Outpost Hospital

by Sheila Ridley

She got up and stood the cards on the table. Christmas was over but they were gay and pretty.

  It was seven o’clock now and time to be getting ready for dinner, though she would rather have stayed where she was than go into the big dismal living room, for she was tired.

  It was dark, too, but as there was no lamp, she had to manage as best she could. Her luggage had not arrived yet, but she had a fresh white blouse in her small case and this, with the gray pleated skirt she had traveled in, would have to do for the evening. She brushed her hair but did not put any makeup on, feeling sure that Miss Kennedy would disapprove of it.

  When she entered the living room Andrew Kennedy was alone reading by the light of an oil-lamp.

  Hearing her, he put down his book and rose to his feet. “Hullo, Nurse,” he greeted her with a warm smile. “Have you everything you need? I’m afraid your room is far from luxurious.”

  “It’s very nice,” Katherine replied politely. “Thank you for putting the flowers there. I’d never seen wild orchids before. They’re beautiful.”

  “Well, I thought the room looked a bit dowdy for a young lady. Come and sit down.”

  They sat by the open window. Outside, the moon was shining, making river and forest a breathtaking scene in silver and black.

  “You know, it seems a bit silly for me to be calling you ‘Nurse,’ ” Andrew said. “Your name is Katherine, isn’t it? May I call you that?”

  “Oh yes, please do,” she said gratefully.

  “Good, and I’m Andrew.” He paused and then went on rather hesitantly, “I—er—I hope you’ll be happy here, Katherine. I expect you think that my sister was not as ... well, as welcoming as she might have been, but don’t let it upset you, will you? You see—” he gazed out at the river, a troubled look on his tanned face. “—Mary is a good woman but she’s got it into her head that you and Dr. Charlton are going to steal my thunder here.”

  “But why should she think that? Our work is quite different from yours,” reasoned Katherine.

  “I know,” he nodded, “but Mary has always been a wee bit jealous for me. She thinks the people here don’t appreciate me as they should, and I can’t make her understand that I don’t want gratitude. So long as I can help my people I’m satisfied. However, I’m sure she’ll soon get used to the new arrangement and we’ll all settle down happily together.”

  Katherine wished she could share his confidence, but she smiled and said, “Yes, I’m sure we will,” with as much conviction as she could muster.

  CHAPTER SEVEN

  Her first morning in Ngombe, Katherine was surprised to be awakened by the raucous cackle of hens.

  She put on her dressing gown and went to the window that looked out the back of the house. A large, neat garden lay before her. Hens pecked on the path, and in a fenced enclosure three small goats cropped the grass. At the bottom of the garden was a round hut that she guessed to be the kitchen and, some distance away, were several buildings of different sizes; they had mud walls and corrugated iron roofs.

  One building was more carefully made than the others; the walls were smooth and the door had been roughly carved. Katherine thought this must be the church—or was it a kirk, since the minister was Scottish? Then, across the quiet morning came the sound of children’s voices singing, making up in gusto what they lacked in melody. Evidently the days began early here, for it was only six-thirty.

  A few minutes later there was a knock at the door. It was the ever-smiling Moses with her washing water. Also outside the door she was relieved to see her trunk and she helped the boy drag it into the bedroom.

  When she had washed, Katherine put on one of the white coats and a pair of the white canvas shoes she had brought with her. She was hoping that if she were dressed for work Dr. Charlton would take it as a hint that she did not want to sit around the house while he got things organized.

  Then she went through a narrow door out onto the porch, just as the doors of the chapel burst open, spilling out a score or so of shouting, laughing boys.

  They were followed by Andrew Kennedy, who waved when he saw Katherine. “Good morning. I hope you slept well. Would you like to come and have a look around before breakfast?”

  She said she would and went around to the front of the house, down the steps and to the back again to meet him. The air was still fresh as the sun was not yet high enough.

