The sky was nearly cloudless. A tiny wisp of angel hair clung to Kibo, and Mawenzie sported a puffy toupee at a rakish angle.
“You should look at the mountain. It’s so beautiful this morning.”
“Kibo will be here tomorrow. You won’t.”
She got back into bed and snuggled next to Pieter. “I’m nervous. I keep thinking I must have forgotten something.”
“I doubt it. And any time you need something, we can get it to you. It’s not like you’re stuck on some desert island.” He sat up abruptly. “I almost forgot your toes.”
As he examined her nasty feet, she studied the scars on his shoulder. If you had to be clawed by a leopard, this was an optimal site. The back was the first lesson in anatomy lab, presumably to avoid face to face encounters with dead bodies on day one. She recalled that slicing through that skin had been startling. Who knew it was so thick? Lying there in the morning light, she tried to imagine Pieter’s wounds when they were fresh, with blood flowing from deep gouges.
“Sit up and I’ll show you how to take care of this.” He tapped the base of one toenail. “This is where the new nail will grow in. You’ll need to trim the old one off as it gets pushed out and pops up. Otherwise it may get caught on something and be ripped off.”
“That sounds painful.”
“For the next week or so, you should wear socks to keep the dirt out. And don’t wear shoes that put pressure on your toes.”
“But I can’t wear socks with my sandals. They have toe thingies.”
“Thingies?”
She held up her flipflop-style sandal. “The thingy goes between the toes.”
He picked his pants up off the floor, pulled a knife out of his pocket, and made a strategic slash in her sandal. “No more thingy, see?”
He knelt to slip the altered sandal onto her foot.
“There, Princess Cinderella, a perfect fit!”
“Cinderella was not a princess.”
“She married a prince, did she not?”
“But when she became a princess, they didn’t call her Cinderella anymore.”
“You have split that hair.”
“You mean, I’m splitting hairs.”
He winked. “Whatever.”
TUMAINI PULLED UP in the hospital van and Margo hopped out. Her jaw dropped momentarily when she saw Pieter following Sarah out of the house. He loaded the duffel bag into the back of the Rav4. “Good morning, Margo. I just dropped by to see you all off. Brought some last-minute items you might find useful.”
Margo’s head gave a microshake and her eyes darted skyward. “Whatever.”
Tumaini took the lead, with Ameera and Rasheed on board. Sarah followed with Margo in the shotgun seat and Pieter in the rearview mirror.
Every inhabitant of the village came out to meet the team. The welcome ceremony included singing and dancing, masala tea and cassava, and of course, roasted goat. It was late in the day before Sarah moved into her house. Like all the other dwellings in the village, it had mud brick walls and a corrugated metal roof. But Rasheed pointed out his significant upgrades in design. The floor was concrete, not dirt, and had a large screened window. He was most proud of the transoms under the eaves. “You will be very happy for this ventilation.”
Sarah gazed up. “Nice. But no screens up there?”
“Hmm. They forgot that. Well, malaria risk is pretty low at this altitude.” He had also installed a wood burning stove, and an outside shower with solar heated water. Of course, she would have to fill the heating tank with water fetched from the faucet in the dispensary. All other water was toted up the mountain from a stream, one large plastic bucket at a time, on the heads of women and children.
Ameera and Rasheed spent the night in Betje’s lodge, while Margo and Sarah settled down in the new house, sleeping on folding cots. Sarah switched off the lantern, and they wished each other good night. But both were too wound up to fall asleep.
“Sarah, you awake?”
“Yep.”
“Remember the safari? The night at Ngorongoro?”
“Your wild night with the Italian boys.”
“I didn’t stay with them. They weren’t so nice—got drunk—wanted me to come to their room. They literally started to drag me. Israel was at the front desk, ordering our lunches, and saw what was going on. He told them to bugger off.”
“Sir Galahad! Lucky he was there.”
“For sure. We sat on the terrace. Talked all night, watched the moon come up.”
“Why didn’t you tell me?”
