When your Dad can crash his airplane into two water buffalo, life is unlikely to go according to plan. Even so, Emily Joy puts on her rose-tinted glasses, leaves behind her comfortable life as a doctor in Britain, and heads off for two years to a remote hospital in Sierra Leone. There she finds the oranges are green, the bananas are black, and her patients are very ill. There's no water, no electricity, no oxygen, no amputation sawand Dr. Em is no surgeon. And there's no chocolate to treat her nasty case of unrequited love. Dr. Em's problems are tiny compared to those faced by the people of Sierra Leone on a daily basis. If they can remain so optimistic, what's Em's excuse? Our green doctor is a bit of a yellow-belly, often red-faced, trying to fight the blues. But green oranges give sweet orange juice. Never judge a fruit by its color.
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About the Author
Emily Joy was a doctor, and is now an author.
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Green Oranges on Lion Mountain
By Emily Joy
Eye Books LtdCopyright © 2010 Emily Joy
All rights reserved.
Surgery for Non-surgeons
And the Golden Rule, Dr. Joy?" "Where there's pus, let it out."
"Exactly. So if you learn nothing else ..." Mr. Lord stared down at the cat's cradle of sutures imprisoning my stubby fingers.
"Remember never, EVER, sew up an infected wound. Especially in a hot climate. The rest is in here — twenty years of African experience." He thumped a tome the size of the Glasgow yellow pages. "Maurice King's Primary Surgery. Everything you need to know from lancing boils to amputating legs."
What? Surely no one would seriously expect me to amputate a leg? Fortunately the phone rang, rescuing us from further insights into the alarming contents of the DIY surgery book.
"Mr. Lord, this is really too much" shrieked an irate female voice, "There's been a delivery to Casualty. From your butcher!"
Mr. Lord held the handset at arm's length. "Indeed?"
"It's dribbling something unspeakable all over my desk!"
"We'll be right there. So, class," He grinned. "Time for our practical."
Mr. Lord marched briskly down the corridor, his moccasins making no noise on the shiny white tiles. My friend Morag (slim, pretty, crisply ironed, compassionate, steady, able, hardworking, serene, professional and if that wasn't bad enough, ever so nice too) glided beside him. I trudged behind, wondering if Voluntary Service Overseas actually believed we could be turned into surgeons in a week?
"I believe you have something for me?" Mr. Lord beamed at the middle-aged receptionist. She thrust a Marks and Spencer's carrier bag over the counter.
"Much obliged." He turned back to us. "Let's practice our bowel anastomoses."
Morag and I exchanged horrified glances. Mr. Lord was talking about major abdominal surgery.
"This way." He held open the swing door opposite. "The plaster room appears to be free."
"Mr. Lord." The receptionist peered over her glasses.
Once inside, Mr. Lord released a tangle of sheep's bowels, letting them slither onto a metal tray. "My butcher is always most cooperative."
We gaped. "Come, come, no time to lose. Trouble with your gloves, Dr. Joy?"
Mr. Lord handed me ten feet of clammy intestines just as I was trying to free my middle finger from the index finger-hole. His slimy offering sloshed faecal fluid across my newly laundered white coat.
"Hold the ends up, woman. Are you trying to give your patient peritonitis?"
Gulping back my nausea, I set to work on the sheep's innards while Mr. Lord paced behind us. "Let us pretend that the middle foot is dead bowel that you have just released from a strangulated hernia. Smooth away the bowel contents back to healthy tissue. Good. Double clamp either end ..."
What would VSO say if I wimped out now? Even worse, what would Morag say? It would mean she would have to go to Zambia on her own, but really, I wasn't up to this.
"Dr. Joy, are you concentrating?"
"What? Yes, of course Mr. Lord."
Ten minutes later, I knotted off my final stitch. Morag's intestines were already neatly arranged on the tray.
"So. The moment of truth is upon us." Mr. Lord declared with relish. "Have you saved your patient's life? Will your anastomoses allow the bowel contents to pass freely without leakage? Undo your clamps!"
We gingerly released the clamps that had held back the intestinal juices from our newly stitched anastomoses.
"Hold up your intestines to test the join. Good, Dr. MacDonald, absolutely watertight, excellent ... Oh dear, Dr. Joy."
Faecal fluid oozed between my stitches and dripped onto the table.
