Outpost Hospital

by Sheila Ridley

  As he listened, Andrew ruffled his unruly brown hair with both hands, a gesture that meant that he was thinking deeply. “I do know that Ona, Joseph’s first wife, has lost two babies and she was terribly upset about it,” he said slowly. “And I’m sure there’s nothing she and Joseph want more in the world than a healthy baby. It would be wonderful if you and Charlton could make it possible.”

  “We can’t do anything without their cooperation,” she said despondently.

  “I’ll talk to them,” he promised. “I know them both well and I think I can help.” He put his hands on her shoulders and shook them gently. “Now don’t look so bothered, my dear girl. You can’t do everything at once you know.”

  “I suppose not. But there’s so much I want to do, Andrew.”

  “I know. And you will do it, I’m sure, all in God’s good time.”

  “I never thought of myself as an impatient person but I feel very impatient now.”

  “You’re impatient for others but ... for yourself?” He still held her by the shoulders and now he came closer and looked searchingly into her face. “No. Not for yourself. There’s an infinity of quiet patience in the depths of those big gray eyes of yours.” His hands tightened their hold as he said, “I sometimes wonder why Dr. Charlton came here, you know, but whatever the reason I’m very glad he did come, and especially that he brought—” A sound made him break off and turn toward the door.

  Katherine turned too and saw Mary Kennedy standing just inside the room, her hands folded at her waist. Even through the gloom she could see that the other woman’s expression was far from pleasant. “Is it not time you were lighting the lamps, Andrew?” she asked coldly.

  “Aye, I daresay it is,” her brother replied equably. “I hadn’t noticed how dark it was getting.”

  The Scotswoman sniffed her disapproval and Katherine, muttering something about getting ready for dinner, made her escape.

  CHAPTER NINE

  Andrew did manage to persuade Joseph’s wife Ona to come to the clinic, but it was largely thanks to Ona’s lively curiosity that she came at all.

  She arrived one warm, dull afternoon. She was very young and rather frightened and, to Katherine’s dismay, she was accompanied by three older women who stood around her in a protective phalanx.

  Very conscious of his importance, Joseph told them to sit on the bench near the door until the nurse could attend them. Katherine, busy syringing a child’s ears, felt four pairs of keen dark eyes watching her every movement, and in at least three pairs, she was sure there was suspicion, even distrust.

  When she had finished the child’s treatment and washed her hands, she went to Ona. Smiling reassuringly, she took the young woman’s hands and led her to a chair by the table. The bodyguard stood quietly watching while she took the pulse and temperature, but when she began to take a specimen of blood the women started to chatter excitedly and to wave their hands about in protest.

  Katherine looked appealingly at Joseph who spoke sharply to them and the chatter trailed off to a low mutter.

  Katherine was getting worried. Both the pulse-rate and the blood pressure were abnormally high. Yet she dared not show her anxiety. Keeping her face and voice relaxed, she said to Joseph, “I’d like Dr. Charlton to have a look at Ona—just to check up. Please go and ask him to come, will you? He’s at the building site.” When he had gone, Katherine persuaded Ona to lie on the bed that was screened off from the rest of the hut. Still the women kept guard and she was trying to think of some way of getting rid of them when Mark entered followed by Joseph.

  The doctor was still in his working clothes—khaki shorts and shirt—and as he washed, Katherine told him the results of her brief examination. Then he went behind the screen. “Who are all these women?” he demanded testily. “I want them out of here!” Katherine tried to shepherd them out but they stood firm. Again she appealed mutely to Joseph, but even he could not budge them. Finally Mark said, “Which one is her mother, Joseph? Right, she can stay but the others must go and wait outside.” And he took the indignant pair firmly by the arms and marched them to the door.

  Back in the cubicle he said, “Tell her to relax, Joseph. I won’t hurt her.”

  The young man spoke softly to his wife and she smiled faintly, looking less afraid.

