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  Sundaygar stood. He said something to Sister Martha, while Julia made a note on one of the dog-eared green cards, and Sister Martha walked Sundaygar to the dispensary.

  “He is walking to his village now. He is climbing tomorrow,” Sister Martha said, when she returned.

  “Let’s bring tetanus and Silvadene next trip. For the physician’s assistant to have when we are not here,” Julia said.

  “Buchanan Hospital has not Silvadene. The health center has not refrigerator,” Sister Martha said.

  Julia looked away for a moment. Then she turned to see who was next.

  The next patient was a twenty-three-year-old with burning on urination (an antibiotic and a talk about safe sex, perhaps translated, but probably not.) Then an eight-month-old with a cough for two days (clear lungs, normal weight for age, no fever—watch and wait, and come back for difficulty breathing, loss of appetite, or if the cough isn’t gone in a few days. Perhaps translated. Perhaps not.)

  Then Sister Martha brought in a young woman carrying a baby. A limp baby. Eyes open but dull. Breathing fast. Way too fast.

  This was trouble. Julia didn’t need a stethoscope, a thermometer, or a blood test. Bad trouble. Respiratory distress secondary to severe anemia. Anemia caused by malaria. Goddamn malaria. All these kids had it. Julia could spot it from a hundred miles away. Sick. Incredibly sick. Could die at any moment sick. Drop everything and run for cover sick.

  The child would die soon—in an hour or in a day—if somebody didn’t do something. Do something fast. Will die. If Julia didn’t do something now.

  The baby was a girl, six months old but barely eight pounds. She was not moving anything other than her chest. She didn’t whimper. Her chest moved in and out twice as fast as a person’s heart beats; in and out, in and out, in and out, the breathing without sound or obstruction but so fast that the skin between her ribs was pulled in with each breath. The mucous membranes were dry. There was no wheezing. The chest was clear. The fontanel was closed. The muscle tone was not good. The baby was breathing way too fast.

  The child’s mother was in her early twenties, a country girl. She was small, bony, and Bassa-speaking. The mom wasn’t frightened enough. Her matted hair was wrapped in plain mud-stained green cloth. She had a small nose and mouth, and she looked away as Julia looked at her baby in the soft morning light.

  Sister Martha spoke. There were four other children at home. The mother carried this baby for three hours. She walked with another woman, her mother or an aunt. They must have known how sick this child was. They had to know. The baby had been sick for days, maybe for weeks.

  Julia pulled the child’s lower eyelid down with her thumb. The conjunctiva, the red-pink lining of the eyelid, was white, not pink. To Julia, eyelids that pale meant severe anemia. The child didn’t have enough red blood cells in her veins and arteries to sustain life. Malaria attacks and destroys red blood cells. This was malaria, as severe as it gets.

  The child in front of Julia had severe malaria complicated by severe anemia and her heart was beginning to fail. Severe malaria in the bush, where most severe malaria occurs, kills a million African children a year. But maybe not this one. Maybe not.

  “The child must to go to hospital. We leave now. Right now. We bring you and the child to Buchanan,” Julia said.

  Sister Martha translated into Bassa.

  “Torwon. Charles. We are leaving,” Julia said, loud and clear so her voice could be heard out of the room. Torwon and Charles were waiting in the main room, chatting up the ladies. “We are leaving. Now.”

  Torwon and Charles came to the door. Torwon was thin, young, and intense. Charles was a big dark-skinned man in his early forties, a big jovial man who loved to tease.

  It was against the regulations to carry patients in the Land Cruiser. Sister Martha waited for Julia to change her mind, to vacillate as Julia often did. But Julia did not look at the faces of her colleagues. She stared only at the child, and the others could see that her mind was made up.

  Then Sister Martha translated. They were leaving. Now.

  The child’s mother spoke in a quiet voice. She had other children. Buchanan was too far. She was afraid of the hospital fees. The child was not that sick. She needed only the pink medicine.

  “Walk with me,” Julia said. “Bring the baby to the Land Cruiser. Now.”

