The young man looked at the old man across from him, who was sitting ceremoniously on the mat. A face heavy with dignity, his eyes nearly closed. The old man could have been graven on earthen stone.

"We will have to do it before noon," the young man said.

"When the sun climbs to the peak of the sky, it will be too hot to move. The flies will come in droves," he spoke again.

The old man showed no sign of movement. Perhaps he was thinking, the young man thought. Or perhaps he was asleep.

"Papi, we have no choice," he called the man that was not his father. That was what they called their village chief, Papi. Because he was father of the village, and had to judge their fights over goats and preside over their marriages.

Papi opened his eyes. He said, quietly,

"No. We will not."

The young man had to control himself in order that he would refrain from shouting. He tried to say calmly,

"How can you? Papi? These are your people. Your people are dying."

Papi closed his eyes once more, as if in pain. His wives looked at him anxiously from behind the beaded curtains of the next room. Someone was trying to hush a child that was crying. He spoke in tones accustomed to projection, over celebratory songs and funeral dirges.

"Crops. We have our God here, to look after us. This has happened year after year, and yet we are. Still here, with our crops."

Papi looked at him, who was about to speak, and silenced him with a thin bent finger. He continued to say,

"You are a newcomer. You are a stranger to our ways. We survive. Your plan will kill our crops. You will kill us all."

He was furious. He stared at the old man, who sat immobile as a stone idol, and thought of how he tried to be civil amidst the chaos. Yet the old man refused to be civil in return. I ask only for courtesy, he thought, anger lighting across his mind like a bolt. He said nothing, however, and only took a sip from the weak tea in front of him. It was ceremony to drink and eat what was offered in hospitality. He took a bite from the bread. And he stood, to leave, knowing that this would be the last time he would see the old man. He was not asking for the old man's permission. His mind was made up. He was asking the old man to save himself and his family.

He walked out, making sure that he did not look back, and tried not to hear the cries of the child. It must be Sumi's, he thought miserably. He did not look back. There were many things at hand.

Quattroyol was known as the land of the blind. It was the name of the village that was also the name of its god. Its god was a totem in the middle of the village square, carved out of old, whitened bark. It had the shape of an inscrutable eagle with human eyes and a hooked beak. Its wings were large, powerful at rest.

The women prayed to Quattroyol for crops to grow and food on the table. The men prayed for rain and children who were not deformed.

No one prayed for their sight to be returned.

In the monsoon season, the skies grew overcast and the air grew pregnant with rain. But it was the river that truly swelled, higher and higher till its banks overflowed. The worms in the river were afraid, and swam in a frenzy, ducking in and out of the weeds where they lived. They were so small that they were seen as a fine thread, as fine as a crack in a porcelain cistern. But the flies had sharp eyes, for only the people in Quattroyol were blind. The flies had sharp eyes for they too were hungry. They swooped into the churning river waters and drank from the river.

At night, when it grew cold and the men returned from their fields to goat cheese and tea and brown rice, the flies went to the houses of the village to keep warm. Hungrier than ever, they fed on the food of the children, and fed on the blood behind smooth, fine, ebony skins.

The worms in the stomachs of the flies that passed into the new blood gave the people of the Sub-Saharan river basin, bad dreams at night, cold sweats, and fevers that ran so high as they babbled and tossed. At the end of the fever, if they were strong and had the fortune of Quattroyol's protection, they went blind. But they would be alive.

It was the children who died.

He was a medical student working in Quattroyol as part of his medical course with his university in the city. A long time ago, his parents had been from Quattroyol. When his parents died as he turned eleven, he was sent away to an orphanage in the city. Working hard, he had won a scholarship to study medicine in a foreign land. He wanted to be a doctor. He had wanted to be a doctor since the time his parents died. He sat in lecture halls and cafeterias filled with skins so white they looked like paper, and studied medicine. He sometimes missed meals so that he could save money for the trip back.

He did not listen to the professors and friends who told him to apply for top medical schools in the foreign land. His mind was full of wet churned earth and muddy monsoon rain. At night he dreamt of the smell after tropical rain. He looked at the paper skins and clear eyes that pleaded with him to stay. He returned to enroll in a medical school in the capital of his country, where it was compulsory to carry out community medicine in the villages as part of one's medical course. He was young, and bore the two rows of tattoos on his cheeks that were inscribed onto ten-year-old boys in Quattroyol during a rite of passage into manhood. He was a tall, broad-backed and graceful gazelle of a man.