  A few minutes later Mark straightened up and looked across at Katherine. She knew he was worried and, like her, was trying not to show it. He stepped outside the screen and she followed.

  Hands thrust deep into his pockets he stared at the ground and said, “She’ll never have this baby normally. She’s too small and the high blood pressure could be dangerous.”

  “Is there nothing we can do?” asked Katherine softly.

  Mark Charlton shrugged his wide shoulders. “If we were at home, of course it’s a case for Caesarean section; but here...”

  “Is it entirely out of the question, Doctor?”

  His dark head jerked back. “My dear girl, I’m not a gynecologist. I’ve never seen this operation performed, even. I’d be scared to death if I had to do it in a properly equipped theater with a fully trained staff. How can I possibly consider doing it here?” He looked around expressively.

  Despite all their efforts with whitewash and D.D.T., clean linen and much scrubbing, the out-patients department was little better than the accommodation other countries demand for their dairy cattle.

  “Of course it can’t be done,” she sighed. She felt depressed. She was unhappy for the young couple. She had seen the fear in the pretty little wife’s eyes replaced by childlike trust. And she was apprehensive. Here they had come up against their first real challenge and Mark was afraid to accept it. His lack of courage was very disappointing and it did not bode well for the future.

  She was turning to go back to Ona when he said, as if to convince himself of the rightness of his decision. “You would have had to give the anesthetic. You were prepared for that, I know, but not for a long operation thrust on you out of the blue.”

  “But if we don’t...” she ventured.

  “The next six weeks are going to be difficult. She’s not strong.” He was minimizing the danger, she knew.

  For a long moment neither spoke. Then Mark took his hands from his pockets and looked at them thoughtfully. They were coarse. For weeks they had handled saw, plane and hammer; how would a scalpel feel now? He flexed the long fingers. “Do you think Joseph would agree to an operation?” he asked half-reluctantly.

  Eagerly, Katherine said she was sure he would but added, “I’m not so sure about her mother, though.”

  Mark nodded. “Fortunately we don’t need her consent.” He spoke in a slightly puzzled way, as if he was wondering why he had changed his mind. A minute ago he had no intention of doing the operation; now, for some reason, he knew he must do it. But there was no time to lose. He wiped his hands and face on a towel and then said briskly, “While I’m talking to Joseph and his wife, you go and tell Simon what we’re going to do. Then come back and start preparing the patient. We’ll do it in the hospital.”

  “But it’s only half-finished!”

  “I know, but they’re putting the roof on and it’s freer of germs than anywhere else in the village. After I’ve spoken to the young people I’ll go and see what needs to be done to get one room into shape; then Kennedy can supervise the men until the job’s done.”

  “There’s so much to do,” said Katherine, excited and nervous. “Must the operation be done today?”

  “Yes, Nurse. Every day she carries the baby weakens her. And apart from that I—well, I’d rather do it at once.”

  She knew what he meant. He didn’t want time to think and grow afraid again.

  The next two hours were the most hectic Katherine had ever spent. Once or twice she stopped in her tracks, suddenly frightened, and then she went on thankful that Mark had decided not to delay.

  After sorting out gowns, masks, gloves and sheets, she pulled out a box of gauze squares and took it to the o
ut-patients department. Here she spread a clean sheet on the table, divided the gauze into two piles, one at each end of the table and put a chair beside each pile. Then by means of smiles, nods and gestures, she cajoled the two women who had come with Ona into the chairs, and within a few minutes, they were folding swabs with dexterous fingers.

  That will keep them busy for a while, she thought, as she went across to Ona.

  When the girl was ready, Katherine gave her an, injection to calm her nerves. Joseph would carry her to the hospital when the time came.

  Now to see how work was proceeding in the operating room. She found that the heavy work was finished. The small room was spotlessly clean and smelling strongly of disinfectant. The furniture consisted of two tables, one on trestles and the other an ordinary type. Regretfully, Katherine thought of the beautiful shining new operating table that was on its way to Ngombe now. However, the trestle one was the right height and the other would hold the instruments.

