I had side-stepped into a radiant world. Here there was sun every day – the perfect side of the sun; generous with a warmth that holds your face, massages your shoulders and liberates your soul. This African sun does things to you: you stand taller, you laugh easier and you tread lighter on this earth.
My first weekend in Kampala flew by. I was whisked past a sea of new faces and thrown the ropes of a new job and an unfamiliar home. I had no time to register how strange everything was. I felt incredibly alive.
The surgery was located in the British High Commission in the city centre. Rick drove me in to show me the way. We bumped down our mud road through the banana plantations, past men wheeling barrows full of the biggest pineapples I had ever seen, to join the tarmac road in Kabalagala. Two things struck me on the journey: first, that the driving was utterly appalling. There were vehicles of all descriptions (though ’dilapidated’ fits most of them) and the drivers paid lip service to any code of conduct or indeed boundaries of the road, regularly veering to undertake on the murram paths lined with pedestrians. Secondly, never in my life had I seen so many dead dogs, though evidently the Ugandans had as they hardly seemed to notice them. This saddened me, I could see how death was readily accepted here and much more commonplace.
All nerves, I was shown into a drab reception room with grey net curtains at the windows and some threadbare armchairs against the wall. Behind a dark wooden countertop, sitting at a desk almost out of view, was a well dressed, middle-aged Ugandan lady. She introduced herself as Miss Kabego, the doctors’ receptionist, and said that Dr Gibbons would be with me shortly. She was one of those people who go about their work so quietly that you quite forget they are there. There wasn’t a single picture on the walls, so I sat listening to Kampala’s rush hour revving up outside, becoming ever more aware of my own quickened heartbeat.
Down the corridor, a door opened and I jolted upright as a figure approached. If you can imagine that classic, old fashioned doctor – the one with the white brylcreemed hair, the half-moon glasses and slightly bent over, then you have Doctor Gibbons spot on. He even had the tweed jacket and the genteel manner. He showed me into his large consulting room, with parquet flooring, dusty venetian blinds and grey filing cabinets along the back wall. He spoke quietly, so one had to lean forward to catch his every word. And every one of his words was worthy of catching. Dr Gibbons was evidently an accomplished clinician, who demanded respect. Admirably, he was the only GP to survive practising through the horrific Amin years. I was even more terrified for meeting him. On Monday, I had to fill his shoes and how different could I be: young, female and a total novice.
He told me of the types of diseases they saw, the mix of patients and my responsibilities. I was to work full time as his locum, with Wednesday afternoons off, on-call alternate weekends and covering rather vaguely as far as could feasibly be driven within an hour – this was the only western General Practice in the country.
I was starting to feel just a tiny bit overwhelmed to the point of claustrophobia at the thought of coping ON MONDAY with strange tropical diseases, weird insect bites – nay SNAKE bites, rabies, and most alarmingly HIV. The world had only known of this virus for ten years and in that period the infection had snowballed in Uganda and prevalence was at an all-time high. I was expected to handle all this with a limited range of medicines available and no reliable hospital in the country for referral. Things went from bad to worse when the venerable Dr Gibbons opened an adjoining door leading to a dark inner chamber, and announced:
‘Here, Dr North,’ (something told me I was never going to be Kate) ‘is your Lab’.
In England, not since before the war had doctors performed their own lab work. I remember touching on it in the first year of medical school. That was the extent of my laboratory experience. So this was a bombshell.
Panic perculated from deep within, yet my expression was blank with possibly a giveaway twitch at the corner of my left eye. I have a horrible feeling my bottom lip also started to quiver.
‘Oh’ it escaped before I could stop it. Gormless.
‘Um’ now rather high pitched, ‘and what kind of things might one be expected to DO in one’s lab?’
Dulcet, reassuring tones. Age-old with years of experience. ‘Well, now. Let me see. Of course, the most common investigation you will be performing will be the blood smear to diagnose malaria. We see countless cases of gastro-enteritis and our patients are primed to bring in a stool sample. And indeed, urinalysis is plentifold too.’
His calm manner had a way of putting me on edge and the strong smell of disinfectant was not helping the twitching.
