by Amy Waldman
The bazaar was a simple place: two rows of facing stalls, about fifteen all told, propped up by stripped tree limbs, with corrugated tin roofs overhead. The main path was mucky from the buckets of water merchants tossed on it to keep down the dust. Waheed gave one-word self-evident descriptions for each stall they passed: butcher (a skinned sheep hung on a hook, its bare pink flesh flecked with black flies), baker (loaves were stacked for those too poor to buy ovens), and tinsmith, a maker of pots and pans. There was a shop with a desultory hodgepodge of stale biscuits, cigarettes, expired medicines, and pirated DVDs (although no one in the village had a DVD player) of 2 Fast 2 Furious and Bollywood films, merchandise that had probably been bought and sold a hundred times between Kabul and here, where it had washed up, as an ocean deposits plastic far from its source, to gather dust.
“Some of those things have been here since I was a child,” Waheed joked.
The shopkeeper laughed a little too hard. People greeted Waheed deferentially, as if he were someone important, and Parveen wondered if this was because she was with him. He bantered with them but did not introduce her.
The blacksmith worked outdoors, next to his forge, which was made from mud. The coals within it glowed orange, and a large kettle sat atop it. The blacksmith was an inquisitive graybeard with sweat trickling down his face, but it was the man next to him who caught Parveen’s attention. He was as big in the belly as he was in the shoulders and had a hennaed beard, a gray turban wrapped expertly around his head, and in place of one hand a metal hook. With his intact hand he was popping pistachios into his mouth, then loudly biting them with a sound like knuckles being cracked. The shells he ejected with a buffoonish pfft. This was Commander Amanullah.
She looked in vain for signs of the terror he had inflicted on so many or of his famed courage. What she saw was a grizzled aging man, hardly in fighting shape. Waheed’s suggestion that he could lead an army against the Americans seemed comical, a pantomime of threat. But when someone changes slowly before your eyes, Parveen thought, the change can be hard to see.
“You are the American doctor,” the commander said after Waheed had introduced Parveen.
She was not a doctor, she clarified.
“Then who are you? We need a doctor here.”
“The clinic doesn’t have one?”
“The lady doctor comes once a week. We’ve instructed our wives to get sick or give birth only on Wednesday, but they don’t always listen.”
The small crowd of men who had gathered laughed; Parveen didn’t find it funny. She was about to tell the commander so but Waheed had disappeared, so she held her tongue and instead asked, “Didn’t Gideon Crane hire a full-time doctor?”
“I don’t know what Dr. Gideon has done.” Like Issa, the villagers called Crane Dr. Gideon, she noticed.
Parveen said that she would report the situation with the doctor to Crane’s foundation.
“You work for Dr. Gideon?”
“I’ve come to be helpful to him,” she said, uncomfortable with this elision but uncertain what to say instead.
The commander asked if Parveen spoke English. The question struck her as hilarious until she remembered that of course they had no way to know what language, other than Dari, she spoke. Yes, she said and smiled.
“Let’s hear some,” the commander said in Dari.
She stuttered, “H-hello, how are you?” and was surprised to hear how strange English sounded to her.
“Yes, she speaks English,” he confirmed in Dari to his minions, who laughed because the commander himself didn’t speak the language and had no idea what Parveen had said. He asked her if she’d learned Dari in school.
No, she told him. Her family was from Afghanistan, from Kabul, where she’d been born. Her parents had left in 1988.
“So they left with the Russians. Were they Communists, your parents?”
“No! That’s just when their visa came through. They were trying to escape the Soviets. No one knew they would withdraw—”
“The little bird has quite a sharp beak,” he said, amused by Parveen’s outrage.
They’d left everything behind, she went on. They’d started over in America with nothing. Her father, for several years, had driven an ice-cream truck. That this was humiliating for Ashraf didn’t register on the villagers’ faces. An ice-cream truck was as mythical here as a unicorn. Truck drivers earned good money.
