Chirwa's son

Chirwa’s son was ill in hospital with pneumonia, so we had promised to pass by and see how he was getting on. “It’s probably AIDS”, said my brother as soon as we were out of earshot. He has been a surgeon in Africa for years and knows more of such matters, but we were little prepared for the scene we were to encounter in the hospital.
Mangochi used to be an important town. Known as Fort Johnson in colonial Nyasaland, it defended the start of the Shire river which drains Lake Malawi into the Zambezi. To my knowledge, no invading force ever came up the Zambezi to invade Nyasaland; aside from the difficulty of negotiating several sets of vicious rapids for which Livingstone and the early explorers had to dismantle their boats and carry them around, there was never anything worth taking and still isn’t. So the country has been left mostly to itself by the empire-backed merchants who stripped most of Africa of its valuables during the past century.
The hospital is new—built of separate pavilions, woven together by long open corridors, and set in ample gardens of dry sand dotted with an occasional sorry-looking jacaranda tree. In the spotlessly clean male medical ward, 40 rusty steel bunks stood in neat rows, a few still covered by the ragged remnants of a foam mattress, most with only a blanket or thin bamboo mat directly on the springs. All seemed occupied by emaciated young men, as was the floor under each bed, and sometimes the space between them. AIDS has displaced all other medical problems in central Africa, and in many hospitals over 90% of adult patients are in various stages of the disease, complicated by every other illness imaginable.
Chirwa’s son was lying in the fourth bay on the left, one bed away from the window. Expecting to find a patient with pneumonia, perhaps already on the road to recovery, we were confronted by the withered ghost of an old man, weighing perhaps 35 kg, and drawing shallow breaths, interspaced by almost interminable apnoeas. Next to the bed sat his wife, a still plump girl who looked considerably younger than her husband, breastfeeding their 6-month-old child.
The most extraordinary aspect of the whole scene was the utter calm and resignation on the face of the young wife as she sat quietly contemplating the inevitable death of her husband, and consequently the almost certain end of her own life and that of their child. There was no trace of suffering in her face, just an expression of extraordinarily serene resignation; of the acceptance that this was part of life and it could not be otherwise.
There is ample evidence that this state of calm is an artifice, carefully maintained for the benefit of the patient, who is enveloped in a cocoon of emotional peace. There must be no room here for nervous speculation, for worries, discussions, and tears: all these will distract him from the arduous task of staying alive. His last strength must be concentrated on fighting the illness which medical science is impotent to solve.
Chirwa’s son, whose name I have concealed from my memories, was perhaps slightly over 20 years old when he died the next day.