Homeland

Chapter 4: The Sick Heart

From the outside, the Isilimela Clinic does not look too bad. Inside hope disappears. In the waiting room, there is a stagnant air, a heavy mood, as rows and rows of people sit quietly, blank eyes staring into blank space. I ask the receptionist if I can chat to one of the doctors, and after a wait Jimmy and I are ushered through to the office of the financial director who offers me a well-rehearsed smile and a chair.

“What can I do for you,” he asks, holding onto his desk and rocking back in his chair. I tell him about my mission and he nods at the end of each of my sentences, and then like a man long accustomed to passing the buck, he picks up the phone and dials the Department of Health head office and hands over the receiver. I bend over the phone, and endure ten minutes of being chastised by a health official for turning up unannounced. I politely accept the reprimand, carefully jot down the number of the person I should have called, and then leave by the front door and re-enter by the back to see if I can corner a doctor.

The wards are dispiriting. Frail, gaunt people lie weakly on grey, steel beds, their bodies loosely covered with white sheets. Jimmy is slightly optimistic though.

“It is cleaner than when I brought my father here,” he whispers.

On the way over Jimmy had told me that they had taken his father home to die. “In hospital you need encouragement, you need hope to get better, but the people who work here don’t care. They are just here for the jobs and the salary.”

Behind the wards is the Gateway clinic, a series of wooden sheds with paint peeling off the walls. This hosts the antenatal and well-baby clinic, as well as the TB and HIV/AIDS information clinics. Sitting outside are a few teenage girls, who shy away when I say hello. Outside, in the afternoon sunshine, a few patients are lying on the grass, wearing striped hospital-issue pajamas. They look more like inmates than patients.

We sit on the wide porch outside the wards and wait. After a few minutes a nurse and two orderlies walk by. Jimmy approaches the nurse, explaining why we are here. The nurse looks at me, takes a step forward, grabs my arm and pushes her face towards mine.

 “What have you got for me? You must give me something. Give me a sweet,” she says with a cackle. The two orderlies at her side have a similar strange look in their eyes.

“I don’t have any sweets,” I reply, completely taken aback. I was expecting her to be dismissive, or too busy, but this is something else.

“Then your pen,” she says, “Give me your pen.”

“But, but, you have a pen,” I say, pointing at the pen in her shirt pocket. “I need my pen.”

“But you must give me something. What have you got for me?” she insists.

Her manner is unnerving. Her eyes are glassy and seem fixed on a place just beyond my ear and there is an energy to her which is as jagged and fraught as a broken glass.

“Are they on drugs?” I ask Jimmy, when they eventually back off and walk away.

“I don’t think so,” he says. “Maybe it is the stress. They see so much suffering. Maybe it makes them a little mad.”

We sit back down on the porch and it is not long before a tall man with an air of calm authority rounds the corner. He listens politely to our request but answers that he is a Nigerian doctor who has only been an Isilimela for a year, he cannot comment on how things have changed since 1994, but he knows someone who can. A few minutes later we are ushered into the office of Nurse Cynthia Qikani.

Cynthia has worked at Isilimela since 1987. She sits at her desk, the nurse’s ledger open in front of her, and pulls no punches.   

“Before 1994 everything was going good. We had doctors, nurses, equipment and services. In 1994 we thought the change was all for the good. But as time goes on there is a constant decline. We can’t blame the government, but we are blaming them. We are in a dilemma.”