Jess in Zim

I’m standing in the rain outside a cinder block house in Mkoba listening to the sound of drums and funeral songs escaping from the open doors and windows. The rain has finally come and shattered the heavy heat that has been hanging over us all.  The storms are spectacular.  The sky turns a sudden, menacing black and the wind picks up, bothering the dry, dead branches of the tall palms.  Rainfall is heavy and insistent.  If you are caught off guard, however close the shelter, however fast you move, you will find yourself wet and cold and shivering by the time you reach cover.  And when the rain comes, making people wet and cold and shivering, these people celebrate.  People here always seem to find a reason to celebrate, even in the midst of grief.

Water gathers in rust-coloured pools around my feet as we wait in small huddles to enter the room and file past the open coffin.  Family and friends have travelled great distances to share this moment of grief together.  Funerals last for several days and cannot start until the most important family members are present.  Traditionally, word of the loss would have spread locally through the haunting sound of women keening.

I stand in front of the mourners and my words of condolences, carefully rehearsed in Shona and word-perfect just moments ago, desert me.  Actually, all words desert me, and I stand mutely, silenced by suffering.  The funeral is not a patient this time, but a colleague, a friend.  I stand and share with people, who did not need to be reminded how cruel and unjust life can be, as they learn new lessons in loss.

I stand there in the wet, trying to remember that the dark, brooding sky, this cold, heavy rain, is actually a benediction.  A reason to celebrate. Trying to remember that there is a life here to celebrate too.  Later today, our friend will be moved to her rural home to spend a final night there.  Tomorrow, at the burial, the community will gather around the grave and share stories.  We’ll honour the memory of our loved one.  Remember her kindness and compassion.  Maybe we will talk about her work with MSF.  Her commitment to a job which ameliorates this grief and suffering that we can never entirely avoid.

Perhaps it will rain again.  The sky will become dark and threatening.  But in the fields all around, full of waiting crops, the rain will be making all things new.

It’s been a long time since I’ve written.  The seasons have changed here in Zimbabwe and Gweru is now dripping with heat and jacaranda blossom.  In town, the sun ricochets off glass and metal and soaks into the tarmac.  In the countryside of Lower Gweru, a warm wind whips up the dust and makes our patients’ long walk to our clinic longer still.  When they arrive, they wait patiently in long lines on benches pulled into the shade, or lie under the trees in the shifting shadows.  Everyone, everything, is waiting for rain.

I don’t know why I haven’t written for so long.  Maybe it’s a result of the inertia that the heat inevitably inflicts.  Maybe.  Or perhaps it’s not that at all.  If I’m honest, I think it’s because recently I’ve been immersed in meetings and minutes, reports and seminars.  Spending less time in the clinics, less time with patients, it’s all too easy to lose sight of your purpose, to lose your inspiration.  Basically, I have a suspicion that spreadsheets stole a little of my soul…

I think I got it back yesterday in a very simple way.  It doesn’t take much.  I just shared a journey with a patient.  One of the five thousand patients we treat at our HIV clinic in Lower Gweru.  Just one.  She was a young woman who needed to be transferred to town to have a chest x-ray.  Too sick to go alone, I accompanied her.  I could do very little for her.  I helped her take sips of tepid water from an empty coke bottle.  I steadied her as she moved from the vehicle to the wheelchair and back again.  On our return to the clinic, she shifted listlessly, trying to make her body and her breathing more comfortable.  Eventually, she rested her head on my shoulder and slept.  Her hair was damp from the heat, from the fever, from the effort of movement.  I braced myself and tried to absorb the impact of the road, tried to make the journey a little shorter for her.

Back at the clinic, we held the chest film up to the light.  It was easy for the doctor to diagnose tuberculosis.  It was what we suspected.  Here in Zimbabwe, amongst our HIV positive population, tuberculosis has swept through the country like fire through dust-dry savannah.  It is the biggest killer of HIV positive patients here and, without access to drugs to treat the disease, prognosis is poor.  Here in Lower Gweru, thanks to spreadsheets and international orders and policies and protocols, we have the drugs.

This patient doesn’t know it, but she needs someone to sit in meetings discussing how best to implement WHO guidelines.  She doesn’t know it, but she needs someone to pour over spreadsheets, calculating consumption rates of medication, estimating project needs, placing orders.  Because heaven forbid a patient arrives one day in need of lifesaving medication that we do not have.

I need to learn to juggle all this.  The nurse in me wants to rush always to the clinic.  Another part of me knows that this, on its own, is not enough.  I need to find a balance.  To sit at my desk and write reports, to attend the meetings and discuss all the issues, without losing sight of the weary woman who thirsts for a sip of water.