Mutare General Hospital was beautiful once, with whitewashed stucco arches curving over open verandas. Now the roofs rust to a deep red as the walls yellow. Grass fills the pavement’s cracks by the weathered guard station. The yard is the color of dried cornhusks from years of drought. Only the green Vumba Mountains, which surround the city, remain untouched by the country’s collapse. A third of the population has fled—including most of the doctors. The dying hospital is not a place to be cured. In a starving country, mangoes rot in the shade by the emergency entrance.
Feb. 1, 2008: I have driven 90 kilometers from a rural orphanage in Marange to visit a boy with cerebral malaria at Mutare Hospital. I’ve been volunteering in Zimbabwe for only a few days and still have to remember to reach for the stick shift on the left. I’ve come here to work for three months at the orphanage, which was founded by a retired American named Paula. I want to help, but all I seem to do is observe: watch the children, assess the need of the poor, check on the sick.
Pafiwa, the orphanage worker who accompanies me on errands, walks ahead of me down the cool, dark hall.The purple windbreaker that makes him the envy of town swishes with his long steps. “Pafiwa” means “where death has occurred” in Shona; he was born the day his grandfather died. I lag behind him. The high ceiling and tile floor echo the slaps of my sandals. Windows above the wooden doorframes let in the sun.
I slow to peek through a door cracked open. A slender figure looks back at me. Dark and bare-chested, he sits upright on yellowing sheets. His head is large, too big for his frail body and a deep red.The skin is missing from the nape of his neck to the top of his brow, as if someone has run a grater back and forth. I hurry down the hall after Pafiwa.
I want to know what could do that to a head. No one tells me about the violence of the campaigning for the March elections. The ruling party, the Zimbabwe African National Union-Patriotic Front, which fought in the liberation struggle and has been in power since Zimbabwe gained independence in 1980, might lose this election. Gangs loyal to ZANU-PF burn the flesh of opposition supporters down to the bone. In the current chaos and corruption, the hospital—once one of the best in Africa, part of a comprehensive healthcare system—has no pain relievers for the man with the throbbing head.
At the doors of the children’s ward, Pafiwa and I walk past a sign—“No visitors, only close family.”The boy with cerebral malaria is too sick to turn his head toward us. Before long, we will drive his body back to Marange. His plywood coffin will be built with so few nails that gaping cracks will be left between the boards.
Feb. 15: Around 8 a.m., Pafiwa and I drive down the orphanage’s sandy paths, lined with mango and papaya trees. Outside the orphanage gate, the fruit trees are mostly wild. Brush scrapes against the truck’s sides. Children run through the tall grass to the side of the road, calling, “Auntie Paula!”
“They never see white people. They think you are Paula,” Pafiwa tells me, smiling. The windows are down in the February heat, and dust from the road settles on my eyelashes and the hairs on my arms. We’re going to Marange’s “tuck shops,” shacks that sell whatever basics the vendor can scavenge, to look for soy chunks and cabbage.Yesterday, we drove to Mutare but found only unpackaged soap on the shelves of the supermarkets. Police patrolled the dark, empty aisles to prevent riots. A sign on the door of one store read: “Will buy bulk beans, maize, soap, see the manager.”
The seats in the truck don’t recline, but Pafiwa leans back and stretches his thin legs. We see a man approach on a bicycle, teetering over the rocks and ditches left from December flooding.
“He’s from the clinic,” Pafiwa says. “An emergency.” The clinic’s only “ambulance” is a wooden wheelbarrow hitched to a cow.When patients need to see the doctors at Mutare General Hospital, Paula sends the orphanage truck. An emergency means an hour of braving potholed roads and explaining to armed soldiers why a white American has bleeding black Zimbabweans in the bed of her truck.This is my first emergency.
“Masikati,” the messenger greets us, his skin shiny with sweat. He hands me a torn Record of Labour with neat writing on the back: “Please can you help us with transipart. We have an emegence who need to deliver here Thank you in advance—Nurse on duty.
