Mbewa Ya Manyazi Inafera Kuuna

Nov 19, 2010 21:37

“Mbewa Ya Manyazi Inafera Kuuna.” The woman, who is holding her new born infant, smiles at me. She says it again. I grin back hopelessly, cursing Rosamund, my translator, who is standing outside shouting animatedly into her mobile phone.

The woman repeats herself, laughing and shaking her head, bemused. It will have to be her private joke. In the three months I have been here I can barely muster more than a “hello”, “look after yourself,” and, “no grilled mouse please” in Chichewa. I mentally berate myself for relying overly on the UN ethnographer posted as my part-time translator.

It helps, of course, that Rosamund is clever, informative and not altogether unattractive. She is deft at putting the patients at ease, advising anxious mothers that the female Bwana is more than qualified to treat their sick children. The first week, she took time away from her research, when jetlag had made me sleepless and antsy, to walk with me through Lilongwe. I crave those long nocturnal walks we take in companionable silence.

I feel that the past year or so has been a dream. That my usual steady focus has gone awry. Morning runs had been replaced by morning lie-ins. Time in the lab had been substituted with the research zeal of Karev and his Lexipedia. The pleasant pink bubble was always going to burst, but I hadn’t foreseen that it would be I holding the pin.

We are all subject to whim. Whim is the sunshine and sparkle to life. Whims put a spring in our step. But how do we know when the whim is real? When it transforms from the temporary infatuation to a permanent relationship? When it becomes one of life’s enduring loves? I have always had trouble discerning fancy from stability. The now from tomorrow.

But there is always one thing that stands above my whims. One thing that is a siren call embedded as strongly as my reflex to address any male a decade older than myself as “Sir”. Duty. Duty is steadfast and unwavering. It does not broker argument. If you set out to do a difficult task, you do it without complaint. The day I posted that grant proposal was the day I made a commitment to making a change in Malawi. Choice or personal wishes didn’t come into it.

But Callie with her vigorous resentful packing, with her trepidation wrapped in love and compassion, muddied my resolve. Her close-minded sheer bull-headed stubborn attachment to the idea of us, made me falter.

In the shooting, I had frozen. Instinct made me cover and save one child. But Callie, she, in her unthinking courage, saved the floor of kids from carnage. She doesn’t even see it. I, who was meant to lead the floor, was shell-shocked into submission. My courage had been proved wanting. Malawi is my chance to amend that flaw, to find courage within.

I knew I needed to sit down and speak to her. To tell her that Africa was a chance to prove that I was worthy of her regard. But yet again I was mute in the face of her inexorable desire to put us above even her own unspoken longing for her life and career in Seattle. It was easier to believe that Africa was OUR dream. Then came the avalanche of paperwork, vaccine shots and packing cases. The talk had disintegrated into a disjointed frustrating shouting match at the airport, that had ended three weeks of disjointed shouting matches over french presses, lamps and other domestic detritus.

So I have to hold onto the dream of my Africa. To salvage one ideal from the ruins of our relationship. But even Africa is proving to be a mirage, its complex reality tempering my naive preconceptions. The only consolation comes from my English red-headed listening post, Rosamund.

I see Rosamund’s freckled arm slip in and part the curtains of my makeshift consulting room. She pulls a face, lop-sided warning etched in,

“Dr Harrison needs to speak to you urgently, Dr Robbins.”

I sigh audibly. Harrison, the clinic chief, although assuaged at the additional funds brought in by the Carter Madison grant, had his own set ideas on how the money was to be spent in his facility. He had made it clear that the surgery I was here to do was the errand of a dilettante.

He had been dismissive during my induction. “Dr Robbins, if you had done your research you would know that almost one in five Malawian children do not make it to their fifth birthday. Are you aware, why?”

As I open my mouth to speak he steamrollered on, his clipped South African accent underlining his characteristic bluntness, “These deaths are wholly preventable, since most of these children suffer from dehydration brought on by diarrhea. The monies spent on your program, if used for an awareness campaign for oral rehydration salts, could have saved thousands. It could have reached the whole country. You are a single person, carrying out three maybe four surgeries a day. You do the math, since the grant board seem innumerate.”

I had left his office with my face burning and eyes brimming. His contempt almost outweighed the shock of the harsh truth he spoke. The speech stung and all noble ideas of my sacrifice to this program evaporated under his cold analysis. The prescience of his comments were compounded as the patients rolled in. I am, not only the paeds attending, but also the hospital’s obs/gyn. There are no residents to assist. A couple of midwives doubling as scrub nurses and one fresh-faced intern make up my staff.