“He told me not to. He’s not supposed to get involved with clients. I guess I could have told you. But … you haven’t been straight with me, either … about Pieter.”
“No,” she murmured.
“You’re wearing the ring again.”
Sarah twisted the ring around her finger. “It’s complicated.”
“You love Pieter, don’t you?”
“I’m afraid so.”
“Why are you afraid?”
“I don’t think it’s serious for him.”
“Did he ever say that?”
“No.”
“Then you don’t know. You have to ask him.”
Sarah changed the subject. “Tell me more about Israel.”
Sarah could hear the smile in her friend’s voice. “He is so great. He wants to get married. But I don’t know. I’m supposed to go to Nairobi next year for a trauma fellowship. I don’t think I should go if I get married. What do you think?”
“Don’t ask me for advice. My track record in such matters is not good.”
THE WEEK WENT by quickly as they unloaded and organized equipment and supplies for the new delivery room and stuffed “goodie bags” for all the TBA students: band aids, antibiotic ointment, scissors, and sterile string for tying off umbilical cords. They hung educational posters in Sarah’s house, which would double as the classroom. By Saturday morning, everything was ready for the first class.
Ten birth attendants clad in their best colorful kitatngas and head wraps filed silently into the room. The cots were folded against the walls and the floor was covered in straw mats. Sarah expected them to sit in rows, classroom style, but they arranged themselves into a circle, some peeking under the edge of the straw mat to marvel at the smooth concrete surface beneath. One woman had a baby slung on her back, but the rest were well past child-bearing age. All had learned about childbirth from their mothers who had learned from their mothers, and so on for countless generations.
Sarah’s Swahili had become passable, and she had practiced her remarks over and over. But the collective knowledge in the room, passed down through generations made her feel inadequate to teach them anything. After a deep breath, she began the first lesson: infection control. Susie had given her good advice, “Don’t give lectures. Speak to them in stories.” Sarah asked if everyone in the room had seen a mother with childbed fever. They all nodded their heads and murmured to each other. One woman, Dura, said that such fever happened when there was not enough prayer. Another woman, Nasila, said that it was witchcraft. Sarah said that infections were caused by something called germs. Many years ago, in a country far away, a doctor was very sad because so many mothers died from fever. He noticed that most of the mothers who got fever had been attended by doctors, rather than midwives.
Dura said that the midwives prayed, but the doctors did not.
Sarah did not dismiss the power of prayer but stated an important fact. Doctors examined the bodies of women after death. Midwives did not. Maybe the doctors got something from the dead women on their hands, something that made some other mothers sick. Then something very sad happened. Another doctor, accidentally cut his finger while examining a body. That doctor died from the same fever that killed the woman.
There was a collective gasp from the group. Nasila declared that the dead woman’s spirit had put a spell on the doctor.
Sarah ignored that comment. She told them that after that doctor died, there was a new rule. Everyone should wash their hands. Suddenly, childbed fever became very rare. Hand washing works is because it kills the germs. She pointed to a colorful poster on the wall with cartoon images of microbes.
The woman with an infant on her back stood up and pointed to a lumpy pink creature in the poster and said that she had never seen such an animal.
Sarah explained that it was just a drawing, a cartoon. Germs were too tiny to see. Unless you looked through a special device. She pointed to a microscope on a small table.
Margo held up a glass slide with a purple dot in the center, a stained clump of bacteria. The women clustered around and one by one, they marveled at the purple-blue clumps of staph germs. Everyone except for Nasila. She was afraid that looking at the germs would make her sick.
Ameera conducted a hand-washing exercise, to show how thoroughly they needed to wash. The women dipped their hands into a purple solution and then scrubbed with soapy water until all the purple was gone.
The class toured the new delivery room, with its spick and span floor and shiny cabinets. The pièce de résistance was the autoclave. Steam poured out when the door was open, and the women oohed and ahed. Ameera pulled out hot packages of sparkling scissors and clamps, packaged in clear plastic and declared that all the germs were dead.
Nasila gazed into the steaming autoclave and declared that it was very good magic.