Band-Aid for a Broken Leg

by Damien Brown

  —But right now an ovary is demanding attention, glistening under the glow of the lamp; car batteries and ketamine will not last forever.

  ‘You see this?’ Roberto asks.

  I nod. Two abnormal cysts blemish the gonad’s milky surface. One’s about a centimetre in size and filled with blood; far from a life-threatening condition, but we at least have a likely explanation for her pain.

  ‘You happy if I remove these cysts?’ asks Roberto.

  ‘You happy to remove them—?’

  ‘Sir,’ he calls to the husband. ‘Come here, please.’

  The husband gets up and peers over, the affected ovary held up for his scrutiny. Another non-squeamish relative!

  ‘We will take out these two problems,’ says Roberto.

  The husband nods.

  Roberto neatly excises the two cysts and sutures closed the raw surfaces. He leaves the rest of the ovaries untouched and carefully reintroduces them to the cavity, then demonstrates her appendix.

  ‘We can take this out as well now, okay?’ he asks me, in what sounds suspiciously like a rhetorical question.

  ‘Uh, why?’

  ‘We always do,’ he replies.

  ‘It looks normal, Roberto.’

  He shrugs.

  ‘Do we agree?’

  He rolls his eyes towards Agostinho.

  ‘Let’s leave it in,’ I say.

  He sighs. ‘Novo Doctor, listen to me. We always take it out. In Mavinga, always.’

  This is probably true. Surgeons routinely remove the appendix once they’ve opened the belly, even if it looks healthy, to avoid future confusion from the scar. But this woman’s appendix is normal. More importantly, the clunk of the suction device has begun as the patient’s saliva accumulates; Veronica’s leg is working hard. Better to finish up, I tell Roberto.

  He’s not convinced. He mumbles irritatedly to the others, perhaps seeing this as an affront to his skill. Turning to the husband, he makes a somewhat loaded query. ‘Sir, would you like us to take her appendix out? If we don’t, she could get a severe infection.’

  Replying that removing it seems like the best thing, the husband is sold. I’m not—and I’ve told them about not ambushing me in front of relatives.

  ‘Roberto, the husband is not the one responsible for that anaesthetic right now.’ I dig my heels in. ‘Explain to him that the appendix looks completely healthy. Let’s just close her up.’

  ‘Novo Doctor—’

  The theatre door opens suddenly. A clinico puts their head into the room. It’s Sabino, and he’s looking flustered. ‘We need you in Nutrition, Doctor,’ he says. ‘Quickly.’

  ‘Now?’

  ‘Yes.’

  I pull off my gown and follow him out, turning back to Roberto as I leave. ‘Close her up please, Roberto. Leave that appendix!’

  Sabino leads me to the Nutrition ward, where a new admission is battling away. We insert a drip and initiate treatment, stabilising her before moving her to Intensivo. The surgical patient should already be in here as well, starting to wake up, but she’s not. No one has seen her.

  There’s a problem.

  I run back to theatre. She’s still on the table, unconscious. The team are around her.

  ‘What happened?’ I call.

  Roberto looks up suddenly.

  ‘Novo Doctor,’ he says, looking startled.

  ‘What’s the problem? Is she all right?’

  He holds my gaze with a surprised look. There’s no movement for a few seconds.

  ‘Roberto?’

  I step closer. I can see the oximeter. It’s still beeping, and her chest is rising.

  ‘Roberto?’ I ask again.

  There’s dead silence. Veronica shuffles awkwardly but Roberto says nothing. And really, as I look around, it’s clear he doesn’t need to. A pink object dangles from the surgical clamp he’s holding.

  ‘That an appendix?’ I ask.

  The slow, acknowledging nod of the indisputably guilty.

  ‘I presume it’s her appendix?’

  The nod continues.

  ‘Probably not much point in asking you to put it back, is there?’

  Only a shake this time, as they ponder whether I’m serious.