I couldn't do it. Well honestly, even with Morag holding my hand, how was I ever going survive two years running a hospital in the back of beyond?
So while Morag packed her bags for Zambia, I returned to verrucas, colds, bad backs and enough marital misery to convince me that being single was probably a blessing. In fact I turned out to be quite a good doctor, but I couldn't stop dreaming of the world beyond my cosy backstreet surgery. One day, after hearing about Mrs. Jones' twenty-two separate symptoms, followed by a drug addict calling me a fucking cow for not replacing his methadone script that had allegedly been eaten by his dog, I finally decided I had had enough. I picked up the phone to the VSO Postings Officer. Surprisingly, prior cowardice was no barrier to future employment.
"Excellent, we need a Doc in Sierra Leone."
South America, how exotic! My atlas index sent me to page 36 — Africa? And sure enough, there it was — Sierra Leone, a country the size of Ireland on Africa's western bulge, sandwiched between Liberia and Guinea. I had heard of Liberia, thanks to an unpleasant sounding civil war a couple of months back. Hmmm, civil war a hundred miles from my new home didn't sound too good. Still, there'd been no recent media attention and no news was hopefully good news.
The details of Serabu Catholic Mission Hospital fell through my letter box the next morning along with a four-page resume of Sierra Leone. The name came from an intrepid Portuguese seafarer, Pedra da Cinta, who had spotted the mountainous Freetown peninsula jutting out into the Atlantic Ocean in 1460 and called it Serra Lyoa — lion mountain.
Over the next few hundred years various Europeans passed through, largely to pick up ivory or slaves until some spoilsport banned slavery in 1807. However the British government couldn't allow ex-slaves to mix with polite white society, so decided to ship them all 'home', although virtually none had originated from Sierra Leone. These British slaves were destined for the euphemistically named Freetown (the Americans had a similar idea and called Sierra Leone's neighbour, Liberia). Most of the early shipments died — those that disease spared were killed off by the indigenous Africans.
Undeterred, the British Government tried to mould the survivors who had no common language or culture into a homogenous Christian community — the Freetown Krios. The rest of the country was labelled a 'Protectorate'. I think that meant that the gold, diamonds, rutile (used for white paint and the coverings of space ships), aluminium bauxite, palm oil (used in making the original Palmolive soap) and piassava (used for the bristles in sweeping brushes) were protected for the exploitation of the British, but history is rarely the strong point of we scientific types. Admittedly railways, power stations, hospitals and telephone lines were built in exchange for removing the aforesaid goods (or in order to remove them more efficiently). We British even set up black Africa's first institute of higher learning, Fourah Bay College, to turn the Krios into teachers and missionaries.
By 1961, the British were washing their hands of the colonies and handed Sierra Leone over to Sir Milton Margai, a former doctor (should have been a good bloke then). Unfortunately the reins of power were soon seized by one Siaka Stevens.
Siaka Stevens and his Swiss bank account did very nicely. So nicely that there was not a single railway line, power station or up-country telephone remaining when he retired thirty years later. Nor was there any opposition (opposition having been conveniently outlawed, murdered or executed) to his handpicked successor, Major General Momoh, commander of the armed forces.
Momoh made his own fortune from the British, the Lebanese and various others with rich pale skins, by coming to an agreement whereby they could help themselves to the gold, and the diamonds and the rutile and the bauxite, without having to worry too much about little inconveniences like tax. Meanwhile the sixteen tribes that made up the four million strong population of Sierra Leone continued to scrape an existence off the land.
Sierra Leone's only claim to fame seemed to be that Graham Greene had once stayed in Freetown and written The Heart of the Matter about the British colonial days, when Sierra Leone was known as 'White Man's Grave' — largely due to the particularly lethal falciparum malaria.
White Man's Grave rather missed the point if you looked at the statistics for the indigenous population. With a life expectancy of 42 and an under-five-mortality of 20% (the world's second worst), the black men, women and particularly children were filling graves much faster than their expatriate counterparts but who cared about them?
That was where I came in. I would care. I would make a difference. I would change those statistics. ...
Five months later, I was sitting on the toilet at Gatwick Airport opening a bag of Maltesers. I popped a couple in my mouth and leaned against the cistern to stare at The Pregnancy Advisory Service number. Not that I was ever likely to need their services. 'Finding a man' was on my list of goals — after saving the world, saving lives and saving my soul. And losing weight. Four more Maltesers followed their siblings.
