Mosquitoes

Kingsley Okonkwo lay shivering and sweating in the tropical heat, his mind full of images of death and decay. He couldn't sleep for more than a few minutes at a time. His body was drenched with sweat, joints full of intense aching pain. He had been lucky up to that point in his life that he had never been particularly ill, apart from the odd stomach bug and sore throat. He looked back at his treatment of people in pain with a newfound empathy. So this is what it was like for them he thought in a rare moment of clarity. He promised never to underestimate their pain again.

He had always wanted to be a doctor. His mum and dad had met in Italy where they had both worked in a bank. They had their first child shortly after moving to England. They were strict but very loving parents and were rarely disappointed with their eldest son's achievements. He had attended a North London comprehensive school and had excelled in all subjects, particularly maths and biology. He had gone on to study medicine at Imperial College where he continued to shine. He had originally been attracted to surgery as a career pathway until a family trip to Nigeria had engaged his sense of social responsibility and sparked a growing interest in public health and tropical diseases. His aunt's family lived comfortably in a leafy residential suburb near Lagos. His uncles and aunts were well-read and passionate about a range of issues. There had been heated late-night discussions about politics, philosophy, the economy, and health care. Kingsley had been particularly struck by one meandering conversation that had touched repeatedly upon the subject of malaria. After completing his studies he had spent a year as a house officer in general medicine while carrying out postgraduate research in epidemiology before applying to work with Médecins San Frontières.

Studying medicine and working in hospitals had given him many memorable experiences; memories that his fevered mind now revisited unwillingly. Walking down empty corridors at 2am. Hearing distant sounds of moaning and the whirr and hiss of respirators. Hours spent dissecting cadavers to study anatomy. The smell of suppurating wounds. The slow desperate realisation he had seen in the faces of the newly bereaved. Always a kind and empathetic person, Kingsley had learnt to compartmentalise these experiences to protect himself from the harmful emotional impact of the suffering he had witnessed. They taught you to approach each case methodically and one quickly learned to prioritise. He was emotionally and physically robust. His friends and tutors called him 'dependable' and 'thoughtful'.

He didn't feel robust at that moment, lying on a metal bed frame with a thin mattress, his sheets uncomfortably crumpled and soaked in sweat. The moon shone brightly through the small windows. He was so tired. He wished he could sleep without experiencing nightmarish visions of hospitals. Beds, cabinets, curtains, sheets. People crying, children dying, blood and drips and needles and surgical instruments, all populated his night-time terrors. He had come to Gabon to study and treat malaria, not to catch the bloody disease. He knew he was lucky; he would get the best treatment, unlike millions of people every year who would die needlessly for lack of effective medicine. This was scant comfort to him as he lay there in the medical compound, trying and failing to get some rest. In his waking fever dreams he visualised the microscopic plasmodium parasite as it infected blood cells, rapidly multiplying. He imagined the red blood cells, watching them swell and burst before releasing tiny creatures that swarmed throughout his pain-wracked body. His mind swam with images of mosquitoes. Big ones, small ones, flying. Whining. Feeding. He saw their faceted eyes, their hairy antennae, the mouthparts that he could name without thinking; hypopharynx, maxilla, mandible, labium, labellum. Piercing. Drinking. Infecting. He shuddered and tried to think of home. He failed. As his tired mind drifted into a feverish state of half-consciousness, his eyes almost closed, he saw mosquitoes everywhere. They came crawling from the shadows, squatting in their thousands on every surface, coalescing in great dark patches that spread across the whitewashed walls. He felt weak with fatigue. He was powerless to stop the terrible sight. He watched in terror as a shadow in the far corner of the room lengthened, grew larger, drew nearer, filled with tiny buzzing wings.