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“Can I see your autoclave?”

She saw the two of them, as well as Jamal, give her an odd look. They must have thought it was funny that the American doctor was more interested in seeing a piece of machinery than more of the patients, but she had a sneaking suspicion what was wrong.

“It’s here,” Rashad pointed proudly. She could see that it had been given a place of honor on a high dresser near the back wall. It was clear that Kenneth and Rashad worked hard to keep their clinic clean and healthy, but that might be working against them.

“When was the last time this was qualified?”

Rashad sighed. “Unfortunately, it has never been qualified or validated in the last three years. I’m not sure that you would even find most of the equipment at the hospital you’ve been working at in Khartoum qualified, but it has all been properly maintained.”

He bent down and pulled a book out of the dresser drawer. “The last time this was serviced was two months ago. We do not run many cycles. This will be good for at least another year.”

Carys smiled as she took the book with the handwritten notes in it. She knew about this method. She also understood how happy some of the rural clinics were with the modern technology, sure that it was a guarantee of safety for their patients. Unfortunately, she had seen many times where it wasn’t. Times where the old ways were better.

“I’m not an expert with these machines, Dr. Nazer, so I can’t determine if they are properly sterilizing your surgical instruments or not. But in the meantime, my suggestion would be to boil your instruments for twenty minutes after you run them through the autoclave.”

She nodded to the machine’s closed door. “Are there instruments in there right now?”

He nodded.

“Has the cycle ended?” she asked.

“Yes.” He opened the door and pulled out some forceps with a clean cloth that was sitting on top of the dresser, and then placed it onto a sterile surgical tray.

“I want to have this analyzed for contaminants. I think this is your culprit.”

“I have something we can put this in.” He found a tub of Tupperware. He asked the nurse to wipe it down with alcohol. When she was done, he placed some of the surgical instruments that would fit into the container and closed the lid.

Carys turned to Jamal. “Can you take this to Perkins in Khartoum? I’ll call him on my satellite phone and tell him what tests to run.”

He nodded. “Are you sure you’re all right to stay without me?” he asked.

“Absolutely. Tell Perkins that I’m going to stay for a couple of days and help out. Everything is going well at the hospital and it looks like the doctors here could use another pair of hands for a few days.” She glanced over at the doctor who had continued to cough on and off throughout the tour. He was going to need to be put to bed before long.

“That would be welcome,” Dr. Nazer agreed.

Jamal took the plastic box and nodded. “I’ll unload your things,” he said.

She nodded.

“Why don’t you talk to our patient with the punctured lung while I discuss our new sterilization techniques with the nurses?” Dr. Nazer said.

Carys nodded.

* * *

It was nightfall when a dilapidated car pulled up to the clinic in a wave of dust. Carys watched as an old man almost fell out of the driver’s seat. He didn’t look like someone who should be out of bed, let alone driving on dark dirt roads. He heaved in a deep breath and tried to yell something in Arabic, but it came out a hoarse whisper.

She ran up to him, but he shooed her away. He made it clear that he didn’t want to talk to some strange white woman he didn’t know. He wanted to talk to Dr. Nazer. She hustled inside to Dr. Nazer’s office where he was asleep on a cot. Quickly she explained the situation and he got up to talk to the old man.

Faizah, the nurse who was going to house Carys for the night, came up to her and said she would be leaving in an hour. Carys had watched her work throughout the day and had been very impressed with her abilities. For that matter, everyone at the clinic had been outstanding. They were caring, professional and kind.

“Let me help,” Carys said as she picked up a bedpan. She might be a surgeon, but when you came to Africa to help, no task was too menial, you pitched in. Faizah and the other nurse grinned as the work went faster.

“Inaya and her husband will be here soon to take over until morning,” Faizah explained. “We try to have everything done for the woman who works the shift at night.”

“Dr. Adams?” Dr. Nazer called from outside. “Please come. Bring Faizah as well.” They looked at one another, and Faizah shrugged as she handed the sheets she was folding to the nurse’s aide.

This should be interesting, Carys thought. The old man didn’t want to have anything to do with her, why was Dr. Nazer having her come back out when her presence bothered him so much?


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