  They went first to the chapel. Inside were rows of benches and, at the far end, a small dais and a lectern. The walls were whitewashed.

  “It’s very plainly furnished, as you see,” said Andrew quietly, “but we are lucky to have plenty of beautiful wood to use. We’re too far from the coast to make it worth anyone’s while to export the timber. Unfortunately, the craftsmen’s skill is not of the same high quality, but they do their best.”

  Katherine could see that, despite its imperfection, he was proud and very fond of his little chapel.

  Next he led her to another building.

  “This is the place I thought you might use as a temporary hospital,” he told her.

  Katherine’s heart sank. She had been prepared for a drastic change from any other hospital she had ever seen, but this was even worse than she had reckoned on in her most pessimistic moments. The hut was empty, the floor of mud; the window spaces were uncovered and the ceiling was simply the underside of the corrugated iron roof. “Well, it’s a start,” she said doubtfully.

  Her companion patted her arm. “I know it’s ghastly, Katherine, but the new building will soon be ready,” he consoled. “I’ve found a perfect site for it quite near the house, and I’ve had men clearing and levelling it since I heard you and the doctor were coming.” When they came out of the hut, a group of people had gathered near the door, jostling each other excitedly.

  With an apologetic smile, the clergyman said, “These are some of your first patients, I’m afraid. As soon as they heard the doctor was on his way they began to pour into the village. I told them they must give him time to settle in before they came but it was no use. Some of them have traveled for weeks to get here, so I can hardly send them away even if they would go.”

  “I’m glad they’re so keen,” replied Katherine. “I thought they might be unwilling at first to come to a white doctor.”

  “Oh, no. You won’t have that sort of trouble except in a few cases, perhaps. You see, these people regard illness as a kind of magic, but any magic can be overcome by a stronger magic, and they believe the white medicine man has that stronger magic to give them.”

  Katherine smiled. “Does Dr. Charlton know that his ‘surgery’ is filling up already?”

  “Yes, I warned him earlier. He’s unpacking some of his equipment now and after breakfast I’m going to bring two young men to meet you both. They were my best pupils and very intelligent. They will interpret for you and help in many ways.”

  “That’s wonderful! I was beginning to feel a bit scared, but now I think we’re going to manage very well.”

  “Of course you will,” Andrew said confidently. “I’ll admit that when I first saw you sitting in the boat I had my doubts. You were younger than I’d expected, and you looked so nervous. I thought to myself, ‘This wee girl won’t be staying long.’ ”

  “Oh dear, I didn’t know it was so obvious.”

  “What was it you were so afraid of?” he asked with friendly interest. “Did you think the boat was going to overturn and you’d be eaten by crocodiles, or was it the fearful prospect of meeting the Rev. Andrew Kennedy that made you quake?”

  She laughed. “Both of those.” Then she added more seriously, “Plus the feeling that I wouldn’t be able to do my work well enough—that I might let Dr. Charlton down.”

  “I’m quite sure you’ve never let anyone down and that you never will,” said Andrew sincerely. “I haven’t the least doubt now that you will do a wonderful job here.”

  How kind he was and how easy to talk to, thought Katherine. If only everyone was like him, how much simpler life would b
e. “I hope so,” she said, and her voice was slightly husky.

  Andrew pointed out the small cluster of round huts with mud walls and palm-leaf roofs some distance away, which made up the village. Beyond and all around was the green wall of the “impenetrable forest.”

  The group of Nigerians had been staring in open curiosity at Katherine all the time she and Andrew had been talking, and others came, in ones and twos, to join the audience, which now numbered about 50.

  “We’d better get back to the house before the entire village turns out to see you,” said Andrew.

  They had breakfast, during which Mary Kennedy maintained a frosty silence except when compelled to speak; then she went into the garden.

  Her brother brought in two young men. They had keen faces and bright eyes and wore white cotton shirts and skirts. Taking each by the arm, Andrew said to Mark and Katherine, “Here are your first two assistants, Joseph and Simon. Having taught them myself, I can recommend them highly. You’ll find them quick to learn.”