  Julia worried for an instant about blood for a transfusion. The hospital in Buchanan didn’t have a blood bank. If you needed blood, you had to find a friend or relative to donate what is going to be transfused. Perhaps the mother would refuse. But Julia could give blood herself. This child would be dead by nightfall if she was not transfused.

  The child’s mother kept her seat.

  “Tell her the baby will die in a day or two if we don’t go to the hospital today. Tell her,” Julia said, “that we have to go now. Today. She has to go today.”

  Sister Martha said a few words.

  The mother stood. She went to get her mother or aunt, who waited outside on a worn wooden bench and wore a yellow Port Angeles Dragons tee shirt over a green and blue lapa, a skirt made of brightly colored African cloth.

  So it was they left the District #4 Health Center, breaking all regulations, and traveled twenty kilometers down a rutted one-track road through the bush in a Land Cruiser with a green Merlin insignia and the red silhouette of a machine gun with a red circle over it and the words “this vehicle carries no weapons” stenciled just beneath the silhouette of the gun on the driver’s door and the back doors, with a child who was dying in her mother’s arms.

  In America, there would have been an ambulance, its lights flashing, its sirens blaring, driving seventy-five miles an hour in the left lane of a superhighway, as they called it in over the transponder, and the trauma center at the hospital emergency department would have assembled a team that would have been set up and ready to go the moment the baby was whisked through the ED doors. In Africa, in Liberia, there was a red dust–covered dented white Land Cruiser nosing through potholes still filled with the runoff from the previous night’s rain, hoping against hope that the child might survive the trip, that the Land Cruiser wouldn’t slide off the road or break down, that the hospital would have some blood on hand, that there was IV tubing to use to give the blood, and that the hospital hadn’t run out of antimalarial medicine yet that week.

  There is no malaria in America.

  They drove as fast as the road would allow. They drove over an unusable log bridge that they should have gotten out and walked over. The Land Cruiser jolted into each pothole and sometimes bottomed out with a jarring bang.

  At the end of the one-track road, they turned right, toward Buchanan, and climbed a hill.

  They hit a rut. There was a jolt.

  The Land Cruiser sagged to the left, and Torwon stopped it on the side of the road.

  Chapter Two

  Carl Goldman. Buchanan, Liberia. July 15 and 16, 2003

  THE MORNING OF JULY 15, 2003, WAS BRIGHT AND HOT BUT NOT INSUFFERABLE, BECAUSE a breeze was blowing in from the Atlantic. It was rainy season, so there were puddles of red water everywhere. Red runoff rainwater still coursed through the brooks and streams, which ran deep in the red earth, but the roads had dried somewhat overnight and were passable, to the extent any road in Liberia was ever passable in 2003.

  The junction market next to the Bong County Road just east of Buchanan was already filling with people, even though it was early, just after 8:00. The market was a big open space in the red dirt where women came and built stalls out of wooden poles and sold anything they could carry—charcoal, pots, roasted corn, pineapples, dried fish, tiny bags of spices, palm oil, lapa cloth, and used motorbike parts—to one another. A shantytown had grown up around the market, in and around the walls of half-demolished concrete block houses, the remnants of a neighborhood that had been destroyed by shells and tanks the last time there had been chaos in the streets. Now the shantytown was jammed with refugees, with people who had come dow
n from the countryside ahead of the fighting. The road and the marketplace filled with lorries, jitneys, and cars, with boys on motorcycles—sometimes three or four on a little 90cc Suzuki—and with people walking, the women balancing multicolored plastic tubs on their heads, the men carrying huge overstuffed cheap fabric suitcases, sometimes by a handle, sometimes on their backs.

  A white Land Cruiser pulled into a shop next to the junction market. The Water for Power crew stopped there to buy water and rolls for lunch on the mornings they went north. The Land Cruiser had the silhouette of a machine gun stenciled on the driver’s door, the passenger’s door, and the back door. A black circle surrounded each machine gun and there was a black line drawn diagonally through the circle, and the words “this vehicle carries no weapons” was stenciled just beneath the silhouette of the gun—the same insignia that was on most of the NGO vehicles in Liberia whether they carried weapons or not.

