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“May I?” Carys asked the old doctor.

“Go right ahead. One of her broken ribs punctured her lung after she fell off her boyfriend’s motor scooter.”

Carys raised her eyebrows. A motor scooter in this part of the country was rare.

“He has many girlfriends,” Dr. Nazer sighed. “His father is a manager at the large Saudi farm. The boy has more money than sense. I’ve delivered five of his children, from four different girls,” Rashad continued in English so the girl in the bed couldn’t understand.

“How is this one doing?”

“She developed an infection. As a matter of fact, everyone here has developed an infection. It is the reason I have asked for you to come here. It is my understanding that you have seen something like this in your time in Nigeria. Kenneth is a smart doctor, but he is a general practitioner, neither of us are good with infectious diseases.”

Carys pulled the chart that was lying underneath the bed.

“She’s not coughing,” she said referring to the cough that the old doctor had.

“No, that’s not the type of infection. It’s bloodborne,” he said just as he went into a spasm of coughing. The woman in the bed looked at him with concern. Finally, he stopped coughing and looked up at Carys, his expression filled with shame and amusement. “Our girl here is smarter than I was,” he said in Arabic. “You never smoked, did you?” he asked the girl.

She smiled shyly and shook her head.

Rashad turned to Carys, “Two packs a day all the time I was at Oxford. It continued for years. Now I have COPD. I’m lucky it hasn’t turned into lung cancer, but this is pretty debilitating.”

Carys frowned. “You know you shouldn’t be here,” she admonished.

“It’s where I want to be. I’m close to my sister and her children. I was foolish in my youth. Do you smoke?” he asked her. “Of course, you don’t,” he answered before she could. “Smart girl.”

Carys shrugged. She wasn’t here to pass judgment on anyone. Carys looked at the girl in the bed and saw that she was watching the two of them with wide-eyed fascination.

“Go to sleep,” Rashad said kindly. “One of the nurses will be back to check on you later.”

She nodded. The doctor turned back to Carys and continued in English.

“So now that we’ve ruled out my cough as part of the infection, let’s get down to our problem with the patients. As I was saying, it’s bloodborne. Kenneth has done a lot of testing.”

“What has he tested for?”

“HIV, Hep B, Hep C, syphilis and malaria,” the doctor held up a finger on his right hand for each item he named off.

“Those would have been my choices. Can I ask you a couple of questions?”

He nodded.

“What are your handwashing protocols?”

He called in the head nurse who talked her through how they went about washing their hands, then Carys asked about the linens and wiping down the beds themselves. Everything she heard impressed her. They’d even gone to the point of boiling all the linens and wiping down every hard surface with alcohol. These women were bound and determined not to have their patients die.

“It’s been very frustrating,” Rashad said. “We can’t figure it out. Kenneth has been racking his brain. We’ve been lucky so far that nobody has died yet, but it’s only because we’ve been able to get stronger dosages of antibiotics from Khartoum.” His voice was laced with a deep level of concern.

“That was another reason why Kenneth decided to go to the men at the farm instead of having them come here. We double- and triple- checked our every sterilization method we can think of. We’ve even taken to boiling our own clothing, and before you ask, all of our surgical instruments go through the autoclave twice now.”

Carys perked up.

“You have an autoclave? You don’t boil your instruments, like everything else?”

“One of the village elders moved to Germany, but he didn’t forget about us. He donated money for this clinic, and he bought the autoclave as well as two looms for the women of our village and a large oven for the community house. He has also purchased three generators for the village and regularly supplies us with propane.”

“He sounds like a good man,” Carys said as she smiled at the concerned nurse and doctor.

“He is.”


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