“Let’s go.” Pafiwa says.The clinic is about two miles away. I drive faster than usual, thinking “emergency.” Pafiwa tells me they won’t be ready for us. A little past the junction where the dirt road meets the paved road to Mutare, across from a beer hall, Pafiwa gets out of the truck to shoo a scrawny cow away from the clinic gate.
The L-shaped clinic sits atop a flight of cement steps. Patients wait for the nurse on its high veranda and in the yard beneath an ancient evergreen. A man thrashes at the grass with a sharp hoe in a rhythmic swish. I rush up the stairs but see no sign of emergency.
From the shade of the tree, Pafiwa yells that Sister Saurombi, the head nurse, is in her house. “They aren’t ready for us.” He smiles; I flush under my sunburn. I want to help, but all I seem to do is observe: watch the children, assess the need of the poor, check on the sick.
Sister Saurombi’s home, just a cement block with an asbestos roof, is across the yard. She invites me in and offers me roasted groundnuts, smoky and soft. Her house smells like the clothes room at the orphanage—piles of secondhand sweaters moldering on damp shelves.
“Where’s the emergency?” I cut off her small talk.
She frowns, adjusts her bobbed wig and leads me across the yard. “You have to examine her first,” she mumbles, taking slow steps on the clinic stairs. We pass a room where two malaria cases lie on cots. Before Paula donated the mattresses, patients had lain on the metal springs.
In the next room, Sabina, the plump nurse with thick braids, sticks a needle into a slender arm.The girl isn’t screaming, sweating or wearing a white gown. She’s still. Only her chest moves, rising and falling with deep, slow breaths. She leans against the upright head of the bed table, her legs bent and spread. Next to her rough foot on the white mat lie a mass of dark pubic hair and a razor blade.
Her skirt is pulled up to her belly button, which shows through her white T-shirt, stretched taut over her stomach. At the center of it all, a little blue arm with a tiny blue hand reaches out from inside her.
Taking slow breaths, the girl stares at Sabina. I imagine the rest of her body could fit inside her own swollen stomach. She has a baby’s face and hair cut close to her head.
“How old is she?” I whisper.
“Seventeen. Underage,” Sister Saurombi replies loudly.
The girl rolls her head toward us. Her face looks 13, or younger.
“She’s Apostolic. She went into labor two days ago, but they refused to bring her here.”
I have met Apostolics. They dress in white and make pilgrimages to a prophet who lives past the balancing rocks. The religion was born here. The Apostolic men often have many wives and don’t believe in doctors.
The girl’s breath deepens as she watches us. A limp tube hangs over the blue hand, small and stiff. I knock my flip-flops against each other, leaving a dusty shadow on the concrete floor. Maybe my mother was right: I should have sent my tips from waitressing instead of buying a plane ticket, mailed my malaria pills instead of using them. I came here to help, but I’m only a spectator.
Sister Saurombi turns her head and, in a loud whisper, tells me the baby is dead and the girl and her family don’t know. The scent of pure alcohol clogs the room. I stare at the flies buzzing around the blue mosquito net knotted above the girl’s bed.
“Did you hear me? They’re going to cut up the baby.” Sister Saurombi breaks from her whisper and snips with her middle and pointer finger.
I nod my head but don’t look at her, hoping the girl hasn’t noticed the motion.
Sister Saurombi pushes her tinted wire glasses up her nose. “They have to cut it out or her uterus will burst.”
I glance back at the small hand and the intimate folds of skin around it.The alcohol fumes grow heavier in the air. I step into the men’s ward—no door. They can see her, too. The white paint is chipping off the metal tables by the beds; they look diseased.
Outside, I breathe again. Pafiwa slaps one of the plastic mattresses against the truck bed as Sabina helps the girl down the stairs. Standing up, the girl seems more like a pregnant woman and less like a child. Her large breasts sag so much that they make her stomach seem even bigger. I feel as though I can see through her thin skirt as she takes careful steps. I start the truck to avoid watching her stretch her leg to climb into the back.
In the rearview mirror, I see that Sabina, whose mass of thick braids blocks most of the back window, now accompanies a frail woman. “The mother,” Pafiwa says. A man jumps in the back with them. “Husband.” The truck, in first gear, rumbles over ditches. The girl must be able to feel the ridges of the truck’s bed through the thin mat.