  Next thing was the lighting. Besides lamps, some direct light from above was essential. She mentioned this to Andrew who was standing by ready to do anything to help.

  “I have a large powerful torch and so has Charlton,” he replied. “We could fix them above the table somehow and then make a shade to direct the light.”

  She approved this idea. Glancing around, she asked where Dr. Charlton was. It was time to be deciding who was to carry out the various tasks connected with the operation.

  “He went up to the house a wee while ago,” Andrew told her. “I expect he went for his instruments. I’d better go and see if he’s all right.”

  “If he’s all right? How do you mean, Katherine?”

  “Oh, I didn’t really mean that. To see if there’s anything I’ve forgotten to do. That’s what I meant. I won’t be long.”

  She walked quickly through the tall elephant grass and up the steps to the porch. The house was very quiet. He was not in the living room. His bedroom door was closed and she stood looking at it uncertainly for a moment. She could hardly knock and say, “Please I’ve come to see if you’ve lost your nerve, Doctor.” She was still hesitating when the door opened and Mark came out, his instrument case in his hand. She felt discomfited at being found there, but he gave her one of his rare, charming smiles and said, “I haven’t been chewing my fingernails or pacing the floor, Nurse, I swear. Just reading up on the subject in hand. Everything in order?”

  Happily, she told him Andrew’s idea for fixing the overhead light; that Simon was filling all the available lamps with oil, that Joseph was with Ona, and that Ona was asleep.

  “Good,” he nodded. “I’ll have a look at her on my way over to the hospital. Then it won’t be long before we can make a start.” Back in the operating room, Katherine ran through the procedure in her mind and realized that something had been overlooked. She dashed out and returned a minute later carrying a shallow oval basket.

  “What’s the vegetable basket for?” asked Andrew.

  “Don’t you know? That’s for the baby.”

  And an hour later a small but vigorous baby boy lay howling lustily in that vegetable basket.

  CHAPTER TEN

  At last the main hospital building was complete.

  The design was very simple. Raised three feet from the ground on poles, it was rectangular in shape and had a sheltered veranda on all four sides. A corridor ran the full length of the building, dividing it into two unequal parts. The larger part was again divided into two wards, one for men, one for women, and the smaller into office-consulting room, storeroom, clinic room and operating room.

  In a separate building at the back was the kitchen and laundry.

  The excited villagers and many others from the surrounding district marked the occasion with a fitting celebration.

  Katherine had heard the patients and their relatives singing and playing their lutes and drums while they waited to see the doctor, and she looked forward to seeing their dances.

  Toward evening, the heavy clouds that had hung over the village all day moved away and left the sky clear and scattered with stars.

  The display was to take place in a clearing in front of the hospital and chairs were placed on the porch for the guests. Katherine wore her gray two-piece and she felt very dowdy beside the local chief and his eldest son in their magnificent robes and head-kerchieves in orange and yellow.

  The local people, from the oldest to babies in arms, formed a wide circle, their faces glowing in the light of the oil lamps arranged around the edge of the circle. Their excited chatter died away as the chief, a tall, dignified figure, rose to his feet. In a gracious speech he thanked the doctor and the nurse for the work they were doing for his people.

  Then Mark replied, thanking all who had helped in the building of the hospital, and when Simon had translated his words, large quantities of fruit and nuts were, according to local custom, distributed among the villagers.

  The festivity began with music. Quiet but insistent, it filled the air. The players knelt at their drums or sat cross-legged strumming lutes, or shaking gourds with beans inside. The people swayed to the rhythm and one, a younger boy, began to sing. A second and then a third joined in the pulsating chant.

  When the singers stepped back into the shadows, the dancers took over. The pace quickened as a dozen boys and girls in short grass skirts with bells fastened to their wrists and ankles, threw themselves into the dance with great energy.

