A/N

This is my first attempt at creating an AU. The story takes place in 2011 in Moshi, Tanzania, where lots of Western aid organizations are based.

I used to work in the region about a decade ago, hence I am familiar with setting and aid context. I am not a medical professional, though, and all errors are exclusively mine.

Writing a story set in this particular context has its difficulties. I hope that I manage to avoid the usual stereotypes when writing about life in an African country which needs to be considered in the tradition of colonialism/postcolonialism. I have been careful to do justice to an adequate portrayal of local particularities, but I am happy to be corrected if there is anything you disagree with.

Thanks a lot to the incredible weshallc for beta-ing.

Under Pressure

Dr Patrick Turner sighed. There were still two donor reports to be written and the applications for the post of a research assistant to be looked over. Also, with the end of the year approaching quickly, he had to finalize all financial reporting with the accountant – a task he was running dangerously late with. And now, the much needed copy machine had broken down.

So far, his day had actually been a good day and he had wanted to go home in a happy mood. Earlier, he had received confirmation that the TB research programme he had developed over the past year would be fully funded by DFID, the UK Department for International Development. With the amount of 5 million Pounds, he would be able to fund a new, modern research lab. In addition, he could also hire four new staff and fund research into prevention and treatment of TB in resource-poor communities.

Patrick Turner was the director of the partnership between Durham University and KCMC, Kilimanjaro Christian Medical Hospital, in Moshi, Tanzania. His tasks included the overall administration of the programme as well as implementing his own research project on the improvement of antenatal care in district hospitals. He also was responsible for providing trainings to medical students both from Tanzania and the UK.

He was indeed a busy man. He had always liked his work, although lately he felt a little overwhelmed. A little over a year ago, his wife, Marianne, had died unexpectedly, leaving him a widower and single father of a ten-year old boy. Patrick loved his work but at the same time, he often felt he was failing his son, unable to be with him as much as Timothy deserved.

After Marianne Turner's death, father and son both had decided they wanted to stay in Moshi rather than return to London where they had lived before. Both had been afraid of leaving a life they had grown used to over the past years. Thus Patrick had asked their housekeeper Teresa to stay on more hours and watch Timothy. He also tried to do at least part of his work from home in the late afternoon and at night once his son was asleep.

With his position came a very high workload – which after Marianne's death also served to numb the pain of his grief. Because Marianne had always supported his dedication to his work, Patrick carried on like he did before her death. In the five years he had held his position, he had instigated several research programmes but he considered his most recent TB programme the most important one.

Tuberculosis – TB – was one of the major health problems in Tanzania. With the country's notoriously underfunded health sector, any disease was a problem, but for a long time now, TB had been a serious concern when it came to maternal health, Patrick's specialization.

Patrick had developed his most recent research programme aiming at improving the prevention and treatment options of the disease suitable for poor communities. To be fair, the idea for the programme and a great deal of working out the details had to be credited to his colleague Shelagh Mannion. Shelagh, employed by British religious organization Nonnatus Mission, had approached him about six months ago with her idea and he had thankfully taken it up because it nicely fit his own interests.

Patrick, still standing in front of the copy machine, its lid open, remembered he needed to tell Shelagh the good news, as she had been working so hard on the proposal. He sighed again. He was supposed to teach a workshop for medical students the next day and urgently needed to copy dozens of hand-outs and lists.

"Bloody idiot," he muttered, angry at himself for leaving things to the very last minute. He checked his watch. It was 6.30 pm already and the small stationary shop down the road would be closed by now.

Patrick groaned. Then he returned to his desk, saved all open documents and shut down his laptop. He gathered papers, his computer and his phone and locked his office door. He would just try his luck and pass by Nonnatus Mission on his way home, asking to use their copy machine. Hopefully, he would see Shelagh and could tell her the good news. At least then he could kill two birds with one stone.

Nonnatus Mission, run by an order of British Anglican Sisters, had been known for its antenatal care and community outreach programme for almost thirty years. They had an enviable reputation for their ground-breaking work providing services to poor communities. Patrick had soon come to appreciate them as his favourite partner organization.

Originally staffed by nuns only, more and more secular women had been employed in recent years. They were now regularly looking for trained nurses and midwives for hire due to the fact that fewer and fewer women felt a religious calling.