‘I don’t suppose you could show me a malaria parasite or two, could you? I mean, we didn’t really get much call for that kind of thing in Milton Keynes’. I emitted a guffawing which tapered off to eventual silence.
Lead balloon pause. I filled the vacuum with more imbecilic prattling (I never learn).
‘And it would be ever so helpful if you wouldn’t mind running me through how to actually make the blood smear, while you’re at it? Ooh and the stool sample, too? If you have time. Please? ‘
He peered at me over his half-moon glasses with bright, kind eyes. ‘Why of course, Dr. North. Now where is that Romanowsky stain?’…
…On my face, I hoped I was presenting an intelligent, enquiring expression. Inside my head, the rubble of the explosion was subsiding to shock.
‘Roman-WHATSKY-stain? MY OWN LAB? Dare I ask him how to operate the microscope, or is that pushing it too far? How does that Sterilising-autoclave-thingy in the corner work, do you think? Oh heavens, there’s a full surgical set of instruments. Please tell me I don’t have to do major surgery too? What about delivering babies? Oh Lorrrd, there’s a centrifuge. What the flip do I do with a CENTRIFUGE?’
An hour later, I stumbled out into the glaring African sunshine, dazed and shellshocked, hoping the Laura Ashley afforded me the composure I was lacking internally. Vincent, the CDC driver took me home and I collapsed on my sofa that didn’t feel like mine, and was about to unwind when I heard shuffling feet and Mauda appeared from the kitchen asking if I could buy her a uniform like all the other housegirls. I managed to put her off by suggesting that we might wait until after her baby was born for the first fitting. She seemed happy with that, though a knowing look in her eyes told me shedding a baby would make no difference to the fitting.
I slumped back on not-my-sofa. It dawned on me that, wonderful as it was to have someone cleaning my house, washing my clothes and guarding my house, privacy was a concept that would be different from now on. Moments like this would be shared with the staff, there would be no more crying or arguing or cuddling in our own space. Our house and garden were now shared with staff, who would stand on the side-lines, spectating our highs and lows, commentators no doubt, intruders of our personal space.
Luckily for us, Mauda and Fabian were more than happy to knock off at 5pm on the dot and retreat to their lodgings at the back of our house, in perfect timing for Rick’s home-coming; bringing relief, familiarity and reason to my day. No time to dwell, we were off out to the British High Commission Bar because it was Friday night and this was what expats in Kampala did. Those first Friday and Saturday nights blurred in a mass of introductions: many new characters, faces and places and the memories of them muddied with copious amounts of the local brew. Bell beer, I learnt the hard way, gives a corking hangover. The clue was in the visible sediment at the bottom of every bottle. After a slow start, Saturday was spent nesting : pot plants galore were purchased, which inspired a frenzy of furniture-shifting and generally bestowing a woman’s touch on a somewhat bare, marble-floored living room. Rick was happy and I remembered what it was like to feel newly married all over again.
On Sunday, I was introduced to another custom : The Sailing Club.
Of course! We were half an hour from a lake the size of Ireland: Lake Victoria. It was discovered by the Speke half of the intrepid duo, Burton and Speke, who set out in Victorian times to find the source of The Nile. These two really got on each other’s nerves, so it didn’t help that they both got really sick. However, Speke’s temporary blindness was less crippling than Burton’s tropical fever, so he soldiered on and stumbled across the Lake, which unfortunately he could hardly see on account of his temporary blindness. Because he was a bit fed up of numerous expeditions into the unknown African interior and falling out with Burton alot, he decided to plump for this being the source of the Nile and sped back to London to break the news before Burton could. It turns out it was a jolly good guess. Lake Victoria – Speke kindly named it after his Queen – does in fact drain into the Nile at Jinja and is indeed the source of the river (apart from a couple of tributaries, but we’re not splitting hairs). How strange, that many years later with three kids in tow, Rick and I would spend five blissful years living at the other end of this magnificent river in Cairo.