  Next, the fantastically masked devil-dancers entered the arena balancing on six-foot stilts. To the low throbbing of the drums they performed incredible feats—jumping, leaping—each trying to outshine the others in agility.

  Long after the guests had retired, the celebration continued. A strange lullaby, thought Katherine drowsily, as she drifted toward sleep.

  The hospital had been well and truly opened.

  There was a long waiting list of surgical cases, so that for a time Mark was operating every day, taking time off from surgery only to see new patients. Katherine had been training four of Andrew’s senior students to do some of the simpler routine jobs, which meant that there was a useful nursing staff ready for work.

  These new nurses were full of admiration and amazement at “loketa’s” powers. After seeing an anesthetic given they spread the news that “Loketa can kill you and then bring you back to life.”

  The patients needed no persuasion to submit to the white man’s magic. In fact, the difficulty was to convince those who did not need surgical treatment that an operation was not necessary. But when the operation was over the nurses had a hard job making them stay in bed while the wound healed. The patients could not see why they should not go straight home to their families. The operation had cured them so why should they lie in bed?

  Every success brought more patients. The huts provided for their relations were full, the village was overcrowded and it was clear that the hospital would have to be extended as soon as possible.

  Though she was always exhausted by the end of the day, it was a happy time for Katherine. There was great satisfaction in the work and it was a strong, if impersonal, bond between herself and Mark. Sometimes, as they hung up their white coats in the little office when the day’s work was over, he would smile at her and say in his deep voice, “Thank you, Nurse,” and she would feel well rewarded.

  The weeks slipped by very quickly.

  One evening when she entered the office, Mark was sitting at his table with his head resting on his hands. He looked up and she saw that there were fine lines of fatigue around his blue eyes and deeper ones across his broad forehead. He is working too hard, she thought anxiously, and wished there were more she could do to help him. How she longed to kneel beside him and soothe away these creases.

  “Simon has reported for night duty, Doctor,” she said. “All the patients are comfortable.”

  He nodded. “Thank you, Nurse.” And as she turned to go he called, “Sit down for a minute, will you? I’ve got a problem on my mind and I’m
damned if I know how to deal with it. You might be able to help me. You remember Fina, don’t you?”

  Katherine remembered her well. A pretty girl of 15, she was suffering from tuberculosis and had been brought to Ngombe soon after the hospital opened. There had not been an empty bed for her and, as she had traveled many miles from her home, lodging was found for her in the village. The young man of the house, Kani, himself under treatment for leprosy, had been attracted to the girl and had bought her from her parents to be his wife.

  Fina finally stayed in the hospital and made a wonderful recovery. But at the same time Kani’s condition worsened, and he had to leave the village and live in a settlement for lepers.

  “Fina isn’t ill again, is she?” Katherine asked.

  “No, she’s fine,” Mark said. “The problem is that she won’t see that her marriage to Kani was a mistake and that she must go back home and forget him.”

  “He is devoted to her,” said Katherine quietly.

  “I know. But he is willing to give her up for her own sake. I’ve promised to get him back his bride-price, but the silly girl says she is going to stay with him even at the risk of catching the disease herself.”

  “Have you done anything about it?”

  “I’ve sent for her parents to take her home. On my last visit to the settlement I told Kani he mustn’t try to get her back and he agreed, but if she goes to him I don’t think he’ll have the strength of mind to send her away.” With a sigh of exasperation he raised his eyebrows and looked at Katherine. “Well, Nurse? You’re a sensible young woman. You see that this child can’t be allowed to waste her life like this?”

  “I don’t think she would be wasting her life and I’m sure she doesn’t think so.” Katherine was surprised at the firmness with which she answered him; she could see that he was surprised too. Gazing down at her hands clasped in her lap she continued, “If Fina is willing to give up her own people and risk her health to be with him, then she must really love him. It would be cruel to separate them.”