Stumbling

I stumble through the dark as I pull on my socks, lace my shoes and slip on my sweatshirt. As I open the gate I almost trip over a pile of human excrement. The darkness is almost complete. Only an occasional star sneaks through the thick layer of angry clouds.

A dry, icy desert wind is blowing across the plain chilling me to the bone.

As my eyes adjust I can barely make out the faintest trace of the path where the white sand makes a slight distinction between itself and the dark flora of the sahel.

I start to jog hesitantly as I fight to keep from tripping and falling.

The only thing breaking the monotony of the obscurity are two dark red glows of distant brush fires illuminating the horizon like a dragon's nostrils.

I wonder if I can find the way.

My thoughts begin to tumble on themselves like stones forever caught in the undertow of a river's eddy.

A seven day old born at home, probably on a dirt floor with a razor blade and some old twine to take care of the umbilical cord. Now I see him in my mind face pinched, eyes squinting, hand clenched, lost forever in the dark clutches of tetanus.

A woman, almost unconscious, breathing fast and shallow, her pregnant belly tender and swollen with blood and a dead fetus from a ruptured uterus. A c-section and hysterectomy later she is rapidly being transfused to desperately save her life. A week later I have her belly open again in front of me with intestines glued together with the destructive inflammation of blood clots. Multiple blood transfusions later I'm forced to open her skin wound to let out the post operative infection.

A small girl with a swollen belly returns to see us after two successful courses of treatment for Burkitt's lymphoma but who decided to not come back for her further doses and now has a spleen and pelvis filled with knotty tumours.

A slender, beautiful 11 year old is back hospitalized after the surgery to remove her rotting lower leg bone sticking out wasn't complete enough to remove the year old infection.

A 22 year old woman with a small baby dies of heart failure due to a heart rhythm disturbance we are unable to diagnose and treat due to lack of equipment and medication.

Another 7 day old has parents who refuse to be hospitalized with fever and a swollen belly and then comes back one day later on death's door.

Five hernia patients wait patiently outside the operating theater.

A woman is referred from a health center 2 days after being diagnosed with appendicitis and treated with aspirin and worm medicine.

A tall, striking 19 year old HIV positive woman comes back with her one and a half year AIDS baby who's bloody diarrhea just won't let up. Her husband is out of town on "business".

A man comes in with small, non-itchy blisters all over his body and is found to have HIV and syphilis.

Drums, drums in the deep pound out a solemn, enchanting rhythm through the night as wails and shrieks waft over the village of Bere like sulfurous trails of smoke below piercing red eyes.

And I'm just talking about yesterday as I stumble once again through the pre-dawn darkness.

I stop by a twisted, gnarled stunted tree trunk with a few branches and scattered leaves. I pause to stretch and as I do the sadness, frustration, fear and inadequacy that has been exploding out in shocking anger now bursts on the scene in deep, uncontrollable sobs as the tears pour down my cheeks.

I continue on, straining to see the road ahead, trying to cry as my out of shape lungs suck in the dry, cool air. My hands are deep in my sleeves and my hood is up desperately trying to chase out the chill.

I pass the first great tree and then turn around at the second according to my habit.

The path is a little clearer. A steel grey sky is starting to peer through the clouds. I pick up speed as I head for home.

The dawn is about to break.