What's more, unlike other aid organizations, Nonnatus Mission had become pioneers in training local nurses and midwives employing them as regular staff. This set them apart from most other larger aid organizations where most positions at programme level were staffed with expats. Nonnatus Mission saw the potential for equipping an enthusiastic available workforce with the necessary skills to serve their own community.

Twice a month, Patrick volunteered at the Nonnatus antenatal clinic. Quite a large number of clients could not afford to see a doctor. Thus Nonnatus Mission made sure that there was always at least one doctor, local or expat, present during clinic to check patients if considered necessary, by the midwives tending to them. Patrick greatly appreciated the opportunity of working with real patients in addition to his regular job, full of paperwork and meetings and telephone conferences. And therefore he was as grateful to the Nonnatuns as they were to him for giving him the opportunity of both applying his skills but also learning a little more about local culture.

Originally qualified as a GP Patrick Turner had also specialized in obstetrics. Throughout the 1980s he had worked at the Royal London Hospital. Between 1991 and 1995 he had worked in different countries with Doctors Without Borders before settling down in London again in 1997. He had completed a PhD in Public Health at the London School of Hygiene and Tropical Medicine and subsequently become an Assistant Professor in their Department of Global Health and Development.

During this time, he also got married and became a father. In 2006, when their son Timothy had just turned five, the Turners felt it was time for a change again and had relocated to Moshi where Patrick, by recommendation of a former colleague and friend, had found his current position.

Patrick walked across the parking lot towards his battered car. Rashidi, one of the watchmen, called: "Good night, Dr Turner. See you tomorrow."

"Good night, Rashidi," Patrick said absent-mindedly. He climbed into his car, which was spotlessly clean from the outside, and wondered why Rashidi kept washing his dusty car every day anew – or, for that matter, why anyone here would bother washing their cars daily, when they were dusty again a mere ten minutes after every wash.

But well, in the five years he had been living here in Moshi, near Mount Kilimanjaro, he had learned a lot, but this was one of those things just would probably never understand about the local people.

He thought about Shelagh whom he had gotten to know a little better while working together on the TB proposal for several months. She knew quite a lot about Tanzanian society and he had often listened intently to her explaining about practices and customs which then suddenly seemed to make sense. He admired that she was fluent in Swahili and thus able to easily talk to anyone while he, embarrassingly, still wasn't even able to greet properly.

When Patrick turned around the car key, the CD he had been listening to this morning began to play again. Queen's "Under Pressure" played at a very high volume. It was the perfect song to describe his present state of mind, Patrick thought desperately.

At least he might get to see Shelagh while at Nonnatus, he thought. Shelagh, … Patrick would have liked to dwell a little longer about her wit and intelligence, paired with those appealing blue eyes - but as he had already entered the campus of Moshi International School, he shook himself out of his daydream.

He had to pick up his ten-year-old Timothy from choir practice for the Christmas musical. Patrick secretly prided himself on not having forgotten to pick up his son. Usually, his housekeeper and nanny, Teresa, would pick up Timothy after school but not when his extracurricular activities ended this late.

Much to his son's dismay, Patrick told him that he needed to make a short detour to Nonnatus Mission.

"Dad, I am tired and hungry. Why do you always have to work?" the boy had complained. "You could have sent Teresa to get me, then I would at least have dinner on time. And I hate your music. It's dull."

Patrick sighed and felt guilt nagging him, but he couldn't help it. He needed those copies and Timothy just had to go with it for now. Even though it made him slightly angry to give in to his son, he turned off the music.

He loved the music of the 1980s, the decade he had come of age, he had studied for his profession and met Timothy's mother. Marianne, a journalist and an expert on contemporary art, had always made fun of his taste in music being stuck in the 1980s, but he did not mind. He might not know a lot about music, but he knew what he liked.

Patrick and Timothy spent the rest of their drive in silence. When they arrived at the gate of Nonnatus Mission, Patrick honked his horn and shortly after, one of the watchmen on duty opened it for him. Patrick nodded his greeting and drove to the car park. Timothy was still pouting and refused to come inside with him. The boy had found a half-empty bag of peanuts in the glove compartment and slowly nibbled them away, still flashing angry looks at his father.

Patrick raised his eyebrows at his son and told him to stay in the car until he got back. He walked towards the entrance of the main house in quick strides where he met Sister Julienne, the head of the Mission. She had stepped out to see who had arrived at this time.

