notes in the file and left the ward for the outpatient department where no patient was waiting.
I left the department and rolled up the trouser legs and took the sandals in my hand. I walked barefoot through the mud of the square, passed the gate and kept the walking feet on the middle of the soggy road. A heavy rain came down. I was wet to the skin when I arrived at the checkpoint where two guards stood under the tin roof of the small control building. The guards let me pass with the sandals in my hand when a Casspir passed by and threw the mud in a high arc in my face that the sand stuck in the hair and eyes and ears. I put off the wet and dirty clothes on the veranda and stood naked behind the mosquito mesh and looked on the lake in front in the twilight of the Sunday evening. It was raining when he went into the shower and washed the sand from the hair and face and body. I went to the kitchen in underpants and cut two slices from the tasteless mixed-grain bread and spread some margarine on and ate the slices with appetite, since I had not eaten the whole day. I emptied the cup with cold coffee from the morning and looked over the place with the pouring rain and trees standing in the lake. Voices came from the guest house on the other side. A women giggled that two men started laughing.
I reflected on the day’s events, while I lit up a cigarette and again I experienced the old phenomenon that answers got shorter the deeper the questions went. I stood up and switched on the light. I took a seat on the hard veranda chair at the veranda table in the small sitting room and started writing a letter. The letter was not finished when I laid the sheet aside and took another sheet to write a poem addressed to myself about loneliness of a stranger and of strangely looking people with a strange language I could not understand and about poverty and faces of fear and many other things that made me feel as stranger in this godforsaken corner. The writing went from the hand that he wrote a second poem about love and human being in need of love. I wrote down the thoughts and desires and smoked some cigarettes. I was worried about the strange reality with working days under the extreme and miserable conditions.
The night went by. There was no radio or tape player to listen to music I liked so much. I went to bed and did not pull over the sheet and listened to the hammering sounds of the rain beating the roof. I had a dream when stones were raining from the sky. They cracked on the roof that I crawled under the bed and put hands over my ears. A rock chunk broke through the roof with an ear-splitting bang and crushed me. I saw the girl Kristofina on the other side of the bridge. She turned her head and called my name like a siren to the other side of the bridge. Kristofina shouted that I should take courage and should follow her. She stretched her arm backwards out to get hold of my hand and to drag me to the other side where she was waiting. I came closer when she said with a smile of confidence that lightning cannot strike her anymore and that the rain has stopped. She thanked for the wishes and blessings by reading psalm five and six and the last psalm I did send her afterwards when she had crossed the bridge.
Kristofina could not finish her words of thanks and I was not sure, if she got hold of my hand when the phone was ringing and interrupted the conversation. I was torn off from the dream of the last great bridge. I felt that I was hanging in the air. My skin was sweaty when I took up the receiver. On the other end was the nurse from outpatient department. She asked, if there was a problem with the phone, since she had tried several times to reach me. I apologized and gave the deep sleep as reason, but did not mention the dream about the last bridge where I met Kristofina. The nurse understood. She told that a female patient was brought from Catholic mission hospital Oshikuku with severe abdominal pain. I was awake when I put the receiver down. The rain had stopped as Kristofina has said in the dream.
I put on the clothes which were still wet after I had beaten shirt and trousers against the mosquito mesh to remove the sand. I rolled up the trouser legs when I looked on the paper of the unfinished letter and read the two poems about loneliness in the strangeness and of the desire for love. I put the poems on the table and thought of the poor little girl on whom I had removed eleven hazelnut-sized stones from the stomach and set off for the hospital. The light was on that I could bypass the puddles in the front garden, but the soggy road lay in darkness. On the walk through the mud I had the sandals in my hand and remembered the ‘raining’ stones and the rock chunk that crashed through the roof and crushed down on me.
I passed barefoot the checkpoint at the exit of the village. A bulb gave a dim light in front of the small control building. The two guards with carbines over their shoulders remembered the mud trudger. They started laughing when I told that I was a doctor and had to walk to hospital. One guard asked why the doctor was not fetched by a car that he must not walk in the darkness alone and barefoot through the mud. I said that no car is available to transport doctors on night duty. I did not say that the major-superintendent had a new Ford mini-loader reserved for himself, though he did enjoy an undisturbed sleep. The guards could hardly believe this explanation. They became quiet with signs of sympathy and respect for the walking doctor, but disagreed how a doctor on night duty was treated by the hospital administration. I passed the checkpoint and looked to keep the middle of the soggy road with the water-filled potholes.
As the night before, I washed the mud from the legs under the tap next to the entrance of the outpatient department and rolled down the trouser legs and put on the sandals over the wet feet. I entered the waiting hall and the nurses looked with big eyes at me. I approached the trolley with the patient brought from the Catholic mission hospital Oshikuku [founded 1924 by frater Hermann Bücking]. The patient was an old woman who could not tell her age what was common with old people. Her sister told that she was fifty, though her face looked older. The abdomen of the patient was bloated and I could not hear sounds of bowel movements through the stethoscope. But there were gargle and murmur and splashing sounds around the umbilicus. Blood was taken for chemistry and a nurse brought the sample to the lab. Since the X-ray machine was not working, the diagnosis had to be made by the physical examination only. I puzzled the findings together and diagnosed an obstruction in the lower segment of the small intestine with intussusception of the last intestinal loop into the large bowel [with a cuffing effect]. An operation was inevitable and the nurse translated the findings and diagnosis and the necessity of an operation into the language of the people. The lab-technician brought the blood chemistry results. The protein was below normal and the white blood cells were increased. The potassium level was above normal. I asked Dr Nestor, the black colleague, who was on duty for the department of internal medicine, to give the anaesthetics.
A nurse and I carried the patient on the trolley to the theatre building. After changing the dressings I filled a cup of tea in doctors’ tea room and stirred two teaspoons of sugar in. The patient was on the operating table when Nestor arrived and changed his clothes. I informed him of the findings and operative management needed. The instrumenting nurse had put the instruments on the instrument table and cleaned the skin over the abdomen with the brownish disinfectant solution and covered the rest of the patient’s body with green sterile sheets. After the midline incision from the xiphoid down to some centimetres below the umbilicus I spread the fascial and peritoneal sheets and opened the abdominal cavity. The small bowel loops were bloated and the large bowel was black with the smell of decay. The instrumenting nurse assisted. I removed the gangrenous bowel and connected the end segment of the small bowel [ileum] with the end bowel [rectum] by suturing the end-to-end anastomosis. It was a big operation which lasted more than two hours. The nurse gave a great example by assisting and instrumenting this operation.
It was three o’clock in the morning when the patient were carried from the theatre to the recovery room where the nurse put the oxygen mask on the patient’s face and measured the blood pressure and counted the pulse rate in short intervals. A bladder catheter was inserted to measure the urine output. The two doctors went for a tea to the tea room. They spoke of the critical situation in the hospital and mentioned the airs and graces of the superintendent in major’s uniform, who turned and twisted the words upside down. He made the morning meetings useless to a waste of time, since nothing came out of practical importance what could lead to an improvement. They agreed that Hutman continued his game as informer for the superintendent by snooping around the people. He undermined the spirit of good work and destroyed what the others tried