The paved two-lane highway begins, or rather ends, at the junction. Hitchhikers wave at us, overstuffed plastic bags at their feet. I speed by them, accelerating past the speed limit, 80 km/h, even though the road scares me. It has no shoulder, just the jagged edge of the blacktop. Pafiwa hangs his arm out the window and closes his eyes. Each pothole jolts the truck.That mattress is so thin. My skirt is hiked up between my legs. I clench my thighs to feel the material, what is there and what isn’t.
Near Odzi Bridge, a soldier in a chunky army-green sweater waves me to a stop. He’s supposed to demand ID; I don’t
have any. Roadblocks have barricaded Marange since the discovery of diamonds there in 2006.
“Mangwanani! Masikati!” I say, smiling.
He laughs at my Shona and hoists his
AK-47 back on his shoulder. “Where are you going?”Young and bored, he stands for hours in the shade of the tall bushes by the road, probably hot in his fatigue pants and heavy boots. Worn epaulettes adorn his sweater. I pull my skirt down to my knees and feel my warm thighs touch slightly.
“Mutare Hospital. We have an emergency.”
“Where are you coming from?” “Marange Clinic.”
“And where do you stay?”
“Mutare.” I lie. “This is an emergency.”
Why isn’t the girl screaming at him to let us go? The soldier looks in the bed of the truck and taps my door, sending us off. Not long after the first, we reach another checkpoint: another officer in his mid-20s, like me, holding a Soviet gun much older than either of us.
After 30 minutes of driving, we reach Rowa, a “growth point,” not quite a town. The dying fields disappear behind tall trees, which shade the women who gather to sell mealy tomatoes along the road. We pass the New Cannibal Inn with its dark wood paneling; Sue Supermarket with its big red and white sign; and some police, who slow us down but let us go.They hunt for overcrowded vehicles so they can collect bribes from the passengers.
Our Toyota is no longer the only vehicle on the road. Going uphill, we slow behind overloaded buses and trucks, some weighed down with mattresses, tables and chairs piled seven meters high.
Fewer people walk barefoot in the middle of the road here, and the potholes grow deeper and wider. Zimbabweans say if you’re driving straight, you’re driving drunk. With more buses coming over the hills, though, I can’t swerve around the potholes. Could a bump rupture the girl’s uterus? Finally, at the outskirts of Mutare, the billboards by the open-air market appear: for AIDS awareness, “Don’t Be Negative about Being Positive”; for Protector Plus condoms, “For the Love of Your Life”; for Coca-Cola, “Welcome to the City of Mutare, Welcome to Refreshment.” We take the high road past the bottling factory.
Vendors and hitchhikers wait around the hospital gate, sitting on cardboard scraps under another Coca-Cola billboard.The street leading from Robert Mugabe Road to the back of the hospital is the worst in the city. I try to ease the truck in and out of the grave-like potholes. We drive past the morgue and the emergency drop-off to the maternity ward.
The girl stands up.Two brown drops fall from between her legs onto the white plastic mat. She can’t get down from the truck. Her scrawny husband puts his shoulder under her rear and, straining, lowers her to the ground.
Her floral skirt, wet with the brown liquid, clings to her thighs. I can’t see the shape of the hand. Barefoot, she steps cautiously over the blacktop to the open hall and the stairs leading up to the maternity ward—two flights.The elevator has been broken for years.
I park next to a rusting ambulance without tires. The brown drops sit on the mat, round and still. I think of them dripping down the blue hand.
I search for more drops on the way up the steps, but the cool, dark stairwell is disorienting after the
heat and sun of the drive.The second-floor maternity hall is crowded yet quiet. The girl’s mother perches on the corner of a long bench; at the other end, the husband twists his baseball cap in his hands. Between them sit sulking women with sagging breasts. A sign on the wall informs patients that they must bring their own food, soap, blankets and toilet paper. The hospital has nothing; cured patients sometimes die of hunger in their hospital beds.The nurses wear old but shiny black shoes; the rest of us have flip-flops or nothing at all, our feet covered with dust.
