chapter 39

Madam September 1997

Ihis hospital no longer treats women," the guard barked. He was standing at the top of the stairs,

looking down icily on the crowd gathered in front of Malalai Hospital.

A loud groan rose from the crowd.

"But this is a women's hospital!" a woman shouted behind Mariam. Cries of approval followed this.

Mariam shifted Aziza from one arm to the other. With her free arm, she supported Laila, who was

moaning, and had her own arm flung around Rasheed's neck.

"Not anymore," the Talib said.

"My wife is having a baby!" a heavyset man yelled. "Would you have her give birth here on the

street, brother?"

Mariam had heard the announcement, in January of that year, that men and women would be seen in

different hospitals, that all female staff would be discharged from Kabul's hospitals and sent to work

in one central facility. No one had believed it, and the Taliban hadn't enforced the policy. Until now.

"What about Ali Abaci Hospital?" another man cried.

The guard shook his head.

"WazirAkbarKhan?"

"Men only," he said.

"What are we supposed to do?"

"Go to Rabia Balkhi," the guard said.

A young woman pushed forward, said she had already been there. They had no clean water, she

said, no oxygen, no medications, no electricity. "There is nothing there."

"That's where you go," the guard said.

There were more groans and cries, an insult or two. Someone threw a rock.

The Talib lifted his Kalashnikov and fired rounds into the air. Another Talib behind him brandished a whip.

The crowd dispersed quickly.

* * *

The waiting room at Rabia Balkhi was teeming with women in burqas and their children. The air

stank of sweat and unwashed bodies, of feet, urine, cigarette smoke, and antiseptic. Beneath the idle

ceiling fan, children chased each other, hopping over the stretched-out legs of dozing fathers.

Mariam helped Laila sit against a wall from which patches of plaster shaped like foreign countries

had slid off Laila rocked back and forth, hands pressing against her belly.

"I'll get you seen, Laila jo. I promise."

"Be quick," said Rasheed.

Before the registration window was a horde of women, shoving and pushing against each other.

Some were still holding their babies. Some broke from the mass and charged the double doors that

led to the treatment rooms. An armed Talib guard blocked their way, sent them back.

Mariam waded in. She dug in her heels and burrowed against the elbows, hips, and shoulder blades

of strangers. Someone elbowed her in the ribs, and she elbowed back. A hand made a desperate grab

at her face. She swatted it away. To propel herself forward, Mariam clawed at necks, at arms and

elbows, at hair, and, when a woman nearby hissed, Mariam hissed back.

Mariam saw now the sacrifices a mother made. Decency was but one. She thought ruefully of Nana,

of the sacrifices that she too had made. Nana, who could have given her away, or tossed her in a ditch

somewhere and run. But she hadn't. Instead, Nana had endured the shame of bearing aharami, had

shaped her life around the thankless task of raising Mariam and, in her own way, of loving her. And,

in the end, Mariam had chosen Jalil over her. As she fought her way with impudent resolve to the

front of the melee, Mariam wished she had been a better daughter to Nana. She wished she'd

understood then what she understood now about motherhood-She found herself face-to-face with a

nurse, who was covered head to toe in a dirty gray burqa. The nurse was talking to a young woman,

whose burqa headpiece had soaked through with a patch of matted blood

"My daughter's water broke and the baby won't come," Mariam called.

"I'mtalking to her!" the bloodied young woman cried "Wait your turn!"

The whole mass of them swayed side to side, like the tall grass around thekolba when the breeze

swept across the clearing. A woman behind Mariam was yelling that her girl had broken her elbow

falling from a tree. Another woman cried that she was passing bloody stools.

"Does she have a fever?" the nurse asked. It took Mariam a moment to realize she was being spoken

to."No," Mariam said.

Bleeding?

"No."

"Whereis she?"

Over the covered heads, Mariam pointed to where Laila was sitting with Rasheed.

"We'll get to her," the nurse said

"How long?" Mariam cried Someone had grabbed her by the shoulders and was pulling her back.

"I don't know,"the nurse said. She said they had only two doctorsand both were operating at the

moment.

"She's in pain," Mariam said.

"Me too!" the woman with the bloodied scalp cried. "Wait your turn!"

Mariam was being dragged back. Her view of the nurse was blocked now by shoulders and the

backs of heads. She smelled a baby's milky burp.

"Take her for awalk," the nurse yelled. "And wait."

* * *

It was dark outside when a nurse finally called them in. The delivery room had eight beds, on which

women moaned and twisted tended to by fully covered nurses. Two of the women were in the act of

delivering. There were no curtains between the beds. Laila was given a bed at the far end, beneath a

window that someone had painted black. There was a sink nearby, cracked and dry, and a string over

the sink from which hung stained surgical gloves. In the middle of the room Mariam saw an aluminum

table. The top shelf had a soot-colored blanket on it; the bottom shelf was empty.