“The suffering of those who left can’t compare with that of those who stayed,” Amanullah said, and Parveen fell silent. “I’ve lost two sons to war. And this.” He waved his hook.
“I’m sorry about your sons,” she said, unsure whether to offer condolences for his hand.
“It’s a blessing to lose sons fighting for God,” he said.
“Of course.” She rebuked herself. She should have known that was how he would see it.
There was an awkward silence. The blacksmith picked up his hammer and began to bang on his anvil. Commander Amanullah looked away, as if to say he was done with Parveen.
SHE COULD SEE THE clinic from the bazaar. She couldn’t not see it, since it was two stories high and painted a white so bright that it looked primed for sunburn. It was completely out of scale and character to the rest of the village. If she hadn’t known better, Parveen would have figured the building for a wedding hall planted by some entrepreneurial provincial. It looked like the photo in Crane’s TED Talk, but it was much grander than the photo in the book, which she had recently perused.
She mentioned this to Waheed, who laughed; the clinic looked smaller in the book because it had been smaller. Originally the structure had been just one story with a few rooms, he said. But after the book was published and donations poured in, that clinic was torn down and a new one built at three or four times the original size.
From what Issa had told him, there were three warehouses in Dubai full of unused equipment, Waheed said. “The donations kept coming; the clinic had to keep growing.” He sounded almost sad, but his eyes were creased with amusement, as if he understood his own illogic. Supplies were brought in, sometimes by helicopters, he continued. A high wall, also white, surrounded the clinic. Both wall and clinic were repainted at least twice a year, because of the dust, Waheed said, then added: “It can never be defeated.”
“Dr. Gideon wants the clinic to look sanitary,” Parveen said, feeling obliged to explain for him.
With one of the large keys Waheed unlocked the metal door that led into the clinic’s courtyard. Among the children who had tailed Parveen and him, only Waheed’s were permitted inside. The rest were harried off. The courtyard was large and dusty, unadorned except for a single shade tree that stood slightly off-center. In the late-afternoon light, its shadow stretched diagonally across the empty space.
“So the doctor comes once a week? Isn’t the clinic open any other time?”
Waheed was using the other large key to unlock the building door. “If there’s no doctor, it stays locked,” he said. “The equipment here is more valuable than all the fields in this village. And what good’s a clinic without a doctor?”
His question struck Parveen as unintentionally profound, more profound than anything in Foucault’s The Birth of the Clinic, which they’d read in Professor Banerjee’s class. Parveen had been taken with the idea of the “medical gaze,” which was how Foucault described the way doctors, even as they were elevated to sages, reduced patients to bodies alone. She’d been curious to see how that would play out here, in the developing world. That there might not be a doctor to bestow a medical gaze had never occurred to her.
The clinic facility itself was good, staggeringly so, Parveen thought. The interior walls were a soothing white and there was a reception desk and several rows of sturdy metal chairs screwed to the floor in a waiting area. The chemical smells—ammonia, bleach, paint—were acute, almost painful. She hadn’t smelled chemicals anywhere else in the village except for the diesel that fed Waheed’s generator. There were skylights and—this see
med almost miraculous—a light switch, which Parveen flipped. Nothing happened.
The fuel was saved for when the doctor came, Waheed explained. They couldn’t run the generator all the time. After sparking a lantern, he walked Parveen from room to room, beginning upstairs with the ten-bed maternity ward and the adjacent nursery, which held three empty incubators. Downstairs he slung the beam of the lantern into windowless rooms labeled, in both English and Dari, EXAMINATION, LABOR, DELIVERY, SURGERY, and RECOVERY. The equipment looked state-of-the-art. That this pristinely kept temple to health—to modernity—should be in this village, of all places, moved Parveen. If, approaching the clinic, she’d questioned the abandon with which Crane flouted the village context, now she celebrated his refusal to let the village’s history or isolation limit its possibilities. The clinic’s seeming excess proclaimed these humble villagers to be worthy of the same medical care that Americans were, a message almost as meaningful as the treatment itself.