  Then he said, “Now I must get to my school. If there’s anything I can do you’ll know where to find me—the schoolroom is only 20 yards from the chapel. Use my houseboys to do any cleaning or carrying that’s necessary. I’ll send you a table and some chairs across from the school.”

  At the “hospital” a makeshift out-patients department was quickly set up. Dr. Charlton sat at the table near the door with Joseph as interpreter. The patients filed past, the doctor diagnosed the trouble and, where treatment could be given at once, wrote the details on a ticket. This was hung around the neck of the patient who was then passed on to Katherine and Simon. Katherine sorted them into “dressings,” “tablets” and “injections,” and Simon did the bandaging and sterilizing of the needles, boiling water on a kerosene stove.

  There was no difficulty getting the patients to submit to the prescribed treatment, but those who were given tablets seemed to feel they had been cheated and demanded an injection. They were all grateful for the help they received, but especially those with bad sores. When they had been cleaned, dressed and bandaged, the patients’ delight was gratifying.

  At lunchtime the queue of people still looked as long as ever and many had to be sent away and told to come back the next morning.

  In the afternoon a start was made on the building work. Huts for the patients and their relatives who came from far away were the first to go up, as the materials—mud and palm-leaves—were at hand. Everyone, including those patients who were well enough, helped with the work, which went smoothly and quickly since the design was so simple.

  And so the days fell into a pattern.

  In the mornings Mark would see the new patients while Katherine treated those who had been before; and in the afternoon she and Simon would continue with this work while Mark supervised the work on the building site.

  The doctor was anxious to get the main building completed as quickly as possible, for his list of patients needing hospital treatment was growing rapidly, and with the rainy season approaching there was no time to lose.

  CHAPTER EIGHT

  There was certainly no lack of patients. But Katherine noticed that, though the women readily brought their children for treatment, so far none of them had come on her own behalf. This worried her because she knew that many babies died in infancy and she felt sure that if the mothers could be persuaded to attend for ante-natal treatment, things could be improved.

  Mark was in favor of the idea but warned her that it would not be easy to put into practice. “There’s more mumbo-jumbo surrounding childbirth than any other phase of life or death,” he told her. “It’ll take some getting through, and I won’t, be able to help you much at the moment. I’m up to my ears already, though of course I’ll examine anyone you think needs it.”

  Katherine decided to try to interest Mary Kennedy in her plan. After all, she reasoned, even if the older woman was not particularly fond of the local people she must have learned a good deal about them in the time she had been in Ngombe.

  Her opportunity came one evening after dinner when Andrew was at a meeting of his Boy Scouts and Mark was in his room studying. As she hesitantly outlined what she had in mind, Mary Kennedy went on plying her crochet needle, not once raising her eyes from her work. “... and I thought you would be able to tell me about the women here: why they don’t come to the clinic; who attends them when they’re confined—”

  The Scotswoman’s long, pale face, always stern, now assumed an expression of acute distaste. “Really, Miss Marlowe,” she said icily, “I cannot think why you should imagine me to be familiar with the sordid details of these women’s lives.”

  Katherine flushed and bit her lip. What a difficult woman this was. And how different from her warmhearted brother. “I don’t regard childbirth as a sordid matter, Miss Kennedy,” she replied quietly with as much dignity as she could muster. “I just thought you might like to help. These people are so fond of children, it’s tragic so many should die in infancy.”

  “I consider that quite enough survive,” was the unkind retort.

  “I see.” Katherine realized that it was useless to try any more to enlist aid in this quarter. She was doubly disappointed, for she had also cherished a hope that working together might have resulted in a friendlier relationship between them.

  However she was still determined to go ahead with her scheme, and when the next day she learned that Joseph was a married man, it seemed that here might be a good starting point. Joseph, the older of the two assistants, was intelligent and enlightened, for he had not lived all his life in Ngombe. After leaving school he had worked as a booking clerk in Makurdi and also as a receptionist.

