Ellen turned away and followed Britta. They traced a circle round the chaos of the unloading bay. Young men were staggering, bent double under sacks of rice, carrying them out from the back of the truck. At one side of the clearing, they tipped the sacks over their shoulders, letting them fall, slap, raising a cloud of dust, onto the pile growing there. The air was thick with shouts. Britta led her past the vehicles to the entrance of one of the giant tents which stood nearby, close to the brick building.
The sun was filtering through the canvas roof, making the light inside dappled and soft. They had entered a women’s ward with two rows of field beds, about twenty in all, tightly packed together. Ceiling fans whirred overhead, battling to clear an oppressive bodily smell of stale breath and vomit and urine all papered over by disinfectant.
A young Pakistani girl, wearing a dark purple salwar kameez, was at the far end of the ward, washing a patient. The patient, a middle-aged woman, sat, hunched inwards, holding onto the girl’s shoulder for support. Her back was bare, the skin glistening. The young girl was sponging down her thin shoulders. Her movements were brisk and rhythmical. The water splashed in a plastic bowl on the bed as she dipped and rinsed her cloth. She looked up as they came in and nodded to Britta, glanced at Ellen with shy eyes, then lowered her head again to her work.
Britta had walked to the first bed and was waiting for her there. An elderly woman lay on her back, her eyes closed. Her left arm was bandaged and raised.
‘Gunshot trauma,’ Britta said. ‘The elbow is fractured. Malnutrition and fever also. Many of these ladies are not strong.’
The old woman’s skin was puckered and deeply wrinkled. Her veins were raised into transparent channels of viscous purple. Her mouth was slightly open, her lips cracked. A fly settled on the woman’s forehead and started to walk across it. Ellen raised her hand and wafted it away. The woman did not stir.
Britta had already moved on to the next bed. This patient was a girl, perhaps seven or eight years old. A drip, connected to her right arm, clicked as it discharged fluid.
She gazed up with dull eyes as Britta laid her hand on the girl’s head, stroking her hair as she talked.
‘Many of them are already sick when they arrive,’ she said. ‘This girl has typhoid.’
A revolting sulphuric smell of decay hung around the bed. Ellen turned, looked away down the ward. She tried to distract herself, to close her nose to it.
‘She is weak,’ Britta was saying, ‘but there are no complications. And she’s young. In a day or two . . .’
The girl’s hand was lying inert on the sheet. The fingers were thin, the nails square and bitten. Britta was talking about dehydration but Ellen was only half-listening. She should take the girl’s hand. Reach out and hold it. Pat it, at least.
Britta went to the foot of the bed to consult the notes there. The hand on the sheet lay motionless, waiting. The ward was silent around them. The only sounds were the swish of the ceiling fans spinning overhead and the low mechanical hum of medical equipment.
Britta straightened up, turned and walked on. Ellen followed, conscious of the girl’s eyes staring unseeing at empty air.
A young woman was lying twisted on one side. Her eyes were closed. Her cheekbones and chin protruded, sharp and angular under a thin coating of flesh.
Britta lowered her voice. ‘As well as medical problems, we have also the trauma. Many of these people have seen terrible things.’
‘In the fighting?’
‘Of course. But also before it, in their lives under the Taliban. The violence and the terror.’
The young woman’s legs were curled up into her body. Her fists made tight balls at her chin.
‘What can you do?’
‘Not so much.’ Britta stood for a moment, looking down at the young woman. ‘We simply don’t have the capacity.’ She seemed hollowed out, eaten by exhaustion. Ellen sensed eyes pulling at Britta from all around, a soft, relentless tug of need.
‘Is there somewhere we could go?’ Ellen nodded towards the back of the ward. ‘To talk.’
At the end of the tent, a canvas flap covered an exit. Britta held it back and they passed through. The area beyond was partitioned by hessian walls into a series of small rooms the size of cells. The clicks and whirrs of the ward were muted.
The first room had been converted into a makeshift office. A table in one corner was piled with files and papers and a battered laptop. The space around it was dominated by piles of roughly stacked cardboard boxes. Ellen moved inside to look at them. Each box was identified by a printed sheet of numbers and a barcode.
She turned to ask Britta about them. A short, stocky woman in her thirties appeared right behind her, blocking the entrance. She was holding a metal basin in her hand and, like Britta, she wore a buttoned white coat. Her skin was dark and her hair completely covered by a neatly folded and pinned hijab. She stared at Ellen.
‘How can I be helping you?’ Her accent was clipped. Her eyes, a deep brown, were overshadowed by thick black eyebrows which almost met above her nose.
‘It’s OK, Fatima.’ Britta’s mild voice rose from behind her. ‘This is Ellen. She’s with me.’
Fatima looked again at Ellen, opened her mouth as if to speak, then hesitated and closed it again. Ellen stepped forwards and offered her hand. Fatima’s fingers were stubby and strong.
‘I’ve just arrived,’ Ellen said. ‘I’m a journalist, with News-World.’
‘I am Fatima, chief nurse here.’
Britta squashed between them into the small room. ‘My right-hand woman.’ She put her hand on Fatima’s shoulder. ‘Fatima is from Egypt. I am from Denmark. We are mini-United Nations here, isn’t it?’
Fatima looked up at Britta, allowed herself a half-smile, then nodded to Ellen and turned on her heel, pushing past the canvas curtain back into the ward. Britta waited until the canvas had fallen back into place.
‘We are both a little nervous.’ She steered Ellen further forwards to the final cell at the end of the row. It too was partly filled with stacked boxes. Beyond them a stretcher was lying on top of a trestle. The stretcher bore the long, lumpen shape of a woman’s body which was loosely covered with a sheet. The sunlight, pressing in through the canvas, touched the surface of the cloth, giving it a luminous sheen.
‘We are only just here and already this is our fourth death. When you came, I was just filling the paperwork.’
‘I’m so sorry.’
The stretcher was narrow. One arm had fallen free and hung loose down the side. The hand was slightly curled as if it were groping blindly for something even in death. The skin of the fingers was slightly yellowed, the fingernails ragged and etched with dirt.
‘What was the cause?’
‘Typhoid. Many of them came off the mountain with fever and diarrhoea. In cramped living conditions like this, typhoid spreads quickly. We have antibiotics,’ Britta sighed, ‘but sometimes it’s already too late.’
‘Are they being vaccinated?’
‘We try.’ She clasped her hands in front of her. ‘Hygiene conditions here are very bad. Water contamination will become worse soon, when the rains come.’
Ellen stood for a moment, looking at the covered body. Britta turned and withdrew. Ellen followed her out through the back of the tent, blinking in the full glare of the sun. She adjusted her headscarf, tugging it forwards to shade her forehead and feeling the prick of sweat in her hair.
Britta was standing quite still outside, her arms by her sides. She had turned away from the tent