The Flesh of an African Heart by Ilanit Chernick

The heat of the sun made me sweat. It was only 7:30 in the morning, but the sun shone on my bed as though it were midday. My clothes were stuck to my body like bubble-gum sticks to your hair. I needed a shower, but I remembered the water had run out again.

I had been up all night with Vincent; a fifteen-year-old boy with Tuberculosis. We were still waiting for the medical convoy to arrive. He needed treatment and he needed it fast.

I was used to the dirt roads, non-existent electricity, water shortages and the shanty settlements. As a doctor in the middle of the Bush, you have to make do with what you have. It was hard to believe that a six-hour drive from here would lead me back to the hustle and bustle of Johannesburg; a cold yet cosmopolitan city where business tycoons ruled and the tall buildings in the CBD made one shiver. Getting caught in the city at night isn’t advisable and you’d be hard done by to find yourself in Hillbrow. Hillbrow is synonymous with drug lords and prostitution and yet, to many, it is still a safe haven in comparison to the prison-like shacks one once lived in on the edge of the city during Apartheid.

I live in Bushbuckridge, a rural town in Mpumalanga. After the dawning of democracy in 1994, it was declared a part of the Limpopo province, but local in-fighting between the municipalities forced this small town to once again become a part of Mpumalanga. The argument, albeit ridiculous, was that Mpumalanga’s ‘capital’, Nelspruit, is much closer to Bushbuckridge than Limpopo’s ‘capital’, Polokwane. Eventually, the government was forced to heed the request of the people and grant their wish to become a part of Mpumalanga.

During the constant bickering, I found it tragically humorous that an argument over the town’s provincial placement was viewed as more important than the well-being of the community that lived just beyond its borders. With no running water, no electricity and contemptible service delivery, the municipality’s biggest concern was not its people, but its placement.

My training as a doctor in Soweto gave me a taste of what was to come during my years as an intern, but it did not prepare me for the difficulties I would face here.

Bang! Bang! Bang!

My thoughts are abruptly interrupted.

“Doctor Du Toit! Doctor Du Toit!”

Bang! Bang!

He continues to pound on the wooden door. I worry it cannot take his weight.

I roll out of bed and call back, “I’m up Lebo, thanks for the wakeup.”

I change out of my worn tracksuit pants and faded white vest into my bright blue scrubs – a blank canvas of blue, ready for the stains of pain, blood, bile. I slip my white coat on and place my stethoscope around my neck as I enter the clinic building. The stench of stale air and sweat winds me to the depths of my lungs.

All around me children are crying; painful moans carry from behind a white screen. The stale air continues to circulate around the airless room. One room separated by screens and curtains. This is no hospital. But this is where we are going to save lives. There are two of us from the city. Chris and I look at each other, fear erupts inside.

I am a privileged white girl from the northern suburbs of Johannesburg, standing in the messy middle of rural South Africa.



It’s everywhere. My gloves, my coat, my scrubs, my takkies. It won’t stop. The mud floor is turning red. I can’t understand why the blood continues to flow. It was a deep cut in his chest but not large enough to cause this much blood.

“He’s not clotting! Get me more lap pads!” I shout to the nurse.

He flat lines.

“Damn it! It won’t stop. Call it,” I hear the senior doctor say in my ear.

No, not today. Not on my watch!

“Call it Daniela …”

I continue working on the young boy’s lifeless body. My gloved hand is inside his mattered chest as we crack it open, the soft flesh of his heart fills my finger-tips. We have to keep his heart going. The Medivac is on its way. We can save him.

“Time of death: 3.45pm.”

His hand is on my shoulder, “let go. It’s over. You did your best.”

Minutes later he is on the phone, “cancel the chopper. The boy is dead.”

His tone of voice is lifeless. Emotionless.

“It’s just another one,” he says with a chilling casualness. My insides squirm, the knot in my stomach tightens. My face burns with anger. Apartheid still reigns in the back of Chris’ mind.

A service delivery protest had gone awry. Five people are dead, scores injured. The young boy was the fourth victim. There is still one more – Chris cannot save him.

I walk motionlessly toward the basin, blood cascading down my body in a waterfall of sadness, shock and anger. I thought this was a sight seen only during Apartheid. Brutality and violence is still a common sight in the outlying areas.

I notice a tear in my glove, right at the top by the nail of my forefinger. I panic. I get to the basin and quickly scrub down, throwing off the gloves. I check my fingers feverishly, no cuts anywhere. I’m safe … I’m safe … I breathe a sigh of heavy relief.

The following day, an old “mama” talks softly as I listen to her lungs. “The end of Apartheid did not change things for us here,” she says despondently. “Things here, they are still the same. They will never change. We live here, we die here … .”

“Take a breath for me Mama.”