Chapter Five
Shake the World
THE NEXT MORNING, WHICH WAS WEDNESDAY, DAWNED CLEAR and warm. After breakfast Parveen practically bounded to the clinic, eager to meet the doctor. She was greedy for another liberation from the house yet uneasy at her own desire. Wasn’t the right to flit in and out of a prison that others couldn’t leave the very definition of privilege? Neither Shokoh nor Bina had ever been to the clinic to see the doctor. Bina claimed to have never been sick.
“You didn’t see the doctor even during your pregnancies?” Parveen asked.
“Why would you need a doctor to be pregnant?” she answered.
This stoicism, if that’s what it was, struck Parveen as worthy of exploration. Was Bina remarkably healthy, or did she never allow herself to be called sick, since there was no one to do her work in her place? She wrote this question in her field notebook, which was still mostly empty.
Aakila and Adeila insisted on accompanying Parveen to make sure she didn’t get lost. They chattered like baby wrens the whole way. When they arrived, the metal door to the courtyard was unlocked, and women were already gathering inside, giddy at the brief furlough from their homes and duties. They had pulled their chadris off their faces and piled them atop their heads, and they kissed and caught up with one another until around ten o’clock, when they heard a car parking outside the wall. The chadris were down before the car doors slammed shut.
The doctor entered the courtyard calling out ebullient greetings. Her name was Yasmeen Wafa, but the villagers mostly called her “the lady doctor” or Dr. Yasmeen. Behind her came a young man, which explained the rush to cover faces. He was Naseer—her assistant, her driver, her son. Dr. Yasmeen had an open, full face that shone out from her fawn-colored head scarf. Parveen liked her instantly. She was plump beneath her salwar in a way that exuded vigor and health. She had an ample mouth and a wide smile with good teeth (it was hard not to notice good teeth in the village, where they were rare). Naseer was her solemn counterpoint; he had the same full mouth—adorned, in his case, with a trace of mustache—but he was less prone to smiling. His skin was darker, his hair wavy and black, and his thick brows nearly grew together in the center. Parveen guessed him to be about twenty.
The women rushed to surround Dr. Yasmeen, their voices overlapping at a high pitch of excitement. Naseer tried to herd them, verbally, to the clinic entrance. He was ignored. Only when the doctor herself moved across the courtyard toward the door did they budge, although they continued to surround her like ectoplasm. At the entrance all of the women, unwilling to give up their proximity to the doctor, attempted to squeeze through the doorway at once.
Because Naseer stayed outside in the courtyard, once the women were inside the clinic they removed their chadris, laid them on the rows of chairs, and sat on the floor. The lights were on.
Parveen followed the doctor to the examination room and, after hovering in the door for a moment, marched in to introduce herself as a recent college graduate who had come to help the village women. Dr. Yasmeen looked at her with great warmth. It was the kind of reception Parveen had hoped for, and failed to receive, from Waheed’s family.
“I guessed you weren’t from here,” the doctor said. “But America! Naseer will be so excited.”
Speaking Dari because she insisted that her English was poor, Dr. Yasmeen asked how long Parveen had been studying medicine.
Parveen confessed that she hadn’t studied medicine at all, and she watched the doctor’s face fall ever so slightly.
“So how is it you plan to help us?” This was asked pragmatically, without judgment, yet the question embarrassed Parveen, as did the fact that while they were talking, Dr. Yasmeen was doing half a dozen preparatory tasks—putting on her white coat, washing her hands, setting out her examining tools, laying paper on the examining bed, and so on.
Parveen explained that she wanted to document how the clinic was being used as well as the women’s reproductive histories and their continuing health problems.
“And this report,” Dr. Yasmeen said, “who will read it and what will happen afterward?”
Still there was no needling in the doctor’s tone but Parveen grew defensive. “Without information, Dr. Gideon’s foundation or others that want to help won’t be able to make improvements,” she said.
