“This is our life…”

Another blue-sky day. Another day in the shamba…

At this time of year, as the Little Rains begin and the Long Rains loom, with the wheat harvest over, time in the shamba planting maize is a priority for everyone, including the staff.

It had been a quiet weekend in the hospital. An undisturbed Sunday morning service. From our perspective, a time to recharge the batteries and celebrate the Day of Rest. The phones, laptops and other devices were being recharged too, from solar as we had another mains power-cut. We also shifted the fridge over to solar, grateful for the back-up system.

Monday morning also started quietly. A brief report on the lack of weekend action, sympathy for the nurse who had fallen out of a tree while collecting fruit, thankfully not breaking her ribs. She was sent to Ludewa for X-ray which showed no fracture, though I’m not sure X-ray is all that useful since there is no treatment aside from pain relief. It brought back memories of a crash when downhill skiing followed by a year of pain, especially when trying to turn over in bed. I didn’t need an X-ray to tell me what I had done.

I took advantage of the lull to continue an on-line course in fetal cardiac scanning since I have a patient who has lost two babies, the second a definite cardiac anomaly, and I’m not confident that the ultrasound of the heart in the current pregnancy is normal.

And then I was called to assist with the car. Our hospital driver is away. Would I go to the forest in my car and investigate an accident? The night-watchman from the Bible School had been injured and maybe killed. Bring him back if he’s alive but leave him there if not.

Taking our experienced male nurse anaesthetist and our laboratory manager (for their availability rather than expertise) we drove down the hill behind the hospital through the sub-village of Msikitani into the forest of pine trees, planted by various villagers, one of the few cash crops in this region. Some way down we reached the scene, where a number of people had congregated. The track is very steep here and we put a rock under the wheel for safety before leaving the car. The village tractor was embedded in the trees, the trailer 45 degrees on its side, the load shed and the body of Andrea beneath the trees covered in a kitenge.

The brakes had failed, the young men in the trailer had leapt clear. Andrea had been beside the driver who also jumped off but poor Andrea didn’t manage to get out of the way. And he had simply been on his way to the shamba and had hitched a lift.

It didn’t take long to certify the death. The impact of the trailer against his chest wall left a deep hollow where the ribs were broken and the heart crushed. For some months earlier this year he had been our night watchman when I had hardly any ability to speak his language and our exchanges were limited to ‘Welcome very much’, ‘Good evening’ and ‘I wish you well in your work tonight’. From time to time he managed to communicate that the light had been left on in the store and I would get the key to switch it off.

The light has gone out now. Good night Andrea. We will miss you.

We are standing for some time among the pine trees belonging to our friend Erasto. He breaks the silence with a short comment. “Our life is…”

I wait for him to continue, not wishing to presume what he is trying to say, though he is clearly searching for the right word in English. Perhaps the word is ‘hard’. Perhaps he is being more philosophical and wants to say ‘short and insignificant’. After a significant pause he rephrases his sentence.

“This is our life…”

The body had to remain where it was until the police and the village chairman and the Ward Chairman had visited the accident scene. I returned home for a cup of tea and was surprised to burst into tears. Where did that come from? I wasn’t aware of feeling upset.

Before long I returned to the hospital office and resumed my online course in fetal cardiac ultrasound. It seemed somehow meaningless. What if we can detect an abnormality before birth? Can anyone treat it here? No, they can’t. This is still the Middle Ages in many ways, except that the tractor and trailer work alongside the donkey and the ox-plough, and I can watch the threshing of the wheat by hand from the window of my car, and there never was a Middle Ages here.

Today our cleaner would have burned our rubbish but she is a close relative of the watchman and went to the forest to sit with him until the body could be brought home. Instead I lit the bonfire after nightfall as a tribute to a friend. It burned brightly for a time and then went out. As we all do, when the time comes.