  Then three white Land Cruisers with the blue insignia of the local steel mill stenciled on their doors burst into the intersection from the Bong County Road, their horns blaring. They forced their way into the line of jitneys, goods lorries, cars, and motorbikes that were headed into the middle of the town, weaving in and out. A few minutes later two blue Liberian National police pickups, each carrying five or six armed men and a rear-mounted machine gun flew into the junction, also racing toward Buchanan.

  “Hot time in the old town tonight,” said David Wenang, the driver, who was dark, short, thin, and quick.

  “They’re going the wrong way,” said Carl Goldman. He was in his late twenties, a thin, tall, brown man with an American accent. He sat next to the driver and was trying to be the person in charge. “I thought the government guys are in Buchanan to protect the north. So why are the Land Cruisers headed south?”

  “MODEL move quick-quick,” David said. “Good fighters. Trained in France. Armed by France and U.S. Maybe six days out. Maybe one. Maybe here tonight.”

  “So, if the army and Taylor’s police are off the north road, that means the road should be clear and we should have an easy time. For once,” Carl said. “Let’s move.”

  “Sooner we gone, the sooner we back,” David said. “The sooner we’re back, the better I like it. No clear in Buchanan when we get back. Too many people. Too many refugee.”

  “We have a long day, David,” Carl said. “Better to have those boys in Buchanan than in the north.”

  “Better for there to be no war again and no war in Buchanan. How many places today? Five? Six? Eight? If I was boss we sleep late and wait for the soldier-boys to come, shoot each other up, and go away,” David said.

  “Six places,” said Carl. “Maybe seven. We make a chlorine run to Godeh, a drop and switch. Then we check wells on the way back. Just in and out. We quick-quick today.”

  “Quick-quick,” David said. He put the truck into gear. They lurched forward through the red dust on the red road.

  David drove even faster than usual on the red dirt. There were no other cars on the road. All the life had emptied out of the north, as if it were a sink from which someone had pulled the plug.

  First there were a few people. Then there were no people.

  They passed groups of three or four huts, each group arrayed around an outdoor kitchen shanty—an open cooking fire in the center of a roofed space lined with wooden benches. But there was no fire and no people in the huts. The huts were made of poles and plastered with red mud to make walls that were solid and plumb, with roofs made of palm thatch laid over a precise lattice of poles. The red walls of the houses were marked with repeating patterns in white paint—handprints, footprints, or silhouettes or stripes that looked, in its way, like wallpaper, or war paint.

  People know war is coming again, Carl thought, and they have gone to find shelter in Buchanan, or gone deep into the bush to hide.

  After a few miles, they began to see people again, but these people looked lost, like people standing outside as rainclouds thickened, not sure if it was time to head for cover. A few stood in one or two of the cooking shanties. Some squatted in front of the fires. Others lay on the benches. Still others walked between the houses, going somewhere and not going anywhere at all, all at the same time.

  There were men with machetes walking on the side of the road. These men did not turn to look as the white Land Cruiser drove by and raised red dust.

  But the land was otherwise empty. No animals, no goats or pigs, only a few scrawny African chickens. War was coming. Everyone was afraid of the war, and everyone was afraid of one another.

  Carl saw Julia before he recognized her. Julia was standing on the roof of a Land Cruiser with her hands on her hips. The Land Cruiser was at the top of a rise to the left of the road.

  David took his foot off the gas. The Land Cruiser lurched as it hit a rain-cut ditch and started to slow.

  Torwon and Charles, Julia’s driver and guard, knelt next to truck, positioning a jack in front of a flat tire. Julia lifted the spare tire off the roof, and then lowered it over the side of the truck, her ponytail moving from side to side over her shoulders. Torwon stood and caught the tire.

  Another woman sat on top of the embankment next to the road. She held a baby in a green lapa fabric sling. Two other women sat with her. They sweated in the hot late morning sun.

  “Stop or go, boss?” David said.

  “Stop,” Carl said.

  David pulled the Land Cruiser to the right shoulder, but he did not turn off the engine. He opened his window. The hot moist air of the day embraced them. Carl got out.

  “Ok?” Carl said.

