Rula Sinara

After the Silence


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      Dear Diary,

      They said writing to you would help. I’m not sure. I can’t tell anyone what I did. Not even you. If anyone finds out, I could go to jail...or hell.

      HOPE ALWANGA STRIPPED off her bloody gloves and gown, then rushed from the room, but there was no escaping the merciless, coppery smell that had penetrated her sinuses. She pressed the crook of her elbow to her nose to shield against the added assault from the sweaty, desperate crowd still waiting to be seen and made her way to the back of the emergency room. A steady stream of patients was expected at any of Nairobi’s public hospitals—she saw it as added experience during her internship year—but this? This was pure chaos. And she’d been forced to do procedures she’d never done before.

      She needed a minute to sit. Just one.

      She collapsed onto a stool near a half-empty medical supply closet, leaned her head back against the wall and closed her eyes.

      “Go home.”

      “No,” she said, jerking her head up and pushing off the stool. The floor tilted, and her hands shot out reflexively for balance. “I’m fine. I just needed a second.”

      Zamir, her supervising doctor, put a gentle hand on her shoulder and urged her back onto the stool.

      “Take that second and then go home. That’s an order,” he said.

      “I haven’t eaten anything. That’s all it is.” That and no sleep.

      “Don’t argue with your superior.”

      Hope rolled her eyes. Zamir could never nail a harsh tone when it came to her. He was closer in age to her much-older brother, and, given that he’d grown up as a family friend, he often teetered between his role as her supervising medical officer and a caring friend. A lot. Only, he knew full well that Hope wasn’t interested in anything but focusing on her education and career. Hope brushed his hand aside and stood, taking a deep, readying breath.

      “You need me here. We’ve lost two patients already this morning, and there has been no news of the rest of the staff coming back. I’m not going anywhere.”

      For two days now, they’d been running on bare threads. It was bad enough that, under normal circumstances, Nairobi’s public hospitals were grossly underequipped. Only months into her internship, she’d already witnessed patients either dying or being turned away due to lack of medical equipment and supplies alone. Even children. God, the children broke her heart. Now, to add insult to an already critical situation, delayed government paychecks had spurred a strike by the majority of their medical staff. As an intern, her pay was barely worth counting anyway, but she wasn’t here for money. She was here to help, but this...this was like asking a gnat to save a drowning shrew.

      She turned to head back toward the main area. Failure wasn’t an option. Not for an Alwanga.

      “Hope, don’t be stubborn,” Zamir said, stepping in front of her. “You need to get some sleep or you’ll be useless. You’ll start to make mistakes. I can’t have that happen. Stay and I’ll write you up.”

      Hope stopped dead in her tracks, then looked right at him. Her pulse drummed at the base of her throat.

      “That man did not die because of me,” she said, pointing down the hall toward the patient they’d just lost. “I did everything—”

      “I didn’t mean him,” Zamir said, shaking his head and holding up his palms. “You were brilliant in there. Hope, that man had been thrown from a boda-boda. He didn’t have a chance. Not with what we have here. But I need you to get some rest before I end up having to resuscitate you. Or before you do make a human mistake.”

      Hope pressed her lips together and cringed at the mental image of Zamir resuscitating her. He’d love that, wouldn’t he? Zamir to the rescue. Always looking out for her. That was exactly why her parents loved him so much.

      But he was right. Anyone who dared hitch a ride on Kenya’s motorcycle-styled taxis, manned by an array of notoriously reckless drivers, was gambling with death. She’d done what she could, stepping in to assist Zamir in the absence of more experienced doctors and nurses. But her trained immunity to the stench of violent death had failed her today. The lack of sleep really was doing a number on her senses, and the last cup of lukewarm coffee she’d guzzled hadn’t done much to help. She ran both hands back over her chin-length waves. She still wasn’t used to the texture after her mom insisted she have it relaxed a few weeks ago. “Fine,” she said. “Just for a few hours.”

      “Don’t come back until tomorrow. I’ll find someone to help. Maybe the strike will be over by then,” he said, twisting his lips. Neither of them was holding out hope on that count. Even if it did end, the suffering and loss would have still happened. The supplies and equipment needed to better serve the majority of locals too poor to seek help from private hospitals or doctors—such as her parents—would still be an issue.

      Hope nodded and walked away, too tired to argue anymore. What was the point? After finishing up her year here, she’d be moving on to her master of medicine in orthopedics before joining her parents’ private practice. That had always been the plan. All she was doing right now was rolling a boulder uphill.

      She grabbed her things, made a quick call to Jamal, their family driver, for pickup and fled the building. A well-dented matatu packed with passengers revved its engine and missed her by two feet as it sped away from the curb. She gasped, then coughed out a lungful of exhaust fumes. And there was the reason she didn’t drive. One had to have a little daredevil and adrenaline addict in them to navigate the streets of Nairobi. Being a passenger was scary enough, but she trusted Jamal. He’d been her family’s driver since she was an infant, hired right after her parents had employed his wife as a housekeeper and cook, because at the time, with Hope’s medical needs and heart surgery, they’d needed the extra help.

      She made her way to where she spotted Jamal waiting. The October sunshine cleansing her face made up for the emergency room “aromas” and exhaust fumes. Boy, was she glad their family home was outside the city. Although lately, she hadn’t spent much time there.

      “Jambo,” she said, climbing in with the oversize woven shoulder bag she carried her life in: clinical books, notes, wallet, a few toiletries and probably a few items lost at the bottom that she’d forgotten about entirely.

      “Jambo, Hope,” Jamal said, closing her door, then making his way around to the driver’s seat.

      She quickly pulled off her socks and shoes and slipped her achy feet into the sandals she kept tucked under the front seat. She sighed and leaned back.

      “Home?” Jamal asked.

      “No, I need to stop at the university first. Then Chuki’s, then home.” She wouldn’t be able to truly relax until she dropped off inhaler samples for Chuki’s little sister. Her friend’s family had been struggling financially for a while now, and the least Hope could do was to try to help out. Especially with the strike going on.

      Jamal glanced at her through the rearview mirror before turning his focus on the road.

      “You look pale. Dalila told me to tell you she’s making some fresh mandazi just for you. She said not to tell your parents. She’ll have stew ready by the time they come home,” he said, winking at her through the rearview mirror.

      “Mmm.” Hope closed her eyes and savored the mere idea of a warm homemade doughnut. Her only vice. Her stomach growled, and she pressed her hand against it. “Dalila is an angel,” she said, barely lifting her heavy eyelids.

      “I know,” he said, grinning.

      Hope gave in to sleep as she smiled back. Not much of a nap, given that the campus building where her brother’s research lab was located wasn’t far enough for the solid dose of REM sleep she needed. She woke up at Jamal’s prompting and dragged her groggy self toward the building and up the stairs to her brother’s genetics lab.

      “Jambo,”