We need an exit strategy.” Pieter gazed out at the throng of village children that surrounded the van, hands and noses pressed against the windows. “I’ll carry Hamid. Sarah, you take Jamal. Tumaini, open the door for us.”
“And run interference,” said Sarah.
Tumaini looked confused. “You wish me to interfere?”
“It’s a term in American football.” Sarah raised her forearms in a feeble imitation of a linebacker. “It means you block for us, get between us and the kids.”
“This is something I can do.” Tumaini imitated her arm posture. “I am very wide.”
Tumaini tried his best to be a human bulldozer, but the children swarmed like bees. Sarah held on tightly to Jamal, making sure that his freshly repaired face remained above the reach of curious little hands.
“Maybe you should try your boogie man shtick,” said Sarah.
“Can’t do that. My arms are full, and I don’t think it would work right now, anyway.”
Sarah and Pieter managed to keep the wriggling Hamid and Jamal under control and delivered them safely to their mother. Keisha fell on her knees, laughing and weeping, embracing her sons and staring at their faces. Then she grasped Pieter’s hands. “Asante sana. We have prepared food.”
The aroma of roasted goat wafted over the village, and pots of rice, greens, and yams simmered over charcoal braziers.
Sarah shot a worried glance at Pieter. “It’s really nice of them to do this. But we need to get going soon. We don’t want to be heading down the mountain in the dark.”
“We can stay overnight. There’s a lodge nearby.”
So, they relaxed, enjoyed the feast, and watched the children sing and dance.
THE SUN WAS setting as they pulled up in front of the lodge. Pieter asked the woman at the desk if she had any rooms available. “We were delayed by the celebration in the village, and it’s too late to drive home.”
“There’s always room for you.” She reached for Sarah’s hand. “I’m Betje. You must be the doctor from America. If you had a celebration, then I guess the boys’ surgeries went well.”
Sarah showed her some pictures on her cell phone.
Betje pointed toward the dining room. “You’re just in time for dinner.”
Sarah patted her tummy. “We were well fed in the village. I couldn’t eat another bite.”
“Then Yusef will show you to your rooms and you can rest a while. See you later for drinks?”
It was a steep walk down to Sarah’s “room,” a mini-villa built into the side of the cliff, with a terrace that offered a sweeping view of the plains below. Yusef pointed into the distance. “There is Kilimanjaro.” From this distance, the tallest mountain in Africa looked like a tiny pimple.
After a nap, Sarah showered and changed and headed back to the main building. Pieter was in the lobby, conversing with a woman who was clearly upset. He switched to English when Sarah approached. “This is Balinda, the midwife from Kandu.”
Balinda bowed. “Karibu, Dr. Sarah. A woman has been in labor two days. I cannot turn the baby. Can you come and help?”
BALINDA LIT A kerosene lantern and led them into the dark dispensary where a young woman crouched in the corner.
Balinda coaxed the woman onto the exam table.
Sarah examined the woman and felt a small hand in the birth canal. “It’s not breech. It’s a transverse lie. And not coming out anytime soon. She needs a C-section. We have to get her to a hospital.”
Pieter had already started an IV. “You’ll have to do it here. She’s bleeding, won’t survive a long drive.” He rolled the woman onto her side and began prepping her back for a spinal anesthetic. “Balinda will show you where to find the instruments and suture. Equipment is basic, but sterile. I’ll scrub in and assist you.”
Sarah took a deep breath before slicing into the skin. She and Pieter worked methodically in the eerie amber light of the lantern, rarely speaking, each anticipating the other’s steps.
Sarah handed the tiny boy to Balinda. The infant was limp and covered with patches of white cheesy vernix. Balinda gently cleaned out his mouth, and he began to wail.
Sarah tied the last knot in the skin closure and looked at Pieter. “We’re not out of the woods, are we?”
“She’s losing a lot of blood. We have to get her to the hospital in Lushoto.”
“But driving down that winding road in the dark. It’s dangerous.”
“We have no choice.”
THE ROAD WAS slick and deeply rutted from the recent short rains of November. Pieter had to get out of the car twice to clear the road, once for a fallen tree, and once for a herd of goats. They had removed the back seats from the van so that the woman could lie down, Balinda holding the baby and Sarah monitoring the IV drip, periodically checking pulse. Suddenly the mother sat up, clutching Sarah’s arm and screaming, “Bibi! Bibi!”
Sarah tried to soothe her, “Shh, the baby is okay.”