He went to the village square, where he directed the men, women and children who waited for him, to take only their healthy animals and leave their crops. He ordered them to take only the essentials. No one could carry heavy sacks of rice or sentimental pictures of their ancestors. And definitely no stone idols of the god Quattroyol. There was some resistance to this, but it faded away when parents looked at their children. The children were to put on shoes, for those who could walk. Those, who could not, were loaded onto carts lined with blankets and straw, so that they could be pulled by man or mule.

They were so weak, some of them, from diarrhoea and vomiting that he could not watch them without pain. The children were whispering for water constantly.

Large cisterns of water were carried in a cart, pulled by the village's two strongest donkeys.

He did not give himself time to think of anything except for the route and the things that had to be packed and carried. They were to reach the next empty town by tonight. The next evening, they would reach the provincial hospital, where they could find a place for treatment and refuge while the monsoon season raged its blind fury in the river of Quattroyol.

"Will Papi be coming with us?" one woman asked him with imploring eyes.

"No," he said. He walked on. He was ashamed.

Two thirds of the village had stayed behind in spite of his pleas. He had stood in the middle of the village square, with charts and diagrams explaining river blindness and treatment to gathering crowds. Then he went from house to house, talking to the women when the men were in the fields, and treating the children's symptoms with antibiotics. But he had a limited supply.

He pleaded with them to vacate the village. He pointed out that villages all along the Sub-Saharan river basin were vacating for the monsoon season. There were clusters of ghost villages all along the river. The people of Quattroyol listened, and some chose to leave, while others stayed with Papi in the land of the blind.

"Think of your children!" he shouted, at first. Before he learnt the dignity of their ways.

"You are a stranger to us. We do not know you. Our God is our God, and he will take care of our children."

As he walked away with the line of men, women, carts, mules and goats behind him, he tried not to think of how Papi had called him a newcomer. They set off in the morning, as the sun was still climbing, their footsteps slow but hopeful. He was born in the village, as they were. He was weaned there, as they were. A stranger. How could a stranger return from foreign lands where the food was abundant and the rivers were bacteria-free to a place where men were blind and women wept for the lack of a future for prematurely dead or deformed children? How could a stranger bear the two rows of tattoo scars that meant he was a man?

He thought of how he had spoken to Sumi as he had never spoken to a woman before. One evening when Papi was not at home yet, he had gone to the house with a package of antibiotics for his wives, for he had measured his chances and realized that the village chief was unlikely to leave the village and its totem god. He talked to the wives, and expressed his hope again that they would leave with him. But no one spoke, only stared at him with large, inscrutable eyes. Sumi spoke up, to his surprise.

"We do not learn your ways of coming and going so easily."

He looked at her for the first time, a thin hard woman in a faded gingham dress, probably from a missionary. She leaned against the doorway, her thin arms folded against her chest. She said again, even though the wives were all looking at her with disapproval,

"You will leave us eventually. We have to live here. If we leave with you, we will return to dead crops and a year of starving."

"It is perhaps better being blind." She added, defiantly.

He knew that she was the fourth wife of Papi, and had two children by him. She could not be considered beautiful, or voluptuous, in the land of the blind, nor yet in foreign lands. But her thin, lovely hands beat the wet clothes against the rock by the river, and she sang softly under her breath as he spoke to her as he had never spoken to a woman, or a man indeed, before.

As he walked, not at the head of the procession, but in its middle, so that he could govern the condition of the ones who were most ill, in the animal-drawn carts, and measure out water for the thirsty. They would not eat until they reached the next town, which was already empty. Its inhabitants had vacated the week before. He envisioned the exodus in his mind briefly, and tried not to worry about the number of beds that might be available in the provincial hospital.

They stopped, and drew out their bread, beaten to such a fineness that it was quite devoid of nutritional value. The diarrhoea that they emitted was similarly thin and watery. He could do nothing about this. The monsoon rains also spoilt food storage on top of crops and made the animals sick.

He wondered how they could live in a place like this for centuries. He thought of how in the universities of the foreign land, the paper skins had talked about how the place where he was born was also the birthplace of all people. The first people had walked here. He did not think how a land that was so inhospitable and harsh could also yield bounty so rich and unpredictable. His mind struggled with why, how, wherefore. But most of all he worried about deaths, not births.

In the rite of passage where they tattooed and circumcised young boys who were becoming men, he sat among the men watching across the leaping flames. Women were excluded from the ceremony.

In another ceremony, which Sumi would tell him but with few details, the women celebrated a girl's marriage by bringing her into a hut and telling her stories of life, birth, reproduction and death. She did not tell him, but he already knew, that women who gave birth to stillbirths, severely deformed or twinned children often took them to the riverside, to bury them in the earth, often as they wept.

