It hurts Nelson to breathe and I don't expect him to live through the next few days. Every minute or so I rise from my chair and wave my book over his small body to disturb the flies that are negotiating his open sores. The flies buzz lazily away, but a few seconds later they are back and I will ignore them soon. I move my chair away from Nelson, closer to the open hut door, allowing me to feel the cooler air outside and diminishing the stench of infection that surrounds us both.
Looking out through a gap in the rancid cloth hanging from the door lintel, I see skinny black knees flash past in the brightness outside. I hear the other children laughing as they play in the street, unaware of Nelson and me, and I recognise the yellow ball skidding through the dust. The ball sat on my lap in the back of a Land Rover for many hours, the seats either side of me stacked with cardboard boxes containing needles, glass vials, blister packs of expensive white tablets and brightly-coloured AIDS awareness leaflets. The clear eyes and excited, enthusiastic smiles of the same children had greeted me on my arrival just a week ago.
A woman enters the hut with a small bowl of water, a battered aluminium cup and a scrap of sponge. She squats next to Nelson's low bed, dipping the sponge into the water and then placing it on his cracked lips. The water dribbles into his mouth and down his throat, which I know is cracked and raw. Nelson's skeletal body shudders horribly as his coughing rises to a crescendo. The woman is Nelson's mother and she is a Bantu Zulu.
I am twenty-three years old and almost qualified now. I chose South Africa from a list of electives pinned to the department notice board. The choice was easy. When I was eight years old, Zulu had been the last word in my dictionary. I had placed this land at the top of a mental list of places to visit, and I kept it there for no good reason.
Nelson's mother stays with him for almost an hour. I don't know whether to stay or go. She is saying nothing, just looking into his fading eyes and stroking his hand softly. I decide to go out into the sun briefly, taking gulps of air, closing my eyes and tipping my face to the sun.
When I return, I remember to say, "Your clinic, it is tomorrow afternoon, please come."
Nelson's mother looks down at him, then at me and nods without smiling. I know what she is thinking. She had thanked me often in the last days, but with glancing looks rather than words. Now she takes my hand as she gets up to leave. She looks at me directly, urging me look back at her.
"My son is hurting too much," she says.
"I know he is and I help him when I can."
"He will die today?"
"He is very sick," I say.
"God is calling him now," she says. "He wants Nelson." She puts her hand over mine. I look down at dark calloused fingers curled around my soft hand. I don't know what to say.
"Please?" she says, and then she releases me and leaves.
I so want to leave with her, but I know I can't. I watch Nelson's ribs rising and falling to no particular rhythm. His chest is bare with a thin grey blanket stretched across him at waist level. His eyes are half open, but bulging in his skull. His arms are limp on the mattress at his sides. I feel his wrist for a pulse and it is thready and weak. Twice in the last three days I have given morphine to Nelson. I see the distress in him again, he doesn't have the strength to scream but I know he would if he could. I want to give him something to stop that horror, but he is quiet now.
I find the vial of clear liquid in my bag sitting on the dirt floor. I find a new needle and fill the syringe carefully, bringing the meniscus up to the full adult dose. Nelson does not look at me when I swab the loose skin on his arm and then pinch it between my thumb and forefinger to insert the needle. When I withdraw it, there is no blood and he makes no sound.
As I walk outside to find my car, the sun is fading fast over the corrugated roofs of the huts around me. I decide not to speak to Nelson's mother before I leave. I will see her tomorrow at the clinic and I'll hand her a packet of the white tablets that will allow her to live and care for the remainder of her family.
I lift my bag to put it on the passenger seat of the Land Rover. I start to think about returning home. I notice the yellow ball lying in the gutter next to the front wheel. It is scratched and covered in dust. I bend to pick it up and find that it is flat now and useless. I kick it firmly with the toe of my boot but it just skids a few yards and then stops, unable to roll any further. I go over to it and scoop it up with one hand. I throw the ball onto the back seat, and then I climb in turn over the engine and drive away.
Steve Johnson has worked as a scientist, publisher, technical author, lobster hatchery technician and waiter. Previously, he has won prizes for science writing, but "The Last Word" is his first published piece of fiction. He lives in Oxfordshire in the UK.