“She is not calling for the baby,” said Balinda. “Bibi means grandmother. She sees her grandmother.”
A chill ran up Sarah’s spine. “Is her grandmother by any chance dead?”
“Yes. She died of red eye fever. The same fever that took Mohammedi. I was sick, too. My mother took care of me.” Her voice choked. “She died, and I did not. When she was dying, she saw her mother in our house.”
“My father saw dead people, too.” Her father had dozed in and out of consciousness during his final days, loudly conversing with long-departed friends and relatives. He would call out a name, reach out to some invisible visitor. Just before his final breath, a half-smile almost fluttered across his lips. And that was it. His soul slipped out of his body before the air finished oozing from his lungs.
Sarah checked the woman’s pulse again. “Pieter, will we be there soon? She’s not doing so well.” She decided not to mention the grandmother thing.
“About ten minutes. I called the hospital. They have one unit of O-negative blood. When we find out this patient’s type, we’ll see if there is any more compatible blood around.”
AS THE FIRST unit of blood flowed in, the lab reported that the mother’s blood type was A negative. There was no more compatible blood in the hospital.
“Not good,” said Pieter. “Surely one of us could donate, but not me. I’m A positive.”
“I’m A negative,” said Sarah.
“One more unit,” said Pieter. “Better than nothing.”
Balinda’s eyes grew wide. “You should not give your blood. It is your life.”
THE LAB TECHNICIAN pierced Sarah’s arm with a large bore needle and dark blood flowed through the tubing into a clear bag. Balinda sat nearby, slowly shaking her head and murmuring some chant. When the bag was full, Sarah put her hand over the needle. “Don’t take it out. One unit won’t be enough.”
The technician protested but Sarah insisted.
Balinda asked “Is my blood good for this?”
“I’ll check,” said the lab tech.
Pieter sprang into action when the Sarah delivered her two units. He was delighted to hear that Balinda was A neg, too, and would donate another unit.
Sarah felt a bit dizzy and clutched the foot of the bed to keep her balance. Everything began to look fuzzy, sounds became fainter and fainter, and the floor got closer …
It was a familiar place. Beautiful music—almost too soft to hear. No words, no melody, just chords. The air was pleasant, not too hot, not too cold, and smelled of flowers. She was floating, or perhaps lying on something incredibly soft. Everything around her glowed pinkish and golden.
Then she felt the cold hard concrete hospital floor beneath her. Pieter held her wrist, looking grave until he noticed her eyes were open. Then he smiled. “I can’t feel a pulse, but apparently, you’re still alive. Are you pregnant?”
“Not unless there is a bright star in the east.”
Balinda sobbed, “I told you. Do not give your life away.”
The lab technician wrung his hands. “She gave two units. I tell her—too much.”
Pieter frowned. “That was really foolish.”
SARAH HUNKERED DOWN in the back of the van, shivering under a thin sheet. She thought about going back to the hospital to look for a blanket but could not bring herself to get out into the night air again. She called out to Tumaini, who was slumped in the driver seat, snoring away. “Can you start the engine? Turn on the heat?”
He didn’t stir. It was going to be a long night.
The door opened, and Pieter tossed her a blanket. “Still alive in there? How are you feeling?”
Sarah grabbed the blanket, teeth chattering. “I’m f-f-f-f-fine.”
“You’re not fine. You’re freezing.” He wrapped himself around her and pulled another blanket over both of them.
She soaked up his body heat, savored his breath on the back of her neck. Her rigors gradually subsided, and she whispered her fear. “She’s going to die, isn’t she?”
“We don’t know that. I think she’ll make it. As long as she doesn’t go septic or get shock lung.”
“But she saw her grandmother.”
“She what?”
“She was crying to her grandmother. You know, sometimes when people are dying, they see dead people. And the near-death people, the ones who see a light at the end of a tunnel, a lot of them see dead relatives.”
“Brain dysfunction—maybe lack of oxygen, low blood pressure,” he said. “It doesn’t mean she’s going to die. Try not to worry. We’ve done our best. Especially you.”
Perhaps he was right about the near-death stuff. Poor blood flow to the brain, just like her fainting spell. She remembered the other time when she had been in that weird netherworld. Her horse had stumbled into a culvert on the way back to her grandfather’s barn. Maybe she had fallen asleep, maybe she had been knocked unconscious. There had been the soft light, the music, the softness and sweet smells. And then she was lying in the tall grass, with the horse and Grandpa standing over her.