Old Lovers Don't Die (14 page)

John eased the bus onto the road and it began to heave and sway its way up the hill, diesel, as predicted, percolating up through the air-conditioning holes in the floor. As the bus laboured, John changed gear and extra clouds of brown diesel flowed up through the floor irritating the chickens, producing a rap cacophony of squawking. Unfortunately, the increased agitation caused spurts of chicken poo, which splattered the crates and aisles around the crates. The smell of diesel and chicken excrement was an overwhelming combination.

Christian cast a glance along the seat at Donna to see how she was managing. She had changed places with Cindy so that she could be next to the window. She had her face resting on her hand with the top part of her head out the window. Christian could see she had her eyes closed so it was difficult to tell how she was feeling; her general greyness indicated that the smell of the chicken excrement and diesel was having a deleterious effect. He had seen that look many times before in accident and emergency, and he knew it was a prelude to vomiting. As if on cue, Donna vomited loudly and prodigiously out of the back window. He motioned to Cindy to change places so he could sit next to Donna. As they were in the process of changing places, Donna vomited again. He sat down next to her and quickly felt for her radial artery. Her heart rate was regular and about 80 bpm. Clinically while she looked unwell, she was not at the stage of decompensating due to dehydration; however, he knew that unless she stopped vomiting, dehydration would quickly occur and with it possibly renal failure. He wondered, given the filthy conditions in the bus, whether he could give her an intramuscular injection of Stemetil, an antiemetic he carried in his bag. One more vomit, he thought and he would take the chance.

The blaring of horns temporarily distracted him from Donna’s vomiting. He tried to peer around the chicken crates but could only see the backs of those standing in the forward part of the aisle. He looked out the side window past Donna and could see that they were still steadily climbing but were now on the opposite side of the road. They were attempting to pass a small truck that had stopped in their upward lane. Donna then vomited again as the bus lurched back rapidly onto the right side of the road, narrowly, or expertly missing a bus which had come around the corner just prior to the apex of the climb. The water that Donna had tried to take in between the vomits immediately was lost out through the window in a continuous stream. Christian unzipped his bag and found the container which held the Stemetil. He had six needles that were blunt-tipped for drawing up medications, the six others for injecting. He quickly told Donna what he was planning on doing and she weakly nodded her consent. As he drew the Stemetil into the syringe, people all around him started to look at what he was doing. Three young children, who had been sitting on their mother’s lap in front of the back seat, peered over their mother’s shoulders, wide-eyed and with great curiosity. By the time he had taken the needle out of its sterile container, more faces were appearing around the chicken crates, and most of those in the back of the bus had stood up to see what he was going to do next. Smiling at all of the faces, he rolled up the short sleeve on Donna’s arm, wiped it with an alcohol swab, and plunged in the needle before injecting the Stemetil. He heard some of the children gasp. Then, as he pulled out the needle and checked the syringe to make sure the full five mg had been delivered, all those who were watching burst into spontaneous applause. Donna mouthed a thank you to him and put her head back out the window.

Half an hour later having crested the top of the hill, the speed had increased significantly. More importantly, flows of fresh air flushed out the diesel and reduced the impact of the smell of the chicken poo. Importantly, Donna had not vomited again. Christian turned to Cindy.

“Would you like to sit next to Donna again now that she is feeling a little better?”

“No.” She smiled. “I’ve always believed you should share a good doctor.”

“Very cute. I’m relieved that she is feeling a little better. It would have been awful leaving you at Rhuengeri if she hadn’t been.”

“Well, at least we can try and concentrate on what there is to see around us now that she’s feeling a little better.”

Christian could see the flat road that they were now on was really just a connection between volcanic ridges. Looking up at the surrounding peaks, every possible inch was cultivated. Horizontal furrows were constructed all around the distant mountains to the very top. Rich volcanic soil provided a life-giving underbelly to everything from potatoes to bananas. Every 1500 m up the mountain, he could see there were small one-room huts. They had four walls, approximately a metre and a half wide, each with a small door, a chimney but no windows. Some had smoke gently drifting out of their chimneys, suggesting occupation. People who cultivated the soil obviously lived in the huts so that they did not have to climb the whole mountain each day.

It was like nothing he had ever seen before, a reminder of one of the human endeavours in Africa required to survive. In another life, he wondered whether he could have existed in a similar small hut. As he thought about the daily grind that would entail, he noticed the 50 km to Rhuengeri sign on the side of the road. For the last few kilometres on either side of the road, there were increasing numbers of people walking with various forms of produce. Some rode or pushed bicycles, which had large water bottles for filling, or branches of trees cut for sale as firewood. Some of the bicycles were so overladen with firewood that there was no room to ride them; the rider was walking alongside the bike while trying to maintain balance.

Rhuengeri quickly came to meet them with its markets and throngs of people. As a town, it was not dissimilar to Kigali, although unlike Kigali it was entirely flat.

