling down first her eyelid and then her jaw so she could look inside her mouth. “Her skin and gums are so pale. She’s either horrendously anemic or—”
The other women accosted Father Booker, pushing him away from their friend.
Father Booker took his hands away from the girl at the insistence of her friends, and his hands were dark with blood. A drop fell from his fingers and splashed on the bedsheet, turning an orange paisley scarlet. He recoiled, holding his hands out in front of him and striding toward the bucket holding cold water and lye soap.
Dree cast a glance at Father Booker and yelled, “Batsa, tell me what’s going on!”
Batsa had been listening to what the girls were saying. One girl spoke rapid Nepali at him, her dark eyes flashing and her hands floating in the air as she exclaimed.
Batsa said, “Your patient has had a baby, two days past. She is bleeding, and she will not wake up.”
“Where’s the baby?” Dree asked him.
After a quick conversation with the women, Batsa said, “The baby was very small, not any bigger than their hand and fingers. It would not suck, and the mother was bleeding very much. The baby died the first night after it was born.”
Dree flinched forward like she’d been punched, and she blinked before she began tugging at the bedsheets that wrapped the woman. “I have to see what I’m working with. Let’s get the sheets off of her.”
Maxence grabbed the paisley sheet and began to unwind it, but one of her friends grabbed his arm and yanked him backward.
Batsa said, “They are insisting on the woman’s modesty. They have only come because Lady Doctor Dree is a woman.”
Maxence asked, “Otherwise, they would have let her die?”
Batsa said, “That is not for me to say.”
Dree was trying to take the sheet off of the woman, too, but another woman grabbed her arm, throwing glares at Max and Father Booker as she loudly begged Dree.
Batsa told them, “She did not want the men to see her unclothed. Her friends promised her they would protect her.”
Maxence glanced up. The house where they had set up the clinic was filled with people, some women, some men, and boys and girls of all ages.
Dree said, “She’s dying. We don’t have time for this.”
Maxence had lived in the midst of half a dozen very different cultures over the last decade of his life. He told Father Booker, who had also traveled the world for missions, “Let’s get the sheets off the beds.”
The old priest didn’t bother to nod but sprinted for the pallets on the other side of the room. They stripped the thick blankets and coverlets off the beds and returned with their arms filled with the large pieces of fabric. “Batsa, we need your help.”
They didn’t have time to string a cord across the room to hang the sheets from, so each of the men took corners of the sheets, faced away from the dying woman on the table, and made themselves into makeshift tent poles with sheets as curtains between them.
Batsa called something back over his shoulder even as they faced out into the room, and the women’s voices calmed.
Maxence sneaked a glimpse backward to make sure this was working.
Dree and the other women were bent over the woman on the table. The young woman’s long brown limbs splayed off the edges of the table. Dree was muttering and using hand signals with the women, placing their hands on her patient’s legs and patting their hands to indicate that they should hold the woman’s legs as Dree examined her.
The orange and blue paisley bed sheet lay on the floor.
Dree occasionally called for Batsa to translate something, but for the most part, they had it under control. At one point, Batsa said something to a woman in the waiting room, and she came and held the sheet aloft as he walked backward for some more intricate translating.
About forty-five minutes later, during which time Maxence again had a lengthy opportunity to review all the events in his life that had led him to this place and observe the interactions of parents and children in the waiting area, Dree announced, “Okay, guys. You can lower the curtain now.”
Maxence turned back. “Did she make it?”
Dree nodded as she scrubbed her hands with a small brush in a bucket of clean water. “For now. She had a fourth-degree tear of her perineum. I gave her a local anesthetic and sutured her muscles and skin. I gave her friends my strongest antibiotics for her. I did my best, but she should have been in an operating theater with general anesthesia and a real surgeon.”
“We only have motorcycles. I don’t see how we could’ve transported her to a hospital in less than six hours.”
Dree blinked hard
as she scrubbed up past her wrists to her elbows. “She didn’t have six hours, especially sitting upright on a motorcycle. I think she might be okay, but she lost a lot of blood.” She blinked again, and a tear dripped down her cheek. “She doesn’t know the baby didn’t make it yet. They told her that they’d given the baby to a wet nurse until she was better.”
Maxence prayed in his mind for the soul of the baby, and his heart contracted with deep sadness for what the woman and the world had lost.
She said, “We have to get these NICUs up and running or something. From their description, that baby could have survived in a halfway decent NICU. It sounded like he was maybe three pounds. He could have made it.”
Max stood beside Dree and stroked her back down her spine. Her body quivered like her lungs were fluttering.
She asked, “How do you deal with it?”
“I’m not,” he said, his throat tight. “I’m devastated. I’ve just seen it so many times that I can feel it without falling apart.”
She turned and grabbed his shirt, burying her face in his chest.
Maxence wrapped his arms around her, one palm on the back of her head under her gray religious head covering.
Her arms were tight around his waist, and he stroked her back lightly.
After a minute, her arms loosened, and Maxence opened his arms so she could step back.
She wiped the tears off her face with both palms. “I have other patients to see.”
Maxence helped her with the rest of the patients, again deciding who needed to be seen quickly and who didn’t need to be seen at all. A light bruise doesn’t need to be seen by an exhausted nurse, no matter how much the status-conscious father wants the privilege and honor of his child being examined.
As darkness fell, Maxence and Batsa evaluated the few remaining people and decided that none of them needed any medical attention. One older man was obviously just interested in the proceedings because his complaint kept changing from headache to an imperceptible wound on his hand to a vague stomach complaint with no diarrhea or vomiting to a ringing in his ears. He’d chatted with every other patient and parent in the waiting area all day, listening to their complaints with animation and then describing his variable maladies. Batsa had been watching him and giving them updates.
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