I am on the last of my patient rounds which ends an eighty hour shift. Another chewing out by the Chief is not on my to-do list. I cup my hand on my chin, while making a V sign with my index and middle finger. Rosamund nods her understanding and takes back the proferred phone.

______________________

Robed up, Rosamund and I run to the delivery ward. “Mother presented pre-eclampsic at thirty eight weeks. Blood pressure rising, 210 over 90. She is becoming increasingly delirious.”

“We need to get this baby out fast. Get me the ventouse”.

I look in disbelief as the ventouse is wheeled in by the midwife. It looks like a plumber’s plunger attached by two black rubber hoses to a hand pump.

“It’s a Malstrom manual vacuum extractor, explains Rosamund. “They were popular in the fifties and sixties. It is preferable when the generator gives out.”
The midwife interrupts, speaking low and urgently. Rosamund nods, “The baby is showing signs of distress.”
I gingerly take up the antique instrument. The midwife begins to vigorously and rhythmically raise and lower the pump’s plunger.
“Dammit, the cup is detaching. The head is presenting obliquely. There’s no flex in this cup.” I mutter, frustrated. Sweat starts beading along my collar. I don’t need a damn lesson in historical re-enactment. I need this wretched machine to work. I also need more hands. In this scenario at Seattle, we would have had two midwives, an intern, a resident along with the paeds attending standing by. I look up again.
“Madam Milne. Take the pump.” She looks at me blankly.
“Rosamund, you were an Oxford Blue. I need you to work the damn pump”.
I indicate to the midwife to come round, take the ventouse and be alert. Hopping onto the gurney, I press down on the women’s abdomen with all my strength.

At the next contraction, I strain more over the patient pushing the baby through the uterus wall down towards the cervix. My ears fill with the sound of blood rushing to my head, fear and sheer effort in tandem.

There are loud screams from mother and baby. The mother’s cry subsides, but the baby continues to scream at his unexpected expulsion from his comfortable home.

I exhale and my heart jumps a little as I dismount the gurney. The midwife holds up the squawking child to be checked over.

“Where the hell did you learn that unorthodox technique?” says the translator, as she puts her two arms on my elbows, giddy with glee and astonishment.

“I knew someone in the Peace Corps in Guatemala. She was pre-med and had some seriously scary stories. I guess I was paying attention.” My heart contracts at the thought of Callie.

Rosamund sees my face cloud over and looks thoughtful. “When does your shift finish?”

“At 7:30, but I have charts.”

“Stuff charts. I will be at the doors when dusk falls.”

At that she turns on her heel and walks away. My eyes follow her retreating form.

___________________

As Rosamund walks into her small studio she gathers up the post that has scattered on the floor. I notice the address, curiosity piqued. “You don’t use your title at work?”

“No. I use it at HQ but not at your place. In your place, I am plain old Madam Milne.”

“But doesn’t it help? Doesn’t it gain you respect?”

“Arizona, I am your translator. I am merely the conduit for your patient’s fears and concerns. On your service, I need to efface my personality to best accommodate their needs. They are intimidated enough, without having to address me as Professor Milne.”

She begins to rummage in one of the several large crates that are piled up in the corner of the living area. “Ah hah.” She raises up a bottle of rum. “English Harbour. 15 year old. Only spirit worth imbibing sans ice.” Taking her glass from the small sink and a battered tin cup, she puts the motley vessels down on the chipboard and stack of books that is what passes for a coffee table.

She indicates for me to sit and folds her long legs down into a kneeling position opposite. Pouring out the rum and passing me the glass, her green eyes shine with mischief. She raises up her cup hand in a toast. I feel the familiar tug of desire.

“To more screaming healthy infants. And,” she pauses, ”to Robbin’s patented massage therapy”

“Amen” I concur, as I swallow down the amber fluid.

_________________

“Morning, sunshine,” Words I hear faintly through a fog of a hangover. I feel warm bedclothes on my legs, and see a pyjama top. Looking down-no bottoms. “Crap”, and I groan at the utterance.

I try to raise my head to meet the coffee cup held before me. Better to be prone for now and possibly for the next week, or the next month.

“Why do I feel so bad?” I wince.

“We finished the bottle and started on warm gin”, smiled Rosamund as she sat on the edge of the bed.

