A strong narrative set in rural SA

The Angina Monologues by Rosamund Kendal (Jacana, R145)

Rosamund Kendal's second novel, The Angina Monologues deals, as did her debut, with the trials and tribulations of being a modern doctor in today's South Africa. Like the first, Karma Suture, it also has a deliciously witty title.

The Angina Monologues centres on three young women interns who are completing compulsory medical community service in rural KwaZulu-Natal, at Prince Xoliswe hospital, in a one-horse town. Each is vastly different, and we follow their lives and struggles with life in a decaying hospital, decay which is made worse by the corruption practised by those in charge. We are introduced to each in separate chapters.

There's Rachael, spoilt and rich. We meet her as she wanders disconsolately around her spartan doctor's quarters, trying to figure out how to make water emerge from the taps. You pump it yourself, of course, or pay the dagga-smoking gardener to do it for you. Shock number one. Yet Rachael is determined to make a go of her community service and to stick it out. Not an easy task when she is beset by her parents at every turn, her neurotic Jewish mother in particular, imploring her to pack up, return to Cape Town and board the first plane to London where she can find a job as a doctor, and a husband too, hopefully.

In contrast to the wild and funny Rachael is the conservative, quiet young wife Seema. Passionately dedicated to her vocation as a doctor, and a brilliant medic, she harbours a painful secret. Her husband Satesh is both insanely jealous of her abilities, and abusive in his jealousy and his lack of love for her. But for Seema to abandon her marriage would mean incurring her family's wrath and alienation. She struggles poignantly with these dilemmas throughout the story.

Then there's Nomsa: feisty, ambitious, and equally passionate about her calling. And yet she too is caught between two worlds - an education in Cape Town away from her family in Aliwal North means that she feels alienated from her home and her rural, illiterate mother. But her mother is sick and Nomsa must return home and face the family she loves with a fierce sense of pride, yet returning means awakening a mass of contradictions within her.

Nomsa's portrait is finely drawn - I found her the most compelling of the three. The tensions that threaten to tear her apart are sensitively revealed.

It is only fairly late in the narrative that the three meet up, becoming more friendly with each other, and I couldn't help wishing that this had happened earlier on in the story. Part of the joy of each woman's life is in the connections they have made with each other, and this forms part of the enjoyment of the reading.

A very apt and large part of the story is Kendal's explanation of conditions at a rural hospital, which are shocking, to say the least. The stories of the various patients are also woven into the novel, and some of the stories are heartbreaking, especially in cases where private, expensive medical care could have saved lives.

Kendal, a medical doctor herself, knows what she is talking about, and her fiction exposes the truths and deceptions in an entertaining, yet ultimately shocking way.

Kudos to her for doing it so cleverly and for uncovering the facts that need to be exposed.

At the end of the year the threads of these young women's lives coalesce in a number of decisions made, and realisations achieved. This is a delightful, witty, entertaining read - serious truths are explored, and lives are deftly and intelligently explored in this strong narrative.

Published in The Star Tonight September 23 2010 and Pretoria News September 27 2010