  • • •

  Tim takes holidays in early August. Pascal covers his job, soon discovering the trials of dispensing monthly salaries in a region with no banks. Most of our hundred staff are paid different amounts (a hundred and eighty dollars per month for a junior guard, up to three hundred and fifty dollars for the older clinicos) so cash requirements must be anticipated, flown in, and securely stored beforehand. Small-denomination US dollar bills are insisted upon, although certain years of production won’t be accepted due to high rates of counterfeiting. For two days Pascal sits surrounded by stacks of bills, checking each one, re-counting, then paying the workers one at a time in the office.

  ‘But this dollar bill is 1982, Chefe,’ says one of the guards, opening his envelope onto the table. ‘And here. This five-dollar bill is 1997. I cannot take it.’

  Another re-enters the office. ‘All my ten-dollar bills are from 1996,’ he says. ‘They will not accept this in the market. And this, look—this dollar bill is a little torn. This also I cannot use.’

  So Pascal, who’s dealing as well with a faulty water pump and lack of spare parts for it, is worn. Andrea and I also have a difficult run—two stillbirths and the death of two children from malaria within ten days—and with only two others to look at during mealtimes, cabin fever sets in. In a telling indictment, a light-hearted debate turns into a days-long argument between Pascal and me over whether glass is structurally a solid or a liquid. Meanwhile, Andrea, whose experience in Brazil was nothing like this, and who can still neither manage to get Dominga to use less oil nor the midwives to check on the newborns regularly, wonders aloud what she’s signed up for. Conversations grow old. So too the food. Someone’s going to crack. I see Pascal sprinting back from the airstrip one afternoon, breathless, ranting in half-sentences as I leave the hospital. Seems he’s the first.

  ‘YOU OKAY?’ I yell.

  He shouts back, waving his arms.

  ‘WHAT?’

  He yells something about a flight.

  ‘PASCAL?’

  ‘THE MISSION!’ he screams. ‘FOR THE MISSION . . .!’

  He arrives at the gate, babbling about a plane.

  ‘What plane? Our delivery’s not due until next Tuesday, no?’

  He’s ragged and wide-eyed, now gushing about Europeans.

  ‘What do you mean, Europeans?’

  ‘That group—visiting the mission,’ he pants back. He says a plane landed while I was in the hospital.

  ‘What—when?’

  ‘Before. The far end. They’ve gone to town. But they’re coming here soon. We need to change! Fuck—we must clean!’

  I laugh at his suggestion and steer him towards the dining room, reminding him that Tim said this would happen. It’s been over two months since any of us have kissed anyone—hell, hugged anyone—and it’s adding to the strain. There’s no end to it in sight either, because relationships with local women are out of the question. Other than being of dubious ethics given that we’re the largest employers, and perhaps also seen as the only prospect of a ticket out of here, cultural idiosyncrasies make it difficult—and dangerous: unwittingly inviting an ex-soldier’s love interest back for coffee presents a security risk to the entire project.

  Pascal’s insistent. He says there were four blondes on the planes. A few others, maybe, and some guys, too, but definitely four blondes. I laugh and tell him we’ll take the night off—he’s clearly been working too hard—but he’s anxious, pacing restlessly, and before I can say anything more the guard leads them in, four blondes, My God, late twenties, fair-skinned and—

  I can’t speak. Connections between brain and mouth dissolve as high concentrations of disbelief and hormone flood through me. Pascal and I try to find chairs, to straighten our T-shir
ts, to not—

  I stand. Then sit. Then stand again. I shake their hands—is that what you do these days?—but they’re European so I opt for a kiss on the cheeks instead. No–they’re English. I shouldn’t have done that! The English aren’t like that! They introduce themselves one at a time but the names fail to register, their lips move in slow-motion as my eyes zoom in tightly, their Vaseline Lip-Care SPF30 looking like Max Factor’s sexiest lipstick ever and now the lights of our dining area dim as one embraces me, and we embark on a dizzying whirlwind of passionate dancing, laughing, carefree, just a couple of crazy kids in the night . . .

  Get a grip.

