Fat Some Day Soon

For the past two days, I've been struggling with a sick child. His medical problems are no more complex than many others-prolonged fever, severe malnutrition, untreated HIV-but deciding how to manage it has been much harder. He is 6 months old and only 3 kg. We would usually admit him to the hospital for feeding therapy. But admitting a child to the hospital means admitting his mother as well. Hospitals are so crowded that nurses are limited in the care they can provide, and mothers are enlisted as nursing assistants for their children.

My patient has two brothers--one six and one three--and no father. He left once he learned the mother was positive. Of course, he refused to be tested and has gone on to find another wife. The mom is left cleaning up the mess as he potentially destroys another home.

And so for the past two days she has carried her baby to the clinic because we can't admit him to the hospital. Despite the struggle, moms always find a way. What is amazing is that many of these sickest children get better. As my translator told the mom, he will be fat some day soon.