I stand close to Pafiwa, trying to look as if I belong. I want to tell the women waiting on the bench that I am here to help. I’m not here to stare at them with their heavy faces. Do they all have dead grandchildren to carry home? The girl—maybe I saved her life today. Isn’t that what I came here to do?
Sabina and the girl disappear down a hall. We wait. Another nurse returns with news: Two patients need attention, but the hospital has only one pair of plastic gloves. Local health workers estimate that one in three people in the region are HIV-positive; no one gives medical assistance without plastic gloves.
I look at Pafiwa. The little purse at my hip won’t close because it’s bulging with a stack of million dollar bills for soy chunks and cabbage to feed the orphans. His small mouth is set. The nurse leaves.
“Should we get gloves?” I whisper.
Pafiwa says the nurses always claim to need things.Then they pocket the supplies and sell them on the black market.
“But don’t they run out of plastic gloves sometimes?”The government barely supports the hospitals; the doctors have just returned from a strike.
The nurse comes back.This time they need drips—intravenous fluid. Pafiwa doesn’t move. Could we be wrong? The girl’s mother balances on the corner of the bench, not understanding our English, not even looking at us, only waiting. No one swats at the flies buzzing around, landing on patient faces. This is Zimbabwe: waiting.
The girl’s husband pushes the women closer together so Pafiwa can sit. I stand awkwardly in the middle of the hall. Sabina waddles around the corner to tell us the girl must travel to Harare, five hours away. Mutare has no sutures or anesthetics. Sabina says we can go back to Marange. Someone else will drive the girl.
We reach the clinic before noon; the shadow of the old tree is much smaller. People crowd under it. A small boy bites into the skin of a mango.
As Pafiwa and I carry the thin mattress back up the steps of the clinic, I notice that the two drops, dried sepia in the sun, are chipping.
Later in February, I drive two illegal diamond miners to Mutare Hospital, blood from
their machete wounds caking the white mats.We leave the mats with them on the floor
of the emergency room. One of these could have been the pregnant girl’s mat; I ask Paula what happened to her that day. At Rusape, the point where my truck’s fan belt will snap
in March, the girl’s uterus ruptured. After the placenta broke away from the uterus, blood filled the abdominal cavity. I wonder how her family, too poor for shoes, brought her remains home.Transport is expensive, with fuel often unavailable even on the black market. Sometimes, I drive the bodies of villagers back to Marange from Mutare Hospital so they can be buried under their ancestral termite mounds, where the packed earth won’t wash away in the rain. I worry that I should have driven the girl to Harare—or should have asked about her sooner.
I think of her on another trip to Mutare at the end of February, waiting for another body in the small parking lot of the morgue, a boxlike building behind the hospital. Arms crossed, I feel cold even against the warm truck. Palm leaves shiver above me in the wind. Several women stand across from me by another white pickup.Two have towels tied around their waists instead of skirts. Eager to show off my Shona, I want to smile and greet them, “Mangwanani,” but I remember why we are waiting and how little I know about anything here.
A couple of nurses and a man in a suit—all wearing plastic gloves and white masks— carry a small plywood coffin from the hospital through the open door of the morgue. The electricity comes irregularly in Mutare, and the morgue is dark. Standing in the bright afternoon sun, I can’t see what they are doing inside.
I want to go to the door and look, but I stand alone and kick pebbles. Soon, I
will leave, returning to the U.S. only a week before the March 29 elections. The country will grow cold as all of Zimbabwe waits months for the results. But there will be no rebirth:The torture and murder of opposition supporters will become so rampant that their leader will pull out of the runoff elections and the ruling party will continue to rule under the guise of a unity government. I will return in 2009 and again drive to Mutare General Hospital. I will walk into the dark morgue, which seems so mysterious to me today, and, still, I will be an observer watching a country wait for change.
A breeze cuts through the summer day. Chills prickle up my arms. One of the women takes a blanket from the truck and carries it to the morgue. In the shadows by the open doorway, she places the blanket in the coffin. On tiptoe, I lean against my truck to look. A gust of wind knocks one of the doors closed, and I can see nothing.
Two other men in white masks bring out the coffin I will take to Marange. A small cardboard box with writing on the side: “Fragile. Teapots.”