On really bad nights, I dream I’m Shanda.

The smell always comes first. Not the sickly sweet pungency of pus, like a designer cheese gone bad. No, it’s the rotting banana aroma that warns me.

I twist around in my sheets, sweating, panting in the dark as the dream unrolls.

*                              *                              *                         *                    *

At dusk, we pull up outside the mud-walled hut. Leaving the Jeep running, headlights turned down low, we walk over to the fence-like hedge of spiny cacti surrounding the hut.

“Bon soir, good evening,” I call into the dimness, clapping my hands in greeting, standing at the entryway to the hut. “Are you Shanda? Sister Marie sent us.”

“Oui, yes, I am Shanda,” a woman’s voice replies after a few seconds, barely rising above a whisper. “What do you need?”

“We’re taking you to Sister Marie, to the hospital,” Joachim—Jake for short—explains, as we duck our heads and enter Shanda’s home.

“D’accord, OK,” Shanda pants.

The wife of the village chief told Sister Marie at the mission that she had not seen Shanda for many days. But Shanda’s neighbors feared going into her hut, for death lived there too. So Sister Marie asked us to bring Shanda to the clinic. Since we had a free day before the regional U.N. medical conference started in the capital city, we said sure.

With every word, Shanda literally struggles. Each breath sounds like the noise made by feet digging into the ground during a Tug-o-War contest at a Fourth-of-July picnic.

“I wasn’t always like this,” she coughs feebly. “I used to dance, oh my, how I danced. My legs, strong, like a banyan tree. And my hair, black, thick, like a lion’s mane.”

No lantern lights up the hut. No cooking fire blazes. Just blackness eveywhere. Following the sound of Shanda’s breathing, Jake and I grab the straw mat underneath Shanda. As I pull the ends of mat closer together, making an improvised stretcher, the stink just about knocks the breath out of me. My stomach lurches toward my throat. I swallow hard to keep from vomiting as we lift her off the dirt floor.

It’s a mixture of the acrid rancidness of concentrated urine so common in dehydration, combined with the pig-sty-like fetidness of constant and uncontrollable diarrhea, topped off with the oniony smell of unwashed armpits. Feeling Shanda’s warm shit dribbling over my fingers, even through the latex gloves I wear, makes me almost drop my end of the mat. Weaving in and out of the foulness hangs the odor of the rotting bananas that she no longer eats or sells.

“We’ll have to put her down and just take the blanket this time, OK? It’ll be easier to get her in the Jeep if we do that,” Jake says. I hear him trying not to breathe, holding his breath in the closeness of the hut. We lower Shanda back onto the floor, gently. Yet she still groans quietly when we pick her back up. This time we get it right as we fill our arms with her body, shrouded in the soiled blanket, trembling with fever.

“Oh, I hurt, I hurt,” she cries as we try to move her out through the narrow doorway of the hut. I guess that Shanda weighs as much as a sack of good quality rice, and the last time I checked, that was no more than 50 pounds. When I grip her right arm to get her through the door, her humerus feels no bigger around that the batons I used to twirl in high school. And her thighs feel as about as big as the handle-end of a baseball bat. No wonder she hurts—nothing exists between skin and bone, just raw nerves.

Even though it’s still hot enough outside to fry an egg on a rock, Shanda’s feverish shaking reminds me of the old Jeep sitting outside the hut, waiting for us like a dog after a swim in a river.

In the blackness, we stumble over something, probably Shanda’s aluminum cooking pot, from the sound of it.

Shanda rambles on, caught in the delirium of her fever and the dementia of the disease, the one the villagers call “slim,” and the one we Westerners call AIDS. Or SIDA in French. She speaks mostly in the local dialect, French no longer part of her memory, her days at the mission school vanished, the Belgian priests gone like ghosts in the morning llight.

In her weak voice, I hear the lilt of the traditional storytellers and the rhythm of the village drums. Through her, Africa speaks.

“First my mari, my man, died, then my baby, coughing, blood everywhere. Harvest to harvest, that’s all she lived, my bébé, then big-boy son, my first bébé, 10 harvests gone by with him, born in the moonlight when I only had five harvests more than he did when he died. And little-girl child, ah, my fille, that the saddest thing. That teacher at the school, Mr. Touaré, he took her again and again in the weeks before he died of SIDA, and she was only nine harvests old. Died last full moon, dried up like old millet, just like me now.” Shanda gasps out her life story, out of a face that I know resembles a talking skull. Eyes staring, blinded by CMV retinitis.** I’d seen it so many times by now.

We stand still for a moment, listening, cradling her in our arms. I also know that no other human beings have touched her for weeks.

In a second, the whispering litany ends. The shaking slows a bit and then stops.

In the stillness, the sudden rattling noise startles us, sounding so much like the guffaws that my grandmother scared me with, when the joke telling started after those big family dinners she was so good at.

“Jake, I think she’s dead. Jake … ,” I whisper.

“Yeah, Ann, I think so, too,” Jake whispers back as we carry Shanda out from the darkness of the hut into the light of the Jeep’s headlights.

* * * *

And in the light, I wake up. Again.

Shanda was just one of the many I tried to help, in a “community-based treatment of HIV-AIDS in resource-poor settings,” as the official terminology goes. By taking the victims to the hospital, to the morgue. By taking their children to the orphanages. By advocating for cheaper retroviral drugs. By feeling outrage that no one in the West seems to care about their suffering.

Nearly 25 million Shandas live in Africa today.

(**Many AIDS patients go blind, due to CMV (cytomegalovirus) retinitis, an opportunistic infection associated with AIDS that destroys the retinas of the eyes.)

(Although Shanda’s story is fictional, the basic facts remain true for millions of people in Africa.)

© 2008 C. Bertelsen