Hiding in the Ladies to avoid check-in didn't say much for the state of my soul and with only two blokes in our group (a little Cockney mechanic and a married man pushing fifty with a wooden leg) finding a man had to be easier in Dunblane.
That left saving the world (always a bit unrealistic) and saving lives (not likely after the Surgery for Non-Surgeons course). I stuffed a handful of Maltesers in and crunched. Although I wore a mantle of sunny optimism, my robust exterior and endless jollity belied my lack of self-confidence but then, of course, all extroverts claim to be shy. People my size, with the voice to match, are not allowed to be vulnerable.
My voice. Ughh, now there was a thing. Too loud and too English. How I longed for a soft Scottish burr like Morag's. I had spent six years at Dunblane High School and six years at Edinburgh University, declaring that I was a real Scot. It wasn't my fault that I had spent my pre-school years as an Air Force daughter (until my father crashed his plane into a water buffalo which inconsiderately ambled across the runway). With this hereditary tendency for embarrassing disasters, why was I setting myself up for more?
"OK, Em. You don't have to go." I was right, I didn't. I hadn't checked in and could easily sneak off before my VSO compatriots even knew I'd arrived. There were other ways of achieving my goals. I could go on a diet, for instance. Hell's bells, I could even start going to church!
I rummaged around in the bottom of the bag of Maltesers to find only a single osteoporotic crumb of honeycomb. Pathetic. I crumpled the bag and was about to sling it on the floor when my middle-class upbringing got the better of me. I was not a mere smoker who indulged her habit in the toilets and threw her butts in the pan. I was a chocolate eater and we were surely a better breed of addict. I put the wrapper in the sanitary disposal unit and sighed. Time to make a move.
I kicked my rucksacks, crammed with Tampax, rubber gloves and of course Primary Surgery, out of the cubicle. The choice between the rubber gloves and a pile of rubbishy best-sellers had been a difficult one, but AIDS mania filled the tabloid and medical press at that time, and Africa's figures were alarming. Catching HIV from a patient during surgery seemed a cruel reward for attempting to save the world. Another good reason for staying at home.
Turning the cold tap full on, I washed my face under the washbasin mirror. My usually warm brown eyes frowned back accusingly, puckering my neat nose and cupid's bow mouth. Perhaps the straight dark bob with Cleopatra fringe didn't flatter my square face and perhaps if I ever tried a little makeup? Still, I looked quite young for twenty-seven — a sturdy example of a female Homo Sapiens, built to withstand the rigours of Africa. Nice teeth too, I was told. I smiled to reveal my best feature. All the better for eating with.
"Hi, Emily, you're here!" I jumped. Lindsey dropped her bags next to mine and threw her arms round me. "The others are all checking in. They thought you'd wimped out!"
"No way!" I laughed. "Not me!"
"That's what I said," Lindsey giggled in a lovely Scottish lilt that I would have killed for. It was hard to imagine a more unlikely librarian. "Wait for me, would you? This is the fourth time I've been. I'm so excited!"
I watched Lindsey's svelte figure slip into my cubicle then cursed at the mirror.
Positive thinking. That was the trick. Visualise yourself as you want to be and it will be so. I closed my eyes to imagine my metamorphosis, two years hence.
There I was, slim and glamorous, an accomplished surgeon, stepping off the plane on the arm of a handsome diplomat, my friends gaping at the swan before them. ...
"Dream on." I stuck my tongue out at my reflection "Just try to survive two years without killing too many patients or sticking yourself with an AIDS-infected needle."
At least there was still time to buy another bag of Maltesers.
We exited the Ladies, arms linked, and spotted our fellow VSOs standing in line at the Freetown check-in desk, each accompanied by matching bulging rucksacks.
"Kushe everyone!" I waved over-enthusiastically.
"Hey, it's the Doc! Told you she'd show up eventually." Klaus waved back. Good Lord! What had happened to his hair? People called Klaus really shouldn't have a skin-head.
Klaus was the Cockney mechanic, despite the name bequeathed by a German father. He was a thirty-year-old ex-rigger, who had worked in Saudi and the North Sea, before adding Sierra Leone to his rather dubious list of workplaces. Half the size of my idea of a rigger, he seemed even shorter with no hair.
