Michael took a deep breath before turning to his next patient. She was the size of a two-year-old American toddler, although her head was disproportionately large. Big brown eyes, but vacant. Skin stretched over bones. Legs like two sticks hinged with a golf ball in the middle. He looked at the chart. Kapinga Kabobo was seven years old. Nineteen pounds. She should have weighed at least forty. The latest cholera outbreak had tripled the number of people seeking medical attention at the International Medical Assistance Foundation field hospital in Goma.
Michael had quickly become a staff favourite, his quiet confidence and warmth revealed in a broad smile and the crows’ feet at the corners of his eyes. He opened the girl’s mouth gently and used a tongue depressor to take a quick look. “Let’s get this girl on a rehydration program. If she can’t swallow, then use intravenous glucose and electrolytes.” Perhaps startled by the foreign sound of Michael’s voice, the girl defecated onto the dirt floor of the medical tent. The watery diarrhea contained flecks of mucous and epithelial cells the size of rice grains, a telltale sign of cholera.
“We also need some metronidazole. Add it to the iv drip please.” He scrawled instructions onto the chart.
The girl’s listless eyes fluttered and closed. She was fading fast.
“Come on sweetheart, don’t give up on us now,” Michael pleaded, unwilling to admit that she was probably too far gone. He checked her pulse. Rapid, way faster than it should have been. He took her blood pressure. Low and falling. There was nothing he could do. He held her hand and stroked her cheek, trying to offer some small comfort as he heard the last, rattling breath. Biting back grief and frustration, Michael closed her eyes. Back in Seattle he could have saved her life. Then again, back in the US he’d never seen a case of cholera and probably never would.
He knew that it wasn’t really the disease that had killed her. It was the fact that she had no clean water to drink, and no latrine for going to the bathroom. There were no parents or other relatives to notify; the girl was an orphan and a refugee. Michael would fill out the death certificate later. There were living, breathing, laughing, crying children needing his help.