  Pascal talks. Accommodation is offered for indefinite periods of time. Tours around the compound are insisted upon, countered by better offers of a ride in the mine-proof car. Wait—the river! Jesus, Pascal—wait until they see a sunset down there! They’ll melt when they see that sky, those ox carts and the kids playing, and we can show them what we call Oxford Street, that short stretch of road where the stalls sell chewing gum and biscuits and batteries—they’ll love it! And my mind darts back to that European poll I’d heard of years ago in which being an MSF doctor had been ranked as the sexiest role on earth, and admittedly it may just be a myth propagated to recruit volunteers but this could be my chance to live it! Right now though Pascal and I are all over the place, two sixteen-year-old boys at a first high school dance, deliriously excited but far too nervous to do anything about—

  Andrea walks in. Composed. A little surprised, but sane. She plays the attentive hostess and offers them drinks and invites them to stay for dinner. Pascal and I excuse ourselves to find Vasco, our guard, and ask him to build a bonfire and kill a goat for dinner, which he obligingly does, and I ransack my bedroom for a T-shirt that’s remotely presentable, but the search is futile—everything hints of some or other incident at the hospital. We beg Dominga to stay late and make some salad and rice, and not long afterwards we all gather at the fire, carry our dining set-up outside and place it under that veil of stars. It couldn’t possibly get more romantic.

  ‘How long are you guys around for?’ I ask, as we fill our plates with goat. The girl across from me smiles coyly (coyly!), runs a hand through her hair as she tilts her head and smiles. Is she flirting? A thousand shudders run down my spine.

  ‘For a few days,’ she says. ‘Actually, for four days near Mavinga, but we have two weeks in Angola.’

  Four days of this! Pascal and I can’t stop beaming as we try to make small talk with them. Tim will never hear the end of this—what a time to have taken his holidays! We go on, delving a little more into each other’s backgrounds.

  ‘And exactly which organisation are you here with?’ asks Andrea.

  ‘A Christian aid organisation,’ replies one.

  Pascal looks up sharply.

  ‘Uh . . . and what do you do with them?’

  ‘Oh, we’re spending some time with the mission we support near Mavinga,’ says the girl opposite me. ‘Documenting their work, interviewing people, that sort of thing.’

  ‘You’re not staying in Mavinga, then?’ I ask. The mission is where our burns patient, José, came from, and is about an hour’s walk from town.

  ‘No. Just with the mission.’

  It’s not ideal, but things are still salvageable. We’re not permitted by MSF to use the road that heads towards that mission, but our guest’s organisation allows them to use their project’s four-wheel drive. They can visit us.

  We talk a little more of their work. I ask how they got into this field, and finally drop the burning question—burning for Pascal and me, at least: ‘Do you have to be a, uh . . . a Christian to do this sort of work? I mean, to work for your organisation?’

  Pascal’s stopped chewing. His eyebrows hover somewhere near his hairline.

  ‘You do!’ comes the answer. ‘I mean, it’s not a written rule, but all of us here are committed to the Church,’ says the girl who’d been flirting. ‘We’re Born Again, actually.’

  Andrea kicks me under the table. The irony of three men being stuck for months with only one woman, who’s both attractive and highly dateable yet far more interested in the Church than any of us, is not lost on the team. Nor the fact that the issue has just repeated itself.

  ‘My fiancé is actually working for this organisation too,’ adds the one beside Pascal.

  Andrea suppresses a laugh.

  ‘And my husband used to work for MSF as well,’ adds a third. ‘In fact, that’s how we met.’

  Andrea’s lost it. Pascal takes a renewed interest in his food. ‘Fascinating,’ he lies, and we instead go on to spend the night chatting of approaches to development, the weather in London, and various other things. Not an unpleasant night by any means, although not how we’d have scripted it. And in fairness to the women, I’d also have professed to be both engaged and born again if I’d found myself in the company of Pascal and me in our present state. Our deodorant ran out weeks ago, razors not long afterwards.