“I guess this is where we say goodbye,” Cindy said, looking dispiritedly at Christian.

“Perhaps not goodbye then, just au revoir. I feel like we are destined to meet again.”

“And hopefully not just for your medical expertise, wonderful though it was,” Donna added, her vomiting greyness replaced by a healthier pink colour.

“That injection that you gave me has made the world of difference. Thank you so much. I’m sure you’ll make a huge difference to the patients at Garanyi Hospital where you’re going.”

Christian felt both sadness and excitement. Sadness that he was losing his travelling companions whom he had, over a short period, grown to know and like, yet excited about the challenge which lay ahead.

“Well, you can always come and visit me, as friends of course, not as patients.” He laughed. “I hear it’s beautiful on the shores of Lake Kivu where Garanyi Hospital is situated.”

Christian looked across to his left and out the window. John was expertly bringing the bus to a halt next to another long queue. Remarkably, nothing had fallen from the roof. As the bus’s motor was switched off, Christian felt the sensation of the rocking motion of the bus continuing for a few minutes. John then reached through one of the missing door panels, untied the front door and the disembarkation proceeded in the reverse order to boarding. The chicken crates in front of them however remained in position and Cindy and Donna had to manoeuvre around them by climbing over the seats. Christian held onto their backpacks and once they were outside, passed them out of the window. Realizing that they would have to remove some of the luggage from the roof, Christian also decided to exit via the missing back window.

“Time for one last goodbye,” he said as he landed on the ground next to the backpacks.

He stretched out his arms and Donna walked quickly towards him producing a prolonged grateful hug. Turning towards a broadly smiling and open-armed Cindy, he breathed deeply and enjoyed the temporary escape from the diesel and chicken pooh.

“Now don’t forget, the orphanage is only about an hour from Garanyi Hospital. If you get a free day, come and visit.”

“I had been meaning to ask who runs the orphanage that you’re going to teach at.”

“The Chinese. It’s one of their new humanitarian outreaches.”

“Well, that could be very interesting from a cultural point of view at least; I would definitely be interested in coming and visiting you and the orphanage.”

“Be careful, Christian. There are reports of lots of Congolese militia and armed groups not far from where you are.”

“I will take care,” Christian said, climbing back in through the bus window, trying to imagine what was behind the Chinese humanitarian aid. The Chinese had always put their business interests first, especially when it came to Africa. The sceptical part of him wondered whether the proximity to some of the world’s most wanted mineral resources was behind the sudden desire to help the poor.

Christian looked back out through the side window as the bus eased its way through the throngs of people gathered at the Rhuengeri market. Donna and Cindy stood like two life buoys in an ocean of colourful humanity, waving energetically as they pulled away. The bus, after a few minutes, turned onto the main road to Garanyi and he finally lost sight of their waving arms.

The two-hour ride to Garanyi was more of the dark rich Rwandan soil cultivated to its last life-giving centimetre. Greenness, in its darkest Sherwood Forest shade abounded, undoubtedly due to the multiple trace elements bequeathed by volcanic activity over the millennia. As Christian looked from the small-cultivated patches at the side of the road to the mountains in the distance, he thought if ever there was a place on earth where life had begun, Rwanda and its pristine beauty would have to lead the list. The overwhelming lushness is what he imagined would be a pre-requisite for any Garden of Eden.

The bus had been traveling for about an hour when Christian noted the lines of people walking on either side of the road expanding to three deep and more uniformed military personnel with automatic weapons. The Congolese border was getting closer. As the bus rounded a long slow corner, an area of rare uncultivated flatland appeared. A ten foot high fence topped with barbed wire surrounded hundreds of large blue United Nations tents. It was the refugee camp for those fleeing atrocities in the Congo, which he had read about in the news. At the front of the camp, a double gate protected the entrance. Four armed guards on the inside of the gate were checking people in and out. Inside he could see hundreds of people, mostly women and children, wandering around or sitting next to small fires. He imagined that many would be seen at the hospital that he was going to, before they made it to the camp.

From the time of his first setting foot in Rwanda a few days ago, its beauty had dominated his senses, irrespective of the surrounding poverty. Such beauty should have prepared him for Garanyi, but it did not. After an hour’s driving beyond the refugee camp, John announced they were approaching Garanyi. The bus again laboured up the side of a hill and then entered a canopy of trees on the road leading down to the town of Garanyi. Half way down the slowly winding hill, the trees suddenly retracted their protective canopy; the effect was like a curtain in a cinema being flung open for the major film. Racing to take centre stage, was a lake of expansive dark green beauty—Lake Kivu, with its attendant smoke, haze, and small wooden fishing boats. The lake, stretched miles into the distance, towards the nations of Congo and Burundi. Trees abounded, squatting in clumps around the lake, some trekking down to the shore, branches gently moving at the water’s edge as the lake breeze stirred.

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 driveway 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.”