Old Lovers Don't Die

by Anderson, Paul G

  The hospital was situated at the bottom of the hill, and the road then ran on to the border. As the bus slowed for the hospital, Christian could see a dusty dirt road leading off from the hospital entrance to the town centre. Interestingly, situated two thirds of the way down the main street was the spire of a mosque. This was the only mosque he had seen in Rwanda of the Muslim religion. He wondered how the religion even had a toehold, given that Rwanda was 95% Christian. The spire was a nugacious protest in the overwhelming sea of counter belief.

  Christian was surprised when the bus stopped outside the hospital, expecting the main stop to be in the town itself. A smiling John soon appeared next to his open window.

  “You can get off here, Dr. Chris.”

  He could feel the eyes of some of the passengers on his back as he climbed out the window after passing his backpack to John.

  “Thank you, John, and have a safe trip back.”

  “I hope we didn’t put you off chicken.”

  “No, not at all.” Christian said laughing and looking back in through the open window at the crates of now docile feathers.

  After picking up his backpack, the first thing that he noticed about the hospital, other than it desperately needed painting, were the stone ovens dotted around the grounds, each surrounded by family groups. The ovens were made of grey volcanic stones, each the size of a square rugby ball, placed one on top of the other. Formed to have a meter wide square base, they allowed cooking from four sides all by four separate families. Above the large stones was a corrugated roof, which offered some protection against rain. Smaller stones he could see had been placed on top of the roof to hold it in place.

  At a quick count there were half a dozen ovens, with families chatting and preparing food to be cooked. Large faded yellow water containers lay on the ground next to small containers of rice and dead chickens. A nanny goat tethered to the fence watched over proceedings, its morphean chewing a contrast to activity surrounding the ovens. A metre from the oven base, colourful blankets spread irregularly over the rocky ground and acted as tablecloths and places to sit. Those who were not involved in cooking sat and watched, some plucking the feathers from the dead chickens. Smoke from the ovens hovered and then drifted indolently when fanned by gentle lake breezes.

  A little further down the hill, beyond the stone ovens, there were three old shipping containers. Rusty brown, the P and O insignia of the shipping line was still recognizable. The containers had had windows cut in their sides and a door added to serve as accommodation for patients and nurses. A third container had ‘X-Ray Department’ painted expertly on the side. X-rays were stacked alongside the container, the sunlight drying them and generating the needed exposure.

  Dr. Emmanuel Sudani was the superintendent of the hospital with whom Christian had been in email contact. He had been very enthusiastic about Christian coming to help for three months and suggested his surgical experience would come in handy. From what Christian had read online, Doctor Sudani had trained in Uganda as a haematologist. He had been superintendent at Garanyi for fourteen years, first working at Rhuengeri hospital. Christian had worked out with his mother that it was probably fifteen years since his father had visited the hospital. It was unlikely therefore, that Dr. Sudani would remember him even if he were the superintendent at the time. Christian in correspondence had been tempted to ask about his father, but in the end, had decided not to in case Dr. Sudani thought that that was his primary purpose in coming.

  From where he was, standing outside the hospital, Christian could see the entrance to Dr. Sudani’s office. The word ‘Superintendent’ painted in capital letters above the door was unmistakable. Christian reached down to get his phone from his backpack, thinking that he would record his first impressions before heading to the office. As he unzipped the small side pocket, a small, brightly-coloured gecko scampered away from underneath his backpack. It was unlike anything that Christian had seen before. It was large by gecko standards - ten or eleven cm in length. What separated this from any other geckos that he had seen were the striking colours. All the colours of the rainbow represented in a sparkling iridescence. It looked as if it had been painted with shiny strips of metallic paint. He watched, fascinated, as it scurried away, a bluish purple iridescent stripe catching the afternoon sun. Another argument for the Garden of Eden theory.

  The waiting room outside Dr. Sudani’s office had three wooden chairs. Each of the chairs was carved in a fashion that reminded him of the waiting room at the Travel Doctor in Adelaide. An overhead fan, sitting above the chairs, was motionless; wires protruded from the roof suggesting that even on a hot day, it would be still be motionless. A slightly yellow light bulb protruded from a broken socket in the ceiling, suggesting that it contributed little, other than appearance of a working electrical supply. Christian put his backpack down and was about to sit down when Doctor Sudani strode out of his office and stood a metre in front of him smiling.

  “You must be Doctor Chris. You are exactly like your photo although slightly taller than what I expected.”

  “Doctor Sudani. It is very nice to meet you and nice to be in Garanyi finally.”

  “Well we can certainly do with your help. Over one million patients have access to our hospital from either side of the Rwandan/Congolese border. Now with all the rebel activity in the Congo we have to treat even more patients. You will have seen the constant stream of people passing in front of the hospital as you came in.”

  “Yes I did notice that. There seemed to be a steady stream heading towards the Congolese border.”

  “There is plenty of work there in the mines and such is the desperation of many people they suffer the enormous brutality from the militias and rebels if it means being able to feed their families. We then unfortunately get to deal with the aftermath. However, enough politics. You will learn about that quickly enough. I am under strict instructions from my wife to bring you back to our home and not put you to work straight away. I hope you like vegetarian curry; meat is in very short supply as we tend to keep our goats for the milk.”

