Time's up

I am leaning over a patient listening to their chest when I become aware of a presence. I straighten up. Sister Nene is standing behind me. She is looking even more serious than normal.

“Doctor. I saw the rota for the high care doctor for next month today.”

“Mmm?” I reply in as casual manner as possible.

“And I looked up, and I looked down but I did not see you name.”

“No.”

“And then I looked at the other wards and I did not see your name anywhere.”

“No.” I look at my feet guiltily.

“Where are you going?”

I cannot look her in the eye. “I am leaving Sister Nene.”

She says nothing but shakes her head sorrowfully. I feel like I have disappointed some aunt. A severe aunt of whom I live in fear but nurture a secret craving for her approval. She studies me silently.

“I was allowed out of my job in the UK for 1 year but I must return.”

She says nothing.

“I might come back one day.”

Sister Perumal joins her. “Ahh – they all say that. Don’t they Sister Nene?”

Sister Nene nods.

“But they don’t come back, do they Sister?” Sister Perumal continues.

Sister Nene shakes her head and looks severe.

I slink out of the ward.

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Abscess

The phone rings. I am lying on the sofa in the dark squinting at the laptop screen: someone has lent me series 1 of Spooks. I struggle up and bump across the room to the phone. “Hello?” “Moran!?” “Yebo.” “How are you?” “I am fine.” “I am fine too.” And then those four dreaded words. “Please hold for maternity.” The line goes dead for a second and then a midwife comes on the line. “Moran?” “Yes.” “How are you?” “I am fine. “I am fine too. I have a 22 year old primip. She is in labour but I cannot do a PV. She has a Bartholin’s abscess.” I ask a few intelligent questions and then, pausing only check what exactly a Bartholin’s abscess is (an abscess of the Bartholin’s gland apparently) I head for maternity. On arriving I am taken to the woman concerned and, yes, sure enough there is a large abscess in the position that I imagine a Bartholin’s gland might sit if I knew exactly what it was. “I cannot do a PV to check the cervix because it is too painful.” The abscess blocks the way. “Right.

10 years on

The door flies open. Lele peers in. "You must come out here and see. They are doing a play!" I finish up my case file annotation and come to the doorway. The waiting area is in chaos. A gang of school children are manhandling a couple of marimba's to the space in front of the consulting rooms, a team of nurses and counsellors are creating a stage area. Patients look on mutely. Some with interest, others - presumably feeling proportionately less well - without. "What is going on?" I ask. "It is 10 years since the clinic started. 10 years since MSF first started the HIV treatment programme and proved that it could be done in Africa. So the staff are celebrating. They are doing a show or something." The sister in charge of the clinic has moved to the front of the crowd of patients. She calls for silence and then gives a short introduction. Lele translates for me. "She is saying that this is a very important day. 10 years ago people were dying. And 10

Ceza Hospital

I am woken with a jolt. The 4-wheel drive has left the tarmac and we are on dirt road. I look ahead into the hills – the road wends its way high up into the distance. “How far?” I ask Amos, our driver. “About 40km.” I settle back and watch as the settlements become less and less pseudo-bungalows and more and more mud rondavels. The road to Ceza It was about a month ago that our medical manager first mentioned that we had been asked to help out at Ceza Hospital – a remote rural hospital about 2 hours away. Its medical staff (only 8 at the best of times) had been steadily departing and only one remained. He was leaving at the end of May and they were desperate. Desperate enough to accept help from us. As I said – a month ago – but it was only last Thursday that I found myself agreeing to go. Two of the others had been that week. I phoned them to ask what it was like. “There are no words to describe it,” said Nomfundo, “speak to Dr Kekana.” Dr Kekana comes on the line and after humming an

In Sierra Leone

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Time's up

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