  So it seems then that fabled stories of passionate love affairs in the field are to remain just that: fabled stories. Unlike others in town, my mosquito net is to witness no romance beneath it, but some respite is ahead. In two weeks I fly out for my holidays, so the prospect of at least some change in this routine looms large. It’s not a moment too soon, either. The tensions born of living on top of each other are building, and I need to not be on call, to not talk about MSF, and to sleep through just one night without waking at least once, worried by the prospect of being summoned to watch yet another child taking its last breaths.

  I need a break.

  10. SLEEPING EASY

  The roar of the plane, and Andrea’s suddenly looking worried. Not without reason. I’m off for holidays, which leaves her as the sole medical expat for ten days.

  ‘And that woman with the breast cancer?’ she asks, as we race to finish an early ward round.

  ‘We’ll have to put a bed in the tent for her,’ I say. ‘Or move her to Intensivo.’ The other patients on Maria’s ward have been complaining about the smell of her ulcerated breast tumour, and she wants to get away from them.

  ‘And Manuel? What am I going to do about him?’

  A good question. Manuel’s on a roll this morning; he gave two litres of IV fluid to a young child for reasons unknown, and hasn’t written any legible notes. He’s all over the place lately, despite the extra time we’re spending together.

  ‘Keep him off nights,’ I say. ‘And out of Intensivo. And the kids’ ward. Don’t let him start treatment on anyone without calling you. Wait—maybe you should keep him out of the hospital altogether. Get Sergio to adjust the roster and give him time off.’

  ‘And the guy with the burns—?’ she asks.

  The pilot’s waiting. I need to go. I feel bad leaving Andrea as the only medical expat here; she’s in for a week and a half of sleep deprivation covering this place alone, but there’s no alternative. Of some consolation, she’ll take holidays right after me.

  I run home to grab my bag and say goodbye to Dominga. Tim and Pascal are already unloading food and mail on the airstrip, the paediatric ground crew buzzing excitedly around the plane. ‘Don’t let the team down,’ warns Tim, who only recently got back from holidays in Cape Town. ‘Make sure you do us proud. Did you email the Red Cross girl?’

  I nod.

  ‘Don’t you dare come back without stories,’ he says.

  ‘Yes,’ says Pascal. ‘We need stories. Good stories.’

  I promise nothing as I farewell them, joining the handful of de-mining technicians in the cabin of the twenty-seater World Food Program plane that’s passing through town today. The propellers soon roar, high fives are exchanged and a warm Castle lager passed around, and everyone’s thrilled to be taking a break from Mavinga. No matter the destination.

  • • •

  Luanda is mine. The Angolan capital, sprawling along a picturesque stretch of foreshore in the north-west of the country, that strikes
me as a poor, rundown version of Havana: a steamy tropical city with a distinctly Latin flavour, its waterfront Marginal lined with coconut palms on one side and tired colonial-era buildings on the other. Spared much of the fighting during the war, the old buildings of this once-beautiful colonial outpost, dubbed The Paris of Africa in its heyday, crumble from neglect rather than mortar damage these days, while new ones are hoisted skywards by the cranes of Chinese construction companies.

  It’s a huge city, and as big a paradox. Hemmed in by vast, crime-ridden shanty-towns into which half of Angola’s twelve to sixteen million people are crammed, and through which street kids and stray dogs pick at decomposing mounds of rubbish, it’s an impoverished, dilapidated metropolis; yet at the same time it’s ranked as the world’s single most expensive city for expats. Rent is around ten thousand US dollars per month for an average house in a reasonably central suburb, and all but the most basic foods need to be imported. Trendy nightclubs exist, too. Plenty of them, not far from the slums, situated along white sand beaches that overlook a horizon sparkling with deep-sea oilrigs, behind which those show-stopping tropical sunsets glow. Inside, sheer hedonism: well-heeled oil-workers and foreign advisors rub shoulders with attractive mulatto prostitutes over fifteen-dollar cocktails; outside, the larger reality: a rabble of scruffy kids will watch your car for a few cents, while os mutilados—Angola’s disabled, known literally as ‘the mutilated’ and estimated to be about ten per cent of the population—pass by with their crutches, prosthetic limbs, or various other injuries. Two days is enough for me.