"Dr Turner, long time no see", she said. "Is there anything the matter?"

"Good evening, Sister Julienne", Patrick greeted her. "I am sorry to disturb you so late. To start with, I have good news: The TB programme Shelagh has worked on with me, finally got approved."

"Congratulations, this is indeed wonderful news. Please, come inside," she nodded towards the entrance. "Is that Timothy in your car?"

Patrick said defeatedly: "Yes, but I am afraid I upset him and he didn't want to come with me. I am sorry."

"Oh no, don't be," Sister Julienne said. "Perhaps I can coax him come out with the prospect of a slice of cake? Bee just made one of our favourites today, I think."

Patrick smiled a weary smile. "Well, you may try, though I doubt it will work. I think his anger is sitting deep tonight. And actually, I did not just come to announce the good news. I also have a favour to ask."

Sister Julienne raised her eyebrows in question.

"Might I use your copy machine? Ours has broken down again and I need a few copies for a seminar beginning early tomorrow morning."

"Of course you may", Sister Julienne replied warm-heartedly. "Please just go through to my office and feel free to use the machine there. And I'll talk to Master Timothy."

Patrick smiled at her thankfully and hurried inside. He held Sister Julienne in high esteem. In fact, he appreciated working with all of the Nonnatuns. They were a Christian mission but he found them to be a lot more down-to-earth in their day-to-day approach than many of his colleagues from other non-denominational organizations that he knew.

The mission was staffed with three religious sisters and four medical professionals who were responsible for the actual programme management of the different activities. In addition to two drivers, the cook Bee and Fred, the logistics manager.

Sister Julienne was the Superior. Stern Sister Evangelina, British like Sister Julienne, was responsible for the coordination of midwifery training. Sister Winifred, a vibrant Kenyan, was in charge of a programme supporting orphaned school children.

Then there was Shelagh Mannion, a Scottish nurse and midwife, whom Patrick secretly considered the most competent member of staff. She was responsible for antenatal and maternal health outreach programmes. These provided regular visits with mobile clinics to remote villages.

Trixie Franklin, another Brit, also nurse and midwife, oversaw the antenatal services housed at Nonnatus Mission. Cynthia Miller, a Tanzanian-British nurse, was responsible for community health education programmes catering to local schools, churches and other institutions.

Also there were two Tanzanian nurses, Jane Appleby, married to a British missionary and Patience Maunto. Jane worked with Shelagh on her outreach programme, while Patience referred to herself as "firewoman", working wherever she was needed the most at the time.

Patrick walked through the cool corridor inside Nonnatus Mission's main house where the offices, kitchen and dining hall were located. He heard muffled noises from the end of the hall and silently cursed at himself for having disturbed the Nonnatuns during their dinner time. The hallway smelled of ginger and garlic and he thought that even though Teresa, his housekeeper, was a decent cook, the few times he had had the opportunity of eating at Nonnatus had found him very much in favour of Bee and the cook's excellent skills.

When Patrick entered Sister Julienne's office, he noticed Shelagh's slender figure sitting at the desktop computer at the Superior's desk.

"Shelagh", he exclaimed. "Still working? Should you not have dinner by now?"

Patrick knew that Nonnatus Mission ran a tight schedule and that meals were usually taken by all staff together. Shelagh flinched and looked up from her work. When she recognized him, she smiled shyly. "Greetings, Doctor. What brings you to us at this hour?"

Unlike most other expats, Patrick was not called by his first name by most colleagues. Somehow "Dr Turner" had gotten stuck with him.

"Sister Julienne kindly allowed me to use her copy machine," Patrick explained.

Shelagh nodded. "I see," she said and looked at her watch. "Uh, it's dinner time already. I was doing research on a new antiretroviral regimen for newborns they are testing in South Africa and I must have gotten carried away."

Patrick smiled. He and Shelagh had been colleagues for about five years; she had arrived at Moshi shortly after himself. Until two years ago she had regularly worked at the antenatal clinics, where he had witnessed her being an excellent midwife.

Unlike bubbly colleague Trixie Franklin, Shelagh was rather quiet and hardly ever talked about herself. After having worked with her a bit more intimately over the TB proposal for the past months. Patrick had begun to see her in a different light. Not only was Shelagh an excellent medical professional, she also had humour and wit. He admired her compassion and how she acted so completely unimpressed by her achievements. He even found that her modesty and her complete lack of vanity made her quite attractive.

