“Sir. . Sir, Hello. . . Hello! Can you come sir? Hello. . .”

Waking a doctor from a drink-induced sleep called for persistence.

We had transported the machete-attack victim the five miles to the government clinic, only to learn an aged, slow-moving male nurse was the only person on duty.

“The doctor for this work”, he said, eyeing the wide blood mark streaking our patient’s back, “is away. You might find him at his house.”

Leaving our patient, I drove another five miles of bad road, where I came to the darkened home of the physician. “Hello. . .Hello. . .”

Thirty minutes later, the groggy doc held a kerosene lantern (electricity had not reached the village) examining the naked wound. Thankfully, Ann’s gauze-and-sheet wrap had held and not too much blood had seeped through.

The wounded man went by Mwita. He sat upright on the cot’s edge as three pair of eyes, beside the doctor’s – Mwita’s brother’s, the male nurse’s and my own – gazed at the deep slash. I had never seen such a wound.

No surgical mask was donned by any of us. There were none in supply. And, I assumed, maybe never had been.

A brief exchange between the bush-surgeon and myself left me surprised. And troubled. The nurse had stepped to another room and was now rolling in a metal cart into view. A steel pan sat and, in it were utensils. Suturing material, I guessed.

My tone was respectful, sincere.

“Sir,” (it seemed doubtful by now the man I had wakened for the upcoming procedure was a doctor in a full, professional sense) “could I ask. . . how are the instruments sterilized?”

Lifting a sizable curved needle offered by the old nurse, the gentleman held it before the lantern for a better look. With a wave of an elbow he declared knowingly, “Oh, you understand, off there in the big cities where many people live, there are, many more germs. Many more.

“But out here in the rural places, we have fewer people. And so – less problems with infection”. The man’s silence as he squinted one-eyed, finding the needle’s opening and beginning the thread, suggested my question had been sensibly answered. This is the way it is. No discussion.

I cringed at my next discovery.

“He will be given anesthetic, right?”, I ventured.

“No, we are out of it.”

Perhaps – looking back – my biggest surprise of the evening was my lack of queasiness.

Witnessing a needle in the firm grip of someone, the needle piercing the muscular surface, tugging a string of black thread in its trail – again and again – left me at the edge of nausea.

Next morning I readied myself to visit the clinic when word of the wounded man reached me via Africa’s reliable grapevine.

“You’re sure?”, I asked a second time.

“Yes, Bwana, he walked home this morning.”

My thoughts retraced the sequence.

Treks to our place last night (who knows what distance?) – losing blood the whole way. Endures several  bumpy miles of ‘ambulance ride’. Without meds to blunt the pain, the flesh of his back takes into itself a suturing needle of questionable hygiene time and again, drawing the parted muscle and sinew close. . .

I’m now feeling queasy.

And, early the following morning, walks home – more than five miles – unaided.  

While missionaries are probably not widely known for referencing Charles Darwin, I found myself at different times suddenly recalling a phrase, “survival of the fittest”.

This was such a time.

© 2017 Jerry Lout

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