In the 1880s, before any of this was a hospital or a national monument, Kalene Hill was a slave-trading hub. Ovimbundu slavers came up from Angola to deal with Ndembu headmen, buying and selling people in the same clearings that would soon host a medical clinic. In 1884 a Plymouth Brethren missionary named Frederick Stanley Arnot travelled through the region, identified the Zambezi's source, and decided the hilltop breezes would keep European travellers relatively free of malaria. His judgment of the hill was later proved, roughly, correct. His judgment of the people living under it was shaped by the prejudices of his century, and the mission that followed would carry those contradictions throughout its history.

In 1905 a doctor named Walter Fisher and his wife Anna arrived from Angola to found a mission hospital on the summit. Every household item and every medical supply had to be carried in by porters from the coast, a two-month walk. The first hospital was built using the Angolan technique of brickwork fired from baked anthills, and its ruins are still there. The Fishers traded cloth, beads and iron tools for labour; one terrible night in the dry season a spark lit the thatch and burned everything to the ground, but help arrived, and construction resumed. Harsh colonial administration in Angola and ongoing illegal slaving pushed Ndembu families to settle near the mission for safety. At first they thought of Fisher as a government official and brought him tribute. The Fishers' two older sons, Singleton and Ffolliott, were raised partly by Ndembu nurses and played with Lunda children; they grew up fluent in both languages. In 1919 Singleton produced the first Lunda-Ndembu grammar, a reference still in use today.

Fisher was, by the standards of his time, unusual. He took on apprentices at no cost and taught them how to identify the microbes behind disease, how to treat them, and how to make a smallpox vaccine from a sick person's own blood. He died on 30 December 1935 and was buried on the hill. The hospital moved to the foot of the ridge shortly after, following the water. The present building, built in the 1950s, is an airy brick structure with a tin roof and roughly 160 beds. It treats maternity cases, children, infectious diseases, surgical patients and malnutrition. Crucially, it trains other clinics' staff - nurses and doctors from Zambia, Angola and the DRC travel here for upskilling. Patients travel the other direction, sometimes hundreds of kilometres, to reach it. Malaria has always been the bulk of the caseload, and children and pregnant women the most vulnerable.

The Zambian national electricity grid does not reach Ikelenge District. It stops 380 kilometres short. Until recently that meant wood stoves, kerosene lamps, and for those who could afford them, diesel generators that hummed through the night. In 2007 the Zengamina hydroelectric plant, on the Zambezi where it drops west of the hill, began feeding twenty-four-hour power to the hospital. The supply has since been extended to the Fisher orphanage (now on Hillwood Farm, in the care of Paul and Eunie Fisher), to the schools, and to roughly 1,000 houses. A pineapple cannery is planned. Better drinking water and sanitation are on the way. Students have light to read by. In 1964, as part of the Zambian independence celebrations, a copper plaque was mounted at the source of the Zambezi and the site declared a national monument. A US$300,000 visitor centre was completed in 2007. The river still starts where it always started. It just has a hospital beside it now, and a name on a brass tag, and power.