“Me-Garrolous happy drunk?”

“Nope-maudlin type”

“I am SO sorry.”

“It’s ok. I did my fair share of woe is me. I think I bored you with my research into Chichewan linguistic traditions for promoting healthcare education in rural Malawi and its funding miseries.”

I arrange my face to approximate shocked denial. “Your eyes began to glaze over,” she counters.

My recall is still poor, and with a churning stomach and full of foreboding, I ask “Did we?”

“If you count one, and I must say, rather magnificent kiss, we did. But before I could take advantage, you passed out. Hence jim-jams and bed.”

“How lovely.”

“It was; lying next to your snoring self. You have cute bed hair.”

“I am so so sorry.” I wince.

“Yes, you said that several times last night as well. But that was because of something, or to be more accurate, someone else.”

“Callie?”

“Gin-soaked, you spilled your guts about one Calliope Iphegenia Torres and...” Rosamund smiles ruefully, “I know unfinished business when I hear it.”

“Cute.”

“And that you are, Arizona. But you can’t lie about all the morning.”

My eyes focus long enough to switch from Rosamund to the clock on the bedstand. “11 am” the display blinks impassively.

Panicked, I throw off the bedclothes and tumble towards the shower. Fragments of the night before begin to merge and coalesce into coherent thought. I turn back to Rosamund, “Yesterday morning’s delivery, the patient, she said, Mbewya Manyazi Inferri...’”

“You mean, Mbewa Ya Manyazi Inafera Kuuna. It’s a local saying; “The shy mouse dies in its hole.” she replies, “She was referring to her vocal infant.”

Stepping into her, I close the space between ourselves, and press my lips to hers. I feel her initial surprised resistance fade, but then I quickly break off what could easily evolve into a lingering kiss.

“Thank you.” I smile. “You are genius. I am a genius.”

“What?” she looks at me dumb-founded.

“We’ll speak later. I have work to do.”

As I stand with the shower raining down its warm watery relief, I can hear her enunciating, “You are infuriating, Arizona Robbins. Delicious, but infuriating.”

___________

Three weeks later.

I stand outside Chief Harrison’s office, hopping from the ball on one foot to the other. He had been on the phone twenty minutes into our scheduled meeting. I could wait no longer and knocked on the door prior to entering,

“Chief, we had a meeting at 10am. It was urgent,” I begin.

He raises a finger up to me, and taking a further couple of minutes, he ties up his call. My anxiety is fast dissipating, with anger being its less diplomatic substitute.

“Dr Robbins, I think you will find that there are other equally urgent matters that are desirous of my attention. As you are probably aware the World Health Organisation has just cut 10% of their funding to the clinic. What is it that you need to speak to me about that you could not put in a simple email?”

I took the opening. “Sir, it was precisely on a funding matter that I came to see you.” His shoulders sag in disappointment, and his manner became more brusque than before, “Join the queue Robbins, and when I find the magic money tree, I pick up the Batphone and call you first...”

“Look here, Sir”, I interrupt. “I was responsible for a $20m private donation for Seattle Grace, as well as the Carter Madison. If you want to speak of money trees, you had better come to me.”

I continue, “I spoke to the Carter Madison board and while there is no additional funding to be had from them, they have agreed to the resubmission of my grant proposal.”

“Any changes to your role Dr Robbins, should have been cleared with me” he interjects, aggrieved.

“Sir, with respect, another element had to fall into place before I could divulge it. I have agreed with the Board that I will step down as Lead on the project on the following conditions.”

Taking a deep breath, I babble on, before the glowering Harrison.

“One: you replace me with one paeds senior resident and one specialist obs/gyn resident for the remaining 32 months of the award.”

“Two: 5% of the grant goes towards up to date equipment.”

“Three: The remaining 30% of the grant is put into a programme to promote rehydration medicine across the country. I have arranged match funding for this element from Bayer Pharmaceutical, but only on the further condition that Professor Milne leads the education campaign.”

“And,” the anger begins to seep through, “If I so much as hear that even one parent in Malawi cannot pronounce Oralyte in two year’s time, you can kiss goodbye to any potential further funding from the Carter Madison or other major US funding bodies for your clinic.”

“Dr Robbins. I..” he looks at me.

“The word you are looking for is ‘thank you,’ but, Sir, I have to leave. I need to make a call.”

I walk out the the door and with a trembling hand pick up the mobile phone from my pocket and began to dial long-distance.
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