"Well, to brighten up your mood a little more," he said, "I have just received the news that they are going to fund our proposal."

"They are?" Shelagh cheered, "This is wonderful news. You should stay and have dinner with us to celebrate."

"I am afraid, I can't." Patrick said with a sad undertone. "I need to get these copies done and then I'll have to be off. Timothy is with me, but he's in a bad mood, so I should hurry up and get us home as soon as possible."

Shelagh nodded. She had shut down the computer and gotten up from her chair. "I am sorry," she said. "How has he been recently?"

During their work on the proposal, Patrick had occasionally spoken about his life as a single father and how much it burdened him.

"Oh, he's holding up well, I think," Patrick said sadly. "It's been almost a year now. To tell you the truth, I am a little afraid of the holidays, though. It will be the first Christmas without his mother. And I am afraid it might undo things. At least, Granny will be with us this year. We'll pick her up from the airport next Friday."

Shelagh looked at him compassionately. "You see, Dr Turner, I can tell you that children are a lot more resilient than you think. I speak from experience. I lost my mother when I was very young. It was hard on me but I got through."

Patrick wanted to reply but was halted by Trixie Franklin: "Doctor Turner, I am sorry to interrupt. But I am afraid your son is getting rather bored outside. He has turned up the radio rather loudly."

Patrick groaned. "That boy," he muttered.

"Here, let me handle your copies, Dr Turner. You go and take Timothy home." Shelagh said.

"But I'd have to come back to pick the copies up," Patrick responded, his voice tired.

"Never mind. When do you need them, tomorrow?" She asked.

"7.30 am at my office," he replied.

"I will send them over with Omari, our night watchman. He can drop them off after his shift tomorrow morning."

Patrick beamed at Shelagh. "You are my saviour tonight, do you know that?"

Shelagh blushed slightly. "Well, I would not use this word under this roof," she said, "But, thank you."

Patrick handed Shelagh the folder with the sheets to be copied and watched the young woman intently. He was aware of the rather strict rules imposed on all staff of Nonnatus Mission. It was expected that they were members of the Church of England and also lived by their faith. Moreover, there was a fairly strict code of ethics regarding relationships between men and women. Relationships at the workplace generally were not allowed and unmarried nurses were not to have male visitors.

Patrick himself was an agnostic. While he had the highest respect for the Sisters, he never quite understood their deep religiosity. He had always found the regulations Nonnatus Mission placed on their employees slightly out-dated and wondered who would want to take on such a job. But according to Sister Julienne, applications were few but regular.

He was shaken out of his thoughts by Shelagh's clear voice: "Is there anything else, Doctor?"

Now it was his turn to blush, feeling caught in his thoughts. "No, no, thank you, Shelagh, I should be hurrying or else, Sister Julienne will impose an order for us to stay away from here in the future."

Shelagh watched Dr Turner disappear into the corridor. She had felt sorry for him ever since he had been widowed so suddenly. Marianne Turner had been an occasional volunteer with Nonnatus Mission. Shelagh had always liked seeing the Turners together. They were friendly and helpful with everyone. Unlike most other expats Shelagh knew, they lacked the kind of cynical neo-colonial attitude very many white people living and working in developing countries showed.

After Mrs. Turner's sudden death, Shelagh had felt especially sorry for young Timothy Turner. Her own mother had died when she was only eight years old, thus she knew about a child's grief. But during the past months, she had also come to see more deeply into Dr Turner's inner conflicts over being a widower with a young son.

He had increasingly let her look behind his jovial façade. Shelagh had found him often rather weary and she could tell that he felt guilty, for not being able to make as much time for his young son as he wanted to.

"Shelagh, are you coming?" Shelagh flinched. She had forgotten about Trixie still standing in the doorframe, waiting for Shelagh to join her to go to the dining room.

"Poor man," Trixie said while the two women slowly wandered along the corridor. "He looks so sad all the time since his wife died. And did you notice his shirt was lacking two buttons?"

Shelagh was not in the mood for discussing the doctor's appearance and said "Trixie, this is none of our business, don't you think? Speak more respectful of him, please."

Trixie frowned and walked on. She had been working together with Shelagh for almost five years now and while she appreciated her for her non-obtrusive manner, Shelagh could be a real spoilsport when it came to gossiping about certain people.