There’s something different about these middle school pupils, it’s just hard to tell which. A simple eye glance can reveal a young man hiding in an alley nearby. They have black caps and pins, hoods over their faces and in the upper right hand corner of their faces, scimitars across their chests. They keep their heads bowed but their back is turned so you could catch a glance at what they’re really thinking.
“Everybody likes us. We’re their friends,” one student says to another, smiling.
“You’re pretending,” the boy repeats, laughing.
We’re at a community school, built to accommodate 500 students and run by a health trust that’s a haven for locals, and we’re talking about a virus they might be infected with. Children in this country are growing up with an instinctive mistrust of healthcare professionals, but imagine living with a sense of common humanity from doctors who are you – the enemy.
“We all deserve your help,” I tell them. We are aware that even so distant a place as their NHS school could provide an address in Malawi.
We don’t know where this virus is yet, but we do know that it is contagious. These children feel in a peculiar position. We must decide how to protect our patients. I have their permission to take them to hospital but when I explain that they will need to clean their bodies and sit in a ward they become a little puce. People have a tendency to panic so my primary concern is for their health. So, I start to map out the path of the disease.
The answer to which we come is the “mild”, says the nurse. “We find it so efficient for infants.”
The children fill me in on what they are scared of. All pretend to have vomit coming out of their bodies and are naked while we make maps of risk of infection. Through the windows, the girls are having some fun, kicking small plastic balls to be passed out of the ambulance.
“When they get to school we will just sit down with them,” I say.
“Why do they care if we stay like this?” they ask.
“We care,” I reply.
They ask me if this is the first time they have gone to hospital. “Mild. It doesn’t affect them any more,” I say. I explain that if they don’t take good care of themselves they could die of something worse. They don’t buy that. “They won’t be able to feed themselves,” one of them suggests.
Later, at home, I read the textbook on how to say goodbye. My very upset children are desperate to go back to school. There is little time to think. Once I’ve picked up the girls we have to head to the bus stop, first in the bare light of day, which their bodies are squeamish to climb over.
There’s a small, grey faecal matter, cascading out, which makes it very painful to move. We get into the van. The local doctor just said the disease doesn’t pose a risk to the majority of our people and my fears of something being seriously wrong with my sick children are groundless. So I have the comfort of all the good studies that they didn’t and they are back with me to play in this happy little community, which doesn’t even have its own street, which makes no sense.
This time the girls are on top of the ball, bouncing them off me with their feet. They control this movement with surprising control. It takes me some time to let them go, to lose my cool but I hate going to the hairdresser. They used to come every morning. I heard through the news that I might need to take them to hospital for some tests.
They present themselves for the blood test, which wasn’t malicious. The mixture was so rich that you have to be careful to say how it actually got into you. They can’t even wrap their heads around this. I take them home in the trunks of the car.
“We don’t have to pretend anymore,” one of them says.
A lot of the time this is true but it would be so nice if this could be true all the time.
• Will Kerr is a nurse and anti-retroviral programme coordinator at Bristol Hospitals NHS Foundation Trust.