“Do you want a lift? Are you going to the clinic?
“Yebo!” they say and they climb into the car.
“Siyabonga dokotela,” says the lady in the front seat. I almost ask how they know, but then what other white person would be driving down this road today?
At the clinic things are a little chaotic. As I walk in a nurse cries, "Excellent! Come!", thrusts a syringe and needle in my hand and pushes me in the direction of a screaming child – he is HIV positive and needs a CD4 count taken. I’m not great at taking blood from kids but with a little probing I get the vein, the screams peak at decibels approaching those of a 747 and it is quickly over. The kid stops his yells and eyes me balefully from over his mother’s arm. The nurse sighs her thanks. “Ach, doctor. It is so busy. We have all the normal patients, and all the HIV patients for their CD4s and viral loads, and all the TB patients.”
The clinic sister insists on working with me rather than sending one of her juniors, “because then I can ask you all the questions I have.” We start work. The first patient is a high blood pressure. “When should I use enalapril?” asks sister. We talk a little about that. The next is a lady who came to the clinic in the night with severe breathlessness. “I though she might have heart failure but her ankles were not swollen. Why is that?” We both huddle over a scrap of paper as I attempt to explain with the aid of a messy diagram.
After an hour she tries to stifle a big yawn. “Oh! I am sorry. I am sooo tired!”
“Why?”
“Well, I am the only senior sister at this clinic, and the only one who can do deliveries. So I work all day. But then if anyone comes in the night who needs a baby or with a difficult problem they call me! So last night I was cooking dinner for my children and then I hear bang, bang, bang, and they are calling ‘Sister! Sister! Where are you? Come and look after us!’ So I stop cooking and have to go and help them. My children have only had bread and jam for 2 nights!”
“And you have to do this every night?”
“Yes. And each night I climb into my bed and pray to my God that this will be the night I sleep. And if I wake and it is morning I say ‘Thank you God for looking after me!’”
“But that is terrible – when do you have days off?”
“I get two nights off a week.”
“And for how long must you do this?”
“Until the other Sister comes from maternity leave.”
“But can’t the hospital find someone else to come and work with you?”
“Ha! They say there is no one – and if I don’t like it I must move to another clinic where you don’t live on the site. But I have been here since it opened. How can I leave? These people know me.”
We see the rest of the patients, and I leave the sister yawning, but smiling. I feel a knot of guilt at my whining over my 1 in 6 weekend calls.
Getting home takes a little longer than expected – slow moving giraffe on the road.
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