  “Damn road,” Julia said. “Lucky we didn’t crack an axle. Just a blinkin’ flat.”

  “Need anything?” Carl said.

  “Just decent roads. We’ve got it covered. We’ll be up and running in a few,” Julia said.

  Charles, who was squatting on the ground next to the flat tire, grunted as he jerked a lug wrench. The truck groaned as the lug nut came loose.

  Then there was a crack and the car settled, sinking to the side and back, like a boat that had taken on water listing to starboard just before it flipped over and sank.

  “You were saying something about a cracked axle,” Carl said.

  “Damned axle. Damned road. Damned country,” Julia said. She lowered herself off the roof of her Land Cruiser, knelt in the dirt next to Charles, put her hands on the wheel and tried to turn it. Then she wiped her brow with the back of her hand.

  “The effing thing is cracked. We cracked one last week. Goddamned roads. I got a really sick kid here. I got to get to town.”

  Julia paused.

  “Hey Carl, can you run that woman there into Buchanan for me? The one with the kid. We need to get her moved.”

  “I can’t carry passengers. You know the drill,” Carl said.

  “I’m asking for a one-time exception. This kid is really sick. Like could die today sick. You’ll beat me by two hours if you go now. Maybe three. It takes them forever to get a rescue truck up here. They don’t know I have a sick kid, and they don’t know to hurry their asses. I don’t do passengers either. This one is different. This kid is really bad,” Julia said.

  “I’m headed north to Godeh. Maybe I can swing back and lift her in when we’re headed home if your rescue truck hasn’t shown yet,” Carl said.

  “I need you to run them to Buchanan now. This kiddo is going to die if she doesn’t get transfused.”

  “Let’s go boss,” David said.

  “The bush is full of dying kids. It’s also full of boy soldiers,” Carl said. “I’ve got to get this chlorine up to Godeh. They’ve got a bad well that’ll kill a hundred of your kids if we don’t get it treated. Let’s do this. We run to Godeh without side trips. If the roads are good, we’ll be back in an hour. We’ll carry the kid in then.”

  “Carl, I have a kid dying from malaria,” Julia said.

  “And I have a village that will crash and burn without chlorine,” Carl said. “Here’s my best a
nd last offer. I put the lady and the baby in the back with us, blast the AC up to Godeh, and keep everybody comfortable. Then we’ll haul ass back to Buchanan as soon as we’re done up north. It ain’t perfect, but that’s the best I can do.”

  “Nowhere near good enough. But it looks like the best I’m going to get out of you today. Just move ass. Super quick-quick. Please.”

  “Anything for you, Dr. Richmond,” Carl said. “Almost.”

  Julia went to the three women sitting on the embankment. The youngest of the three held a limp baby.

  “Sister Martha, please go with them,” Julia said. “I’ll wait for the crew. There’s nothing more we can do for this kid until we get her to Buchanan. And Sister Martha pray or something, will you? We got this far. But now we are gonna need all the help we can get.”

  Carl helped each of the women into the back of his Land Cruiser. The limp child lay on its mother’s lap. The two other women sat next to her on hard benches. Julia put one hand on Carl’s shoulder as he latched the door, and then touched his waist.

  Carl turned and put the flat of his hand on the small of Julia’s back, “You drive a hard bargain. That’s what I like about you.”

  “Just that?” Julia said.

  “Nothing more for public consumption. Private is different,” Carl said.

  “Later for that. Now move,” Julia said. “We don’t have much time.”

  Carl got into the truck and David dropped it into gear. The Land Cruiser jerked forward.

  They bounced and grunted and groaned down the hill, the Land Cruiser shuddering and thumping as it slid sideways and forward on the rutted red road.

  At the bottom of the hill, the Land Cruiser fell into a deep washout and its undercarriage hit the road surface with a bang. Carl’s head slammed down and back, jamming the bones of his neck. He turned to see if his new passengers were okay and his eyes followed the light through the back window.

  Out the rear window, Carl saw a pickup, which could have been blue, coming across the hill from the right speeding down the District #4 Health Center road, speeding toward Julia and her disabled vehicle. The pickup raised a cloud of dust.