She breathes in slow and deep, “… out there in the cities, that is where change has come. Not here. Never here.”

Her lungs are clear. For a 92-year-old woman, she is in good health.

“I’m still alive?”

I smile, “impilo enhle Mama, impilo enhle.”

Ngiyabonga kakhulu Sisi, you are a good doctor. God bless you.”

Her granddaughter hands her a walking stick. She refuses to let me help her down from the bed.


Dynamics in the rural settlements are strange. In the city, there is still an invisible barrier that one can feel at times. Yes, we all live in a democracy now. We have equal rights and votes. We work together, walk on the same streets. But we are too afraid to face our past. We do not say what is on our minds because South Africans have a problem: we are too polite.

Race by race we do our best not to offend our black or coloured counterparts. I try not to talk about our family’s black domestic worker in front of my black colleagues and when I do, the usual dilemma fuels confused thoughts: ‘Do I call her my maid?’, ‘My helper?’, ‘My domestic worker?’ I am too afraid or too polite to say something that might offend those in my surroundings – especially in the new South Africa. These barriers bind us to silence and abet politeness.

“Is it wrong?” I ask as I trace my finger across the rim of a beer bottle. We’re sitting in the local shebeen, a Castle in hand. Rain thunders against the tin roof sheltering us from the downpour outside. Lightning flashes overhead, specks of rain fall violently onto the veranda. The coolness is a reprieve from the usual heat. There will be many mosquitos out tonight.

“Is what wrong?” responds Chris.

“To feel guilty … for all of this?” I gesticulate toward the tin shacks. “I mean, are we responsible for this? Did my ancestors do this?”

He laughs, “They’d be living like this without them too you know. Colonization was a part of life back then. The Dutch, the Brits … the Afrikaans. The ‘other’ was the ‘other’, no questions asked.”

“Are you racist?” I demand, staring at him seriously.

“What?” he starts laughing again. “Would I have chosen to come here if I was?”

He raises his eyebrows, a wry smile plays across his mouth and he shrugs his shoulders. “You’re too sensitive Daniela. Were your parents white freedom fighters? ‘Cause it sounds like that you know. I’m not saying it’s a bad thing – my parents were those kinds of people. Used to protest all the time on the Wits University lawns. But now under the current government, place has gone to kak if you want my honest opinion.”

I’m about to answer when the old bartender calls to us in “Englu”: A term we’ve coined for the broken Zulu and English spoken to the white doctors. We, us three, are the only white “faces” for the next 200 kilometres.

“Doctors, Woza! sikadali yakho isikulungele. It will be cold.”

We grab our steaming plates of stew. It looks relatively edible. We dig in, a silent tension falls between us. Unsaid words which tell the story of this country’s history, of the bonds and boundaries built throughout time.



Home. Its connotation resonates strongly within. We are continuously moving, from one place to the next, naming it to ourselves as home. Wherever we go, wherever we sleep – even if it is just for one night – we call it home. My home is in the bush and my home is in Houghton: two worlds which are separated by the deep barriers entrenched in class and race. I struggle to make sense of their impending collision.

It’s my first weekend off in six months and I have chosen to make the trek home. It’s a long drive. The crunch of the gravel under the wheels concerns me. Potholes spring up like those of rabbits in rolling hills.

As I head along the N4, I stop off in Machadodorp, renamed as eNtokozweni, to fill up my car. A flash of irritation crosses my mind as I think about government’s ridiculous move to rename the old, outlying Afrikaans towns, never mind the big cities. It’s just absurd. The petrol station is small and dilapidated, rolling hills to my right and the Elandsriver to my left. I’m surprised government hasn’t started renaming the rivers too.

I get out the car and head towards the small attendant window.

I knock and a smiling face comes to the window, “Howzit, I’d like to fill up my car please.”

“Sorry Sissi, Joseph is coming. He will help you.”

She turns her head, yelling at the top of her lungs, “JOSEPH!”

She exchanges a number of irritated words with him as a grey-haired black man makes his way out the shop door. He’s bent over.

“He’s slow and old … and a good for nothing …” she says as she turns back to me, “don’t get married. Men, they are pigs!”

I suppress a giggle. She reminds me of the older woman from all those KOO adverts on TV.

Joseph eventually makes it to the car.

“Hi, full tank please.”

“Oil and water? Tyres?”

“They’re all fine. Thanks. Just the fill-up.”

I’d be here for the rest of the day if I let him do anything else. He slowly walks to the pump and plugs it into my tank.

“You need anything else baas?”

“Excuse me?” I respond shocked. I am no baas. This word bothers me like the mosquitoes after a Highveld thunderstorm. He still sees me as his “baas” and he the “servant”, the “subjugated” African who is there to serve the white-man. I am horrified at this prospect. I am no one’s “baas”. We are equals here. And yet I say nothing. I cannot find it in myself to reprimand him for referring to me in such a way. Torn and conflicted inside. A storm of emotions rages within me.