"Klaus! Love the hairdo!" I rubbed his shorn head. Neo-Nazi or Buddhist monk, it would undoubtedly prove cooler than my bob.
"So, Doc!" Mike with the wooden leg appeared and put his arm around me. "You didn't abandon us?"
"Would I do that?"
"Course not, we need you to tend to all our ailments," winked Mike. "Glad you're here too, mate." Mike thumped Klaus on the back. "Rescue me from all these women, eh?" Mike's much younger wife smiled indulgently beside him.
"Pity we're posted miles away from the delectable Lindsey." Klaus nudged Lindsey's shoulder. Lindsey tucked a wayward brown curl under the twist of multicoloured material holding her fringe off her forehead, and stuck up two fingers.
"Good odds though, Klaus. Seven to two!"
"Six to one," corrected his wife.
"Of course darling."
"Six to one, and take a look at the one!" I thought, eyeing Klaus unkindly before adding out loud. "So tell me, Mike, what's with all this extra luggage?" I looked down at his two large rucksacks, plus a three-foot oblong box.
"My spare leg."
"In case this one gets eaten by termites."
"A hazard of wooden legs, I suppose."
"Not with my high-tensile graphite number. Look." Mike hoisted his trouser leg and unstrapped his leg as the queue shuffled forwards around us. "No termites are likely to get this boy."
"It's so light!"
"Shhh! I claimed an extra twenty kilos," Mike whispered. "And since good old VSO is too PC to quibble with poor disabled me, there's lots of extra books and sweeties for us!"
"You are defrauding VSO of valuable funds," a high-pitched Home Counties voice cut in. Susan was a medical secretary who would be teaching typing to Salonean college girls. Unlike the rest of us who all wore light cotton trousers and a T-shirt, she was dressed thirty years out of her time, in a brown corduroy skirt, brown jersey and high-necked lacy blouse, set off by delicate pearl earrings nestling in short blonde curls. "Funds that could be better spent on the Africans we are trying to help."
"Oh Susan," Lindsey sighed. Mike just laughed and strapped his leg back on.
"So, girls." Lindsey changed the subject. "How did you fit two years' Tampax into your bags?"
"Left everything else at home."
"Won't it be the rainy season when we arrive?"
"Yees?" Lindsey furrowed her brow. "Why so concerned, Susan?"
"What will happen to all the Tampax if our rucksacks get wet?"
We collapsed in giggles at Susan's face and the vision of hundreds of expanding tampons bursting out of our bags.
Keen to thwart any potential VSO uprising, the customs men pulled Susan aside and started rummaging through all her Tampax. They obviously didn't believe anyone could look so innocent. Whilst Susan blushed, the Neo-Nazi mechanic popped his bag onto the conveyor, where it slid unobserved past the TV monitor displaying spanners, monkey-wrenches and all manner of other lethal weapons.
"What have you got in there?" I asked as Klaus swung his bag off the conveyor belt as easily as if it contained a mere change of underwear.
Excerpted from Green Oranges on Lion Mountain by Emily Joy. Copyright © 2010 Emily Joy. Excerpted by permission of Eye Books Ltd.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Surgery for Non-Surgeons 11
Arrival on Lion Mountain 21
Stand Back I'm an Administrator 29
What for Chop Today? 37
Oh Lord, Give this Patient Well Body 51
I'm Not Old, I'm Just Ugly 59
Locked Out 67
Break a Leg 75
Let Them Eat Plassas 81
A Woman's Life 87
A Christmas Carol 95
The Junkie 107
The High Commissioner's Party 113
No Socks, No Sex 125
Mariama's Wedding 135
Where Mi Krismas? 141
Happy New Year 149
Saffa and Scooby 153
Creature Crawling in Abdomen 161
Raising the Roof 167
The Rebels are Coming 173
The Refugee 181
The Refugee Returns 187
Post Evacuation Blues 195
Phillippe's Party 201
Guarding the Hospital 207
Rebels this Way 215
Last Orders 221
Running Away! 239
Queen Without a Throne 247
Emergency Operation: Please Bring Welding Equipment 255
Epilogue 2003 279
The Return of the Prodigal Daughter 283
Epilogue 2009 299
School in Africa by Art(11) 301
Sierra Leone: A Potted History 306
What People are Saying About This
Very down to earth, very funny, very human. (Sarah Ferguson, Duchess of York)