There were two competing sailing clubs, Kaazi Club for the serious sailors, and Entebbe Sailing Club for the serious socialites who fancy a little bit of sailing on the side. We opted for the latter. Every Sunday, like-minded expats headed out to Entebbe for a day of sunbathing, volleyball and picnicking on the beach. This was not a fancy affair: the clubhouse was a basic, lofty canteen and we all mucked in to serve drinks and provide tucker. Eventually, someone would rev up a motorboat for a spot of fishing, or rig up the sails for a dash of sailing.
On my first Sunday, all was going swimmingly. More Bell beer drinking was interspersed with lopsided volleyball and chess playing. This was a good life and better than emptying out the hoover bag and cutting back the brambles in autumnal MK. Rick became very immersed in a game of chess with a great guy of similar banal banter to us called David. There was activity down at the shore, so I wondered down to take a look. A couple of guys were rigging up a catamaran and using lots of technical-sailing-language like ‘starboard’, ‘boom’ and ‘jibing’ which washed over me as I surveyed the scene. I was stirred from my reverie by the Captain of the operations, asking in nautical terms if I would care to join him for a spin.
Never, ever one to pass up an opportunity, I jumped at the chance and leapt on board. After all the frenetic preparations, it struck me as strange that I was Captain Ian’s only crew member. I consolled myself with the fleeting thought that catamarans must sail better with a small crew. As we set off from the beach, the wind seemed to be whipping up nicely. I was at pains to point out that I had never sailed, windsurfed or catamaran-ed in my life, and that I was also a little bit accident-prone. Ian didn’t seem perturbed by this news and reassured me that it was nigh-on impossible to capsize a catamaran. We did seem to be tanking along very quickly and I noted that the group on the beach were already tiny specks. The temperature dropped suddenly, I looked across the lake and sure enough a dark, ominous cloud dropping its load was heading our way…FAST. I started to regret never, ever passing up opportunities.
At this point, not wanting to appear a wimp but equally not wanting to die today (though that would conveniently get me out of MONDAY and unidentifiable squiggly things in MY LAB), I suggested that maybe we should consider heading back. As I looked at Ian, I recognised the same look of panic in his face that I had tried so hard to hide from Doc Gibbons, and I wondered if doing a U-turn was actually in his repertoire. By now the wind was bashing the boom-thing around, and it took a fair bit of concentration to avoid sustaining bodyblows or the more fatal headblows. I had to shout above the noise of the lashing rain.
‘Just wondering, Ian. Err how many times have you actually SAILED a catamaran?’
I thought he looked sheepish, though it was hard to tell as the sheeting rain was now pounding us both very hard and we were doing that thing they do in the Fastnet Race when the sails are tipped horizontally AND THE SAILORS ARE TIED ONTO SOMETHING. Events overtook us, time stood still and very suddenly the lake water was extremely cold as I registered I was actually IN IT. I swam around to grab hold of the catamaran, and realised to my horror that on my maiden voyage we had managed that nigh-on impossibility: we had capsized a catamaran.
If you can be a gentleman whilst clinging to an upside-down catamaran with egg on your face, then Ian was the epitomy of one. He was gallant and gracious, albeit soaked to the skin, and bashfully confessed he had only ever been on a catamaran twice before. We both sat shivering miserably on the upturned boat and awaited the rescue party, who had witnessed the whole humiliating mishap. Rick recounted later that they had been genuinely concerned for our safety. As it was towed into shore there was a real danger that the inverted mast would snap as it came into contact with land in the shallows. Luckily the force of towing the catamaran swung it the right way up. The entire membership of Entebbe Sailing Club crowded the beach, acknowledging our safe return with a standing ovation whilst marvelling at our incredible incompetance.
Happy our choice of sailing club was indeed correct, and assured we were certainly making our mark on the community, we drove home in the trusty Lancruiser for a crashed-out Sunday evening on our getting-more-familiar-sofa and watched the dazzling sun set behind the tank of Tank Hill.
Had I really only been in the country for three days? So much had happened in such a short time! And tomorrow was Monday and the start of a brand new job. The thought of sitting in that Lab, using a Roman-whatsky-stain to identify unknown pathogens terrified me. In time, I would come to understand that working in a lab can produce some intensely emotional moments. I didn’t know it then, but those four dingy walls were to bear witness to the two most frightening minutes of my medical career, followed six weeks later by two of the most joyful.