One of the women saw Mariam looking.

"They put the live ones on the top," she said tiredly.

The doctor, in a dark blue burqa, was a small, harried woman with birdlike movements. Everything

she said came out sounding impatient, urgent.

"First baby." She said it like that, not as a question but as a statement.

"Second," Mariam said.

Laila let out a cry and rolled on her side. Her fingers closed against Mariam's.

"Any problems with the first delivery?"

'No.

"You're the mother?"

"Yes," Mariam said.

The doctor lifted the lower half of her burqa and produced a metallic, cone-shaped instrument- She

raised Laila's burqa and placed the wide end of the instrument on her belly, the narrow end to her

own ear. She listened for

almost a minute, switched spots, listened again, switched spots again.

"I have to feel the baby now,hamshira "

She put on one of the gloves hung by a clothespin over the sink. She pushed on Laila's belly with one

hand and slid the other inside. Laila whimpered. When the doctor was done, she gave the glove to a

nurse, who rinsed it and

pinned it back on the string.

"Your daughter needs a caesarian. Do you know what that is? We have to open her womb and take

the baby out, because it is in the breech position."

"I don't understand," Mariam said.

The doctor said the baby was positioned so it wouldn't come out on its own. "And too much time has

passed as is. We need to go to the operating room now."

Laila gave a grimacing nod, and her head drooped to one side.

"Thereis something I have to tell you," the doctor said. She moved closer to Mariam, leaned in, and

spoke in a lower, more confidential tone. There was a hint of embarrassment in her voice now.

"What is she saying?" Laila groaned. "Is something wrong with the baby?"

"But how will she stand it?" Mariam said.

The doctor must have heard accusation in this question, judging by the defensive shift in her tone.

"You think I want it this way?" she said. "What do you want me to do? They won't give me what I

need. I have no X-ray either, no suction, no oxygen, not even simple antibiotics. When NGOs offer

money, the Taliban turn them away. Or they funnel the money to the places that cater to men."

"But, Doctor sahib, isn't there something you can give her?" Mariam asked

"What's going on?" Laila moaned.

"You can buy the medicine yourself, but-"

"Write the name," Mariam said. "You write it down and I'll get it."

Beneath the burqa, the doctor shook her head curtly. "There is no time," she said. "For one thing,

none of the nearby pharmacies have it. So you'd have to fight through traffic from one place to the

next, maybe all the way across town, with little likelihood that you'd ever find it. It's almost eight-

thirty now, so you'll probably get arrested for breaking curfew. Even if you find the medicine,

chances are you can't afford it. Or you'll find yourself in a bidding war with someone just as

desperate. There is no time. This baby needs to come out now."

"Tell me what's going on!" Laila said She had propped herself up on her elbows.

The doctor took a breath, then told Laila that the hospital had no anesthetic.

"But if we delay, you will lose your baby."

"Then cut me open," Laila said. She dropped back on the bed and drew up her knees. "Cut me open

and give me my baby."

* * *

Inside the old, dingy operating room, Laila lay on a gurney bed as the doctor scrubbed her hands in a

basin. Laila was shivering. She drew in air through her teeth every time the nurse wiped her belly

with a cloth soaked in a yellow-brown liquid. Another nurse stood at the door. She kept cracking it

open to take a peek outside.

The doctor was out of her burqa now, and Mariam saw that she had a crest of silvery hair, heavy-

lidded eyes, and little pouches of fatigue at the corners of her mouth.

"They want us to operate in burqa," the doctor explained, motioning with her head to the nurse at the

door. "She keeps watch. She sees them coming; I cover."

She said this in a pragmatic, almost indifferent, tone, and Mariam understood that this was a woman

far past outrage. Here was a woman, she thought, who had understood that she was lucky to even be

working, that there was always something, something else, that they could take away.

There were two vertical, metallic rods on either side of Laila's shoulders. With clothespins, the

nurse who'd cleansed Laila's belly pinned a sheet to them. It formed a curtain between Laila and the

doctor.

Mariam positioned herself behind the crown of Laila's head and lowered her face so their cheeks

touched. She could feel Laila's teeth rattling. Their hands locked together.

Through the curtain, Mariam saw the doctor's shadow move to Laila's left, the nurse to the right.Laila's lips had stretched all the way back. Spit bubbles formed and popped on the surface of her

clenched teeth. She made quick, little hissing sounds.

The doctor said, "Take heart, little sister."

She bent over Laila.

Laila's eyes snapped open. Then her mouth opened. She held like this, held, held, shivering, the

cords in her neck stretched, sweat dripping from her face, her fingers crushing Mariam's.

Mariam would always admire Laila for how much time passed before she screamed.