  “Curries are a big favourite of mine.”

  “Great, get your bag and come with me. Chantal, my wife is waiting to meet you. It’s just a short drive, ten minutes from the hospital towards the border but a five-minute walk from the lake’s edge. And please call me Emmanuel.”

  The Toyota utility parked at the side of the hospital was an unwashed camouflage green suggesting its military use in another life. The word Ambulance had been roughly hand painted in French on the bonnet, and there was a partially shattered windscreen on the non-driver’s-side. Christian smiled to himself thinking how he was adapting; viewing Rwanda out of open windows now second nature to him. The back tray of the Toyota had been removed to allow easy access for two stretchers, each bolted to the floor, preventing the stretchers from being stolen.

  Emmanuel turned the ignition key several times until the diesel engine finally coughed into life. They then drove slowly out through the front gate, waiting for a break in the throng of people, before making their way down the hill towards the lake.

  “There’s not anyone swimming,” Christian said, looking out the side window towards the lake.

  “Schistosomiasis exists in the lake - what you probably know as Bilharzia. Worms from freshwater snails. We have had an education program going for some time now. It’s even in the churches and mosques along with posters so the people are slowly understanding.”

  “It is the eggs in the adult worms that get into bladders and the small intestine of those who go wading or swimming, which then creates an inflammatory response. If it’s not correctly treated, patients get blood in the uterine and stool as well as very large livers.”

  “Excellent response, Doctor Chris. You are indeed well prepared; I knew you were a good choice.”

  After a further 100 metres, Dr. Sudani slowed to a stop and waited until those walking had passed the front of the Toyota, before he drove up a short driveway. The dr
iveway was lined with grey chips of finely compacted volcanic rock. On the left side, majestic apollonian palms protected the house from the late afternoon lake breezes. The fronds of the palms draped themselves across the driveway, creating an arch with a two metre high hedge. The driveway forked to the front and to the side of the house. Two stories high, it was quite different than other Rwandan houses and reminded Christian of some of the houses he had seen in South Africa. At the front, it had a very similar veranda or stoep to Cape Dutch houses he had seen in South Africa. The windows were shuttered and had security bars, which was remarkably similar to what he had seen in Cape Town. Emmanuel turned left and stopped front of the veranda.

  “I can see what you’re thinking,” he said turning to face Christian. “Not your traditional Rwandan house. Many years ago, we thought that we were going to get the services of a Dutch surgeon. This house was built on his instructions, the land belonging to the hospital. When he did not arrive, the house became the superintendent’s.”

  Emmanuel walked up onto the veranda and rang the front door bell. It opened on the third chime.

  “Welcome to Garanyi, Doctor Chris. I am Chantal; Emmanuel’s wife and we are delighted to have you here with us. Please come in.”

  Christian followed Emmanuel and Chantal down a short hallway. The floor he could not help noticing was a dark rich teak wood, similar to Jarrah floors common in South Australia. As if reading his mind, Emmanuel without looking behind said.

  “All imported materials, Christian, but finished by local craftsmen. Quite different to what you will see anywhere else in Garanyi. Although with increasing numbers of people and wealth in Kigali, there are several similar designs.”

  Chantal turned left through a door half way down the hallway. Judging by the wonderful curry smells wafting through the door, it was the kitchen.

  “I’ll show you where you can put your bag and where you will be sleeping and then we can come back and sample Chantal’s wonderful cooking.”

  Christian’s room was to the back of the house. The room held a single wooden bed and a small open wooden closet for his clothes. There was also the obligatory mosquito net hanging from the ceiling tied into a neat bundle, which was released for sleeping under.

  “The door opposite is a toilet and shower. All of our children have left home so it is just two servants, Chantal, and me. We have a security code and deadlocks, which we will explain to you. Being on the main thoroughfare to the Congolese border we have to be more vigilant than otherwise would be the case.”

  “This used to be a back lounge but when our two children were growing up, we divided it to give each their own room. When you’re ready come through into the kitchen, I know that supper won’t be too far away.”

  Chantal’s kitchen was a testament to her love of cooking. Approximately ten to twelve cookbooks sat in a neat rack at the end of the bench. Most had French titles, although the one that was open on the central island was in English. Garlic hung in bunches from the wall and small herbs grew in pots along the windowsill.

  Chantal’s figure was still slim suggesting that she controlled the desire of all good chefs to sample what they created. Her long black hair was gathered up, and held on top of her head, a small thin wooden clip straining against the thick hair. It exposed a long thin neck, fine cheekbones, and aquiline nose that Christian had come to associate with the Tutsis. At nearly six foot tall, Chantal also had elegance about the way that she moved. Christian sat on one of the stools and watched as vegetables were quickly chopped and disappeared into the curry base.

  “It will be ready in half an hour,” she said, looking up and smiling at Christian.

  “It smells delicious, Mrs. Sudani.”

  “That’s very polite. But if you call me Chantal, I will stop calling you Doctor Christian!”