He finishes off. I pay him, thank him and leave. As I get back onto the N4, shame and guilt overcome me. So this is what it’s like – white guilt. I feel disgusted with myself. Twenty years of democracy and still this white skin leers at the black.

There should be no expectations. We are all equals, flesh and blood. Men created in the image of God. There should be no superiority. And yet the complexities of colour and class confound us daily. The realisation hits me: there will be no united or utopian South Africa. Not in my lifetime anyway. I have to embrace the realist inside. My idealism has been shed. There is no going back.



A shack fire has killed three children. An oil lamp spilled over. The children’s parents were sitting in the shebeen drinking while their children burned in their sleep.

I cannot get the smell of burning flesh out of my nostrils. The screams of the families fill my ears as a group of men run with buckets to put the fire out. Chris shoots across the open veld to get the two fire extinguishers from the hospital.

Black, red and orange coil together like deadly snakes lighting up the evening sky as the fire grows higher.

He comes back, brandishing the heavy red canisters of foam in each hand. Together the men put out the fire. All hope is lost.

Chris goes in and bravely retrieves the burned bodies from the shack. My insides are cold. Cries of the mothers are carried across on a gentle wind that starts to blow. There are clouds in the distance.

The fire department arrives an hour and forty-five minutes after the call was placed. The fire is out as they rush in.


I awaken in a puddle of sweat, my body is aching everywhere. The moon shines through my window. As I turn over to grab my water, I feel a stabbing pain. It hurts to breath.

Something doesn’t feel right. Waves of nausea undulate through me. I have to get someone.

Walking toward the door of my container feels like a ten mile walk through the desert. As I stagger toward Chris’s room, I trip over my feet, hitting the earth hard. I struggle to get up; two hands grab me under my arms and help me to my feet.

“You look like shit.”

I look up at Chris’s gaunt face in the moonlight.

“Jesus, you’re as white as a sheet. Let’s get you to the clinic Doc. What the hell did you pick up?”

I start throwing up violently, my legs give in. The last thing I hear is Chris’s voice shouting for help. Darkness envelopes me.


“It could be TB but not all the symptoms ring right.”

“We should get her to a proper hospital.”

“She’s not stable enough yet and if this is something serious …”

The voices are far off; they slowly become clearer as life refills my body.

I open my eyes; a blurred figure of Chris is visible at the foot of my bed. My head is aching, I cannot lift it up.

There’s another white doctor in the room, both have masks and gloves on. I’m in isolation. This is serious.

I start coughing, I feel warm liquid pass my palate.

“Easy, easy,” says Chris gently as he places a silver pan under my chin. It’s dark red in colour … blood … a lot of blood. This is not TB. There is too much blood.

“You’ve been out for three days. We’ve tried two antibiotics … you’re not responding to anything.”

My brain starts to fit the pieces together.

“I need to go.”

“What? You’re not going –”

I start getting myself out of the bed, I’m weak but I can hold myself steady. I grab a handful of tissues. Both doctors try to block me, I push past them. Chris tries to grab my arms.

I try to fight his grip and push him to the ground, running out of the room, still spluttering blood into the tissues.

“Daniela! Are you mad? Get back here!”

Her shack is not far. “The boy,” I heave, I knock on her door as hard as I can in my weakened state.

She comes out of her home shocked at the commotion, “Where was he from?” I scream.

She shakes her head; the barriers of communication block me once again. Her older son soon joins her at the door.

I look at him desperately, “Tokelo, where was he from?”

“Who?” he musters out frightened.

“Your cousin, Jameson, where was he from? He was not South African.”

My breathing is shallow, sweat is pouring down my face, despite it being the middle of winter.

“I don’t know …” he responds.

“Ask your mother, ask her!” I cry.

In his mother tongue, he speaks to her gently. She looks up at me and answers softly, “Guinea, he from Guinea.”

My head explodes. That explains why we couldn’t stop the bleeding. Ebola, he was carrying Ebola. He didn’t die of internal wounds from the protest, he died of a haemorrhage. A bleed caused by late-stage Ebola.

Chris comes behind me, “Are you mad? You’ll infect the whole bloody village!”

A sinister smile crosses my face. “This village is the least of your worries. The boy who died, the day of the protest, he came from Guinea. There is no direct flight from Guinea to South Africa.”

“I need to call the SA Health Organisation …” he stutters out. He runs toward the main building.

“Never mind the South African Health Organisation; you better bloody well call the World Health Organization!” My words trail after him.

“There’s going to be an epidemic …” I whisper quietly.

A sudden quiet falls on the village. A realisation comes to pass.

The deepest and darkest death life has to offer is on the horizon and we are its first victims.