“I’m not sure a lack of information is the reason this clinic has, most days, no doctor.” So what was the reason? Parveen asked, but Dr. Yasmeen had no more time. She handed Parveen the soap and told her to wash her hands. “No, not like that. More thoroughly, in between the fingers.”
“But I’m not going to—”
“Always be prepared.” The doctor smiled. “We’ll talk later. They’re waiting.”
EVEN THOUGH IT WAS the younger women, Parveen would learn, who often had the graver needs, physical and otherwise, the doctor saw the elder women first. Their ravaged bodies shocked Parveen—skin parched, mottled, and bruised; shoulder blades protruding like sharp breasts; breasts hanging like empty stockings. And the majority of these women were under sixty, an age beyond which most didn’t live.
A woman, her black hair streaked throughout with gray, entered weeping. To Parveen’s surprise, Dr. Yasmeen assumed a posture of skepticism—arms folded, eyebrows raised—and asked, in the weary voice of an actor who has run her lines one too many times, “Saba, are you well?”
“How could I be well?” Saba blubbered. “You know better.”
Saba had given birth to eleven children, the doctor told Parveen in Dari as Saba nodded along. Seven of them were living, the oldest ones with children of their own, but Saba wanted more offspring. Her aging ovaries had other ideas.
Saba said, through her tears, that she had taken the pills the doctor had given her, but they hadn’t helped.
“They were vitamins,” Dr. Yasmeen said. “The end of menstruation is not something to be cured. You’ve watched your mother and grandmother and every woman older than you in this village age. Do they ever grow young again? In a few years, Saba, I’ll go through the same change. This is God’s plan for us; it’s not for us to try to alter it.”
The suggestion that she was trying to defy God’s will quieted Saba for the time being. Like many of the village women, she was pious, or eager to appear so. Her manner suddenly businesslike, she reported that another village woman was selling the pills Dr. Yasmeen had given her.
“Is that so?” the doctor said neutrally.
This was common, Dr. Yasmeen said later, villagers making all kinds of accusations against one another, often for crimes they themselves committed. Saba’s own vitamins would soon appear at the bazaar now that she knew they wouldn’t restore her fertility.
Saba seemed to want to talk more, but Dr. Yasmeen ushered her out and called the next patient in. Parveen privately accused her of lacking compassion. Over the next hour, however, as the doctor saw a dozen patients—for ailments including bronchitis, diarrhea, hypertension, anxiety, and epilepsy—Parveen came to see that the doctor couldn’t afford in
dulgence. She had to balance allowing the women to voice their concerns with treating as many as possible. Even though it was a women’s clinic, mothers brought their children, for there was nowhere else for them to be treated, which meant that children with coughs and rashes and the runs were squeezed into the rotation too. Other children were simply placed in Parveen’s care while their mothers undressed, as if she had flown here from America to babysit. In truth it was the most useful she’d felt since arriving in the village. But when a young woman named Anisa handed Parveen her baby boy, less than a year old, he began to bawl.
“Move him, sing to him,” Dr. Yasmeen instructed a touch incredulously, as if she’d never met someone so untutored in infant care. Parveen had spent a lot of time with her nephew, but he’d never made her nervous the way these babies did.
Anisa’s baby finally quieted beneath Parveen’s bouncing and cooing. She nuzzled his soft head and inhaled his sweet-sour smell, thinking about Ansar, then looked up and gasped at the naked skin of the young mother. Pale as paper, it was splotched with bruises whose sickly gorgeous colors—violet, yellow, puce—were the most vivid thing about her.
“I’m dizzy, I’m tired, I can’t breathe well,” Anisa said.
Anemic, the doctor said, and she handed Parveen the stethoscope so she could hear the frantic heart for herself. Anemia was almost inevitable, the doctor continued, given how poorly the village women, even those breastfeeding, ate, with a diet of mostly tea, yogurt, and bread, perhaps dipped in a meat broth. She asked Anisa when she’d last eaten meat.