  “That sounds like a very good deal,” said Christian laughing.

  Emmanuel walked back into the kitchen and motioned to Christian to follow him. The lounge which he led Christian to had a green leather three seater sofa and two reclining comfortable chairs, all facing the front window. Despite the fine curtain, Christian could still see the constant pedestrian traffic heading towards the border and the shores of the lake in the background.

  “The lake looks inviting, doesn’t it? You would not know just looking at it that it could be the source of so many medical problems for us in the hospital.”

  “Looks like some children are getting ready to go for a swim.”

  “Unfortunately we cannot educate them all. Let me just quickly tell you a little about the hospital and then we can settle back and enjoy Chantal’s cooking. We usually do ward rounds at 8 AM. That is for both surgery and medicine. Patients accepted into our emergency department remain there until we see them. Some of those may not have been seen if we have been deluged by emergencies from the border and will need to be triaged. Given your surgical experience, we thought we would put you in with the surgical team. Currently we have no full-time surgeon, just one of our graduates who has done a bit of surgery. In many things, you might well be more experienced than he is, but our doctors here have to do everything from gynaecology through to urology and orthopaedics. You said in your letter that you had done some rotations in gynaecology and orthopaedics?”

  “Yes that is right. I did a rotation in gynaecology in outback Australia. I have done about thirty caesarean sections and then a rotation at Alice Springs in orthopaedics. So I should be able to help with most things other than the really complicated orthopaedics.”

  “That’s good. I will introduce you to Doctor Theodore Nikita. He will show you around the theatres and explain to you how everything works as well as outpatients. We do not have any real anaesthetists as you know them, just anaesthetic technicians. Anaesthesia in Garanyi is basically monitoring the patient and supplying oxygen, and a sedative drug of choice. I usually walk up to the hospital. That takes about twenty minutes and it’s quite safe although one of the staff will come back with you if it’s late at night.”

  “Come on you two, food is ready and you can continue the discussion over supper.” Chantal’s voice drifted down the hallway and into the lounge where they were sitting.

  Chapter 12

  The Accident and Emergency ward was attached to the side of the old hospital. It had been added on, jutting out from the main medical and surgical wards, like an inadequate afterthought. The hospital itself had an H shape accommodating 300 beds. Each side of the H had 150 beds. Medical and surgical wards were on one side of the H, Gynaecology and Paediatrics wards on the other side. The Accident and Emergency mutated from the middle of the H bringing it conveniently closer to the dirt roadway, which ran round the outside of the hospital. That meant the ambulance then could stop outside the entrance and quickly transfer patients.

  The front door leading from the roadway consisted of two halves, which opened internally to allow stretchers and wheelchairs through. When Christian arrived with Emmanuel the following morning, both doors were tied back. Patients who could not be accommodated inside were sitting in the dirt at the front door, wounds crudely bandaged. One patient, Christian noticed, had a stick tied roughly with string, acting as a stabilizer of the obvious fracture. Another elderly man next to him seemed to be asleep, but Christian could detect no respiratory effort and he wondered whether he was dead.

  Emmanuel carefully stepped over the patients sitting on the ground before stopping at the old man. He bent down and felt for a carotid pulse. After a few seconds he stood up, looked at Christian and shook his head; the old man was dead. Inside the front doors were six beds. Corrugated iron beds were painted white to hide their age, each with thick, dark, red blood-stained plastic mattresses. There were no sheets on any of the beds which were surrounded by grey floor tiles. Dried blood created Dali like art on the floor tiles.

  There were two patients on each bed; if there were two males, they were head to toe. One bed strained under the impact of two woman and two children. Under four o
f the six beds, Christian could see patients with intravenous lines, the bags of saline which ran through them attached to the window catch. Others patients sat on the floor in between the beds apparently uninjured and were therefore most probably family.

  At the end of the ward was a small wooden table, at which a young man in a white, neatly pressed shirt sat writing vigorously. Four patients were crowded onto the bench next to him waiting to have their details recorded. Standing behind him in a white coat, with a stethoscope around his neck, was Dr. Theodore Nikita. Broad shouldered with shiny black leather shoes, he did not look up as they entered, continuing to scrutinize patient notes, while intermittently asking questions of the young man at the desk.

  “Dr. Nikita.” Emmanuel said, stopping next to him.

  “Good morning, Doctor Sudani. As you can see, another busy night. Most of these came from across the border in the Congo after militia burnt down another village. Well, I should correct that - some of the ones who survived came here.”

  “I see there is one outside the front door who didn’t survive.”

  “Yes, we couldn’t deal with anymore at about 2 AM and I had to close the front doors. I found him this morning and he had no pulse. We are going to get him taken to the morgue.”

  Emmanuel nodded. “This is Doctor Christopher de Villiers. He has come to work with us for three months from Australia. You might remember me telling you about him and that he had some surgical experience that we could do with.”

  Christian stepped from behind Emmanuel to shake Doctor Nikita’s hand. Before he could do so, Nikita turned from both of them reached up and took a white coat from a peg on the wall. Then he turned and thrust it in Christian’s direction, avoiding a handshake.