Resurrection? . . .

I take the well-worn path between the house and the hospital. The rains have turned the desert in to a jungle barely kept at bay by the piggish, constant munching of two half-starved horses. Hortence has called me to look at a child with a hemoglobin of 5 (normal 13-15) to see if he needs a blood transfusion. I savor the cool air, slight breeze and overcast sky. Maybe it'll rain. I walk down the verandah of the OR and towards the Nurse's station.

A few minutes later we are in the dimly lit cave that is Pediatrics. The tin roof windows are mostly closed to keep out the "cold" leaving the entire ward lost in the shadows of late afternoon. After verifying that the 5-year-old is stable enough not to need a risky blood transfusion I walk back down the rows and stop to look at the "miracle" baby. She is, amazingly, still alive. Her chubby body lies flaccid on the mattress, her breathing shallow but not too fast. Her eyes are rolled back and she is unconscious. Her body is hot to the touch. I grab a thermometer and insert it in the baby's anus. 38 degrees Celsius: a high fever consistent with her cerebral malaria. I prescribe an injection to lower the fever and walk back to the nurse's station with the father of the child in tow.

As the father of the child pays for the medicine I can tell he is tired and discouraged.

"It's a miracle she's still alive." I say.

"Yeah, but it's all a waste..." the dad replies leaving unsaid the obvious fact that he's sure she'll die.

As I look at the tears that well uncontrollably in his eyes the whole story of her resurrection passes quickly through my head as told to me by Sarah:

"I was just making normal rounds on Pediatrics when I saw that little baby Koussekoura's IV wasn't working. They hadn't been able to find an IV in her anywhere except her external jugular. There she was, semi-conscious, with this big taped IV and tubing coming out the left side of her neck. Israel and Pernilla tried to help me get it working. We tried everything: injecting a syringe of Glucose solution, wrapping the IV tubing around our fingers to press the fluid through the catheter, inserting needles in the IV bottle to let out the air, everything. This was only her 2nd day of treatment for cerebral malaria and she needed that IV!

"Just then, I noticed that she was breathing faster. Then her hands curled up into fists, her eyes rolled back in her head and her body stiffened as she had a generalized seizure. The mom and great aunt were standing by. Before I could do anything, she stopped breathing. Israel, Pernilla and I all searched for a pulse and couldn't find one; neck, wrist, groin, chest, nothing. The women starting crying softly as the mom came to close the eyes and arrange the limbs. The baby was completely limp. The great aunt went to look for a cloth to wrap the body in. We started to comfort them.

"Several minutes passed when, suddenly, the baby gave a small gasp for air, then another. Shocked I checked for a pulse and found a slow one. I started doing external cardiac massage until the heart beat became faster. She was still unconscious but now definitely alive! Then she started seizing again and I had to give her three doses of Valium before they calmed down. She was then breathing short and fast with big pauses. I thought there was no way she'd live through the night."

It is now a day later and little, chubby Koussekoura is still alive, but the dad is convinced she won't last. It is still sketchy but something in me rises up and forces its way out.

"No, it's not a waste!" I cry, "She's alive. Our only responsibility is to do what we can while we can. Our money won't last. One day it's going to burn. But what we do with our money lasts. One day, whether she lives or dies right now, one day you'll see her again. God will reward you because you have given from your heart. You sacrificed to buy the medicines to treat your baby even though you thought she would die. Whether she lives or dies is now in God's hands because you've done all you could. That's all that's required. But if you didn't do all you could, then you would be responsible. Courage! You're doing the right thing!"

As the dad walks back to his comatose daughter and I walk back to my house I look up at the stars that have now come out and pray that God will reward that dad's love and sacrifice. I feel an unexpected warmth and peace as I walk the familiar path home.

James

P.S. As of the writing of this email, little Koussekoura is alive but still in a coma.