He was interrupted from his thoughts by shouts. He stood up. A crowd was gathering to welcome a new group of travellors who had joined them. They were people from Quattroyol who had eventually changed their minds about leaving the village. He saw that Sumi was among them, and was overjoyed.

She was lying on a cart, with her child. The child's skin was patchworked with blood rashes, and so weak that he could not even ask for water. A dry crust flecked his lips. He saw that Sumi had been infected too. Her thin housedress, which he had thought clung to her limbs attentively, now lay flat against her thinner, fighting frame. The child was dying, and his mother, who had obsessively taken care of him, was very ill.

He went to her, and forgot momentarily. What he was doing. Then he remembered that she had warned him before, not to let his behavior suggest any untowardness on their part. Adultery was punished, on the woman not the man. She would be tied up by the river, as they performed the operation, without anaesthetic, without sterilized tools, to cut out from her the pleasure of sex, the thing that made women go bad.

He held back, and called immediately for water to be brought for the woman and her child, as well as the others. He did not want to show his agitation, which they might mistake for favoritism. He asked, in a voice that he made as calm as possible, where Papi was.

"He is still in Quattroyol. He refused to come, but he let her come," a man said. He gestured at Sumi, lying on the cart. "She is so sick. Maybe he thought she might make the rest of them sick."

He said nothing, and looked into the distance. As a baby, he had told Sumi, he could remember this sliver from his distant memory. His parents had laid out objects in front of him, a few bright things, and waited for him to pick one. She had laughed and explained that it was a custom for newborn children, in a game that they hoped would predict the baby's future. They laid out things that represented different futures. There were a flower, a jewel, a spoon, a bell, a pair of spectacles. Everyone wanted the baby to pick up the spoon, meaning food on the table for the rest of his life.

"What did you pick up?" she asked, with a smile.

"I picked out the bad thing. They made me put it back again and again. I think I kept picking it up, even though they made me try again and again."

"Oh yes," she laughed this time, her teeth white and even against her lips. "They do it in the hopes that the naughty baby could avoid his future."

"How Pavlovian," he said, and had to explain what he meant to Sumi, greedy Sumi, who always wanted to know what he meant. Satisfied, she then asked him what the naughty object was.

"It was a book," he said. "I don't know why they thought it was a bad thing. To read a book you would have to see. It would mean I would live, and still have my vision. No river blindness for this baby."

She was quiet, and looked at him in a soft way that he had not seen before. "They thought it was bad. Because it stood for something foreign to their lives. Hope."

He gave the orders for the villagers to move on. They began to argue, for the first time since they set off that morning. It was night, and they had been walking the whole day. They must rest, or they would not complete the journey.

He had to struggle to stifle his irrational thoughts. He was afraid that she would die before the next morning. He did not want to wait for another day to reach the antibiotics at the hospital. He had never touched her, and yet she was wasting away before his eyes, silently without calling out. Sumi would not call out for help.

The sunset was spectacular. The sky rapidly darkened to a blackness. The blackness was so complete it was without stars. The walls of jungle vegetation stood all around them, and the buzz of insects poured into the air they breathed. He could not see the figures properly, as he moved among them, dispensing water, comfort, although he had little comfort in him.

He thought of other sunsets, in a place where the towers were high and pierced the sky. He thought of how he had sat, robed in black, on a bench in a pruned garden, reading a book by his favorite writer, as it changed his mind and ideas. It had transformed him, to sit in that place reading that book. It had been very real.

He had the book still, in his bag, even though he had told the villagers not to bring unnecessary objects. He took the old, torn, loved book out in the night, and could not even see the cover for the darkness. But he knew what it read. Plato's Cave.

But the book was from the foreign land, the white book, what did it know of his land, this reality, and the clouds of flies that descended upon whole villages to annihilate them? It was not a biblical plague, sent to punish the wicked. This was where the cradle of life began, in the hot, infested womb of the land. His land that was going blind.

He heard a child scream. Someone tried to hush it, murmuring. A woman - Sumi? - coughed. There was love and death in the smell of the monsoon rain. But was there hope, could one pick hope out like it belonged to him? Like he deserved it, and had the right to it as he had the same right to life. As though he could see it in the land of the blind, but only with his heart.


Author's Note: River blindness, or onchocerciasis, is a real endemic condition that affects 30 countries in Sub-Sahara Africa. The World Health Organization has further information. The land that I have set it in, however, exists only as literary fiction.