  She talked to him as they worked together changing dressings. For this daily task they had rigged a pole about two feet from the ground. On one side of the pole stood Katherine and Joseph with a bin for soiled dressings and a drum of fresh ones; on the other side was a line of patients, each with a leg resting on the pole.

  As Joseph removed a soiled dressing, the patient would hop along to where Katherine waited to put on a clean one.

  When the work was going smoothly, Katherine asked, “How is your wife, Joseph?”

  “You talking about my first wife, Miss Nurse?”

  She dropped her roll of bandage. “You mean you have more than one?”

  The young man told her calmly that he had two wives.

  “Oh. Er ... and how many children have you?”

  He did not answer at once and, glancing sideways at him, Katherine saw that his usually cheerful face was full of sorrow. After a moment he said sadly, “I have no child yet, Miss Nurse. My first wife is big with child.”

  “That’s wonderful, Joseph. You will soon be a proud father, then.”

  He shrugged his shoulders. “An evil spirit lives in Joseph’s house. It will kill the child.”

  “Oh, but you know—” Katherine stopped abruptly. What was the use of saying, “You know better than that,” to a man who obviously believed implicitly in what he said? “Why don’t you bring your wife to see us here? I’m sure we can help her.”

  Joseph was not convinced. “The evil spirit is very strong,” he said, working stolidly on.

  “But we have strong magic, too. Good magic. You’ve seen—” She made a gesture with her hands as if she could conjure up events of the past few weeks and remind him of the many times his eyes had almost popped out of his head in his astonishment at what the white doctor’s magic had done for his brothers. But he just smiled tolerantly, so she dropped the subject for the time being.

  When the first rain fell it was unlike any rainstorm Katherine had ever seen. It seemed to be almost solid as it hurtled down into the depleted river.

  She was standing at the living-room window watching it. She was alone. It was early evening and, feeling tired after the day’s work, she leaned against the wall resting her head on her hand. “Thoughts of home from abroad?”

  At the sound of a voice behind her, she turn
ed, startled. “Oh, Andrew. I didn’t hear you come in.”

  “I know. You were miles away. In England, I’d guess. Am I right?”

  “Well, I was thinking how nice it would be to see the crocuses coming into flower,” she admitted with a smile. “It’s hard to believe spring is beginning at home.”

  “I know what you mean, but ... you don’t really wish you were back in England, do you, Katherine? I thought you’d settled down so well and I hoped you were fairly happy with us.” His thin, kindly face was anxious as he waited for her reply.

  “Oh, I am happy,” she assured him sincerely. “I enjoy my work here very much.” She did not notice the sudden disappointment that darkened the gentle brown eyes that watched her. “I’m liking it more than I expected to, as a matter of fact,” she went on, “especially now that I’m getting to know the people as individuals. I think they’re wonderful, and I only wish we could do more for them.”

  “I’m glad you feel like that, Katherine,” he replied warmly. “That’s how I feel, too.”

  “I was talking to Joseph this morning about his wife—er—wives,” she told him.

  He smiled broadly. “I expect you were rather shocked to learn that he has two?”

  “Well, I did think it was a thing of the past now, except perhaps among the older people.”

  “No. I’m afraid polygamy is still widespread in the country district, and it’s difficult to know what to do about it. Of course, officially I’m against the practice, but there are sound practical reasons for it. In Joseph’s case, for instance, when his elder brother died six months ago Joseph automatically took his sister-in-law as his wife. That’s the custom of the tribe. If you’re going to put an end to polygamy you’ve got to have an alternative way of dealing with the spinsters and widows; they can’t be left alone and unprotected.” He smiled. “But I mustn’t preach at you. You have your own problems.”

  Katherine told him of her wish to start an ante-natal clinic and that, with Joseph’s support, she thought the plan might succeed.