Her Very Special Boss. Anne Fraser

If there is anything we can do.’

      Within moments the small child, a girl, was lying on the couch, her mother sitting close by, her eyes flitting from Kirsty to Greg. One of the nurses had joined them and was talking to the mother in rapid Sotho.

      ‘The child stopped taking the breast two days ago. She’s been sick for over a week. A traditional healer gave her mother some herbs to give her, but when they didn’t help and she stopped taking the breast, the mother decided to bring her to us. It’s taken two days for her to get here.’

      While the nurse repeated the history, Greg and Kirsty had been searching for a vein in which to insert a drip. Kirsty knew that they had to get the small child rehydrated as soon as possible.

      ‘I can’t find any in her arms. They all seem to have collapsed,’ Kirsty told Greg, fear catching her voice. They had no time. The child could die if they didn’t treat her right away.

      Greg looked up at her. ‘Slow down. We’ll find one. Look here just above the foot. We’ll need to do a cut down. It’s not ideal, but it’s all we have. Have you done one before?’

      ‘I have, but I’d rather watch you first, if that’s OK,’ Kirsty said. This child was so small, so desperately ill. What if she was too slow?

      ‘You’ll have to do it, I’m afraid. You may have noticed my right hand only has restricted movement. It’s fine except for the most delicate stuff.’ Kirsty could only guess what it cost Greg to admit his limitations. At the same time she admired him for it. She had once seen a doctor attempt to perform procedures above his capabilities and the results had almost been disastrous.

      Greg noticed Kirsty’s hesitation. ‘You’ll be fine. I’ll talk you through it.’

      Somehow his belief in her gave her confidence and with very little assistance from Greg she performed the procedure perfectly and without any wasted time.

      ‘Excellent job.’ Greg’s praise was fulsome and genuine and Kirsty felt elated. She thought that she might grow to like her job here.

      ‘OK, let’s get her started on the usual regime.’ He directed a few rapid words towards the mother.

      ‘She’s three years old,’ he translated for Kirsty.

      Once again Kirsty was horrified. Three! It wasn’t possible. The child looked no older than nine months, a year at the most. She was so tiny.

      ‘Obviously we can’t use her age to work out how much we need to give her. By my guess she weighs just over eight kilograms. Could you pop her on the scales?’ he asked the nurse.

      The nurse scooped the child up and laid her gently on the scales.

      ‘Just right—eight kilos,’ she told Greg.

      ‘Any thoughts on the dosage we should be administering?’ Greg asked Kirsty.

      Kirsty thought frantically. She had completed six months in paediatrics as part of her houseman jobs. But the children there had been so much bigger, stronger than this child in front of her. She had never seen anyone in such an advanced stage of starvation before. How could she have? But she remembered a child, physically handicapped, who had been brought in following a severe episode of diarrhoea. The child’s condition had been similar to if not quite as drastic as that of this child in front of her.

      She was about to hazard a guess, but Greg hadn’t waited for her response. He adjusted the drip and straightened up. She could sense the fatigue and something else—could it be anger?—behind his professional exterior.

      ‘We’ve done everything we can for the time being. It’s in the lap of the gods now.’ He tossed his gloves into the bin. ‘The main problem is caused by formula. The government spends substantial sums of money promoting breast-feeding, but the problem is with the women who are HIV positive. The danger of them transmitting the disease to their infants through breast milk is just too large, so they are encouraged to give their babies formula. Unfortunately formula is too expensive for most of them, so they start diluting it to make it go further. Then the children simply don’t get enough calories or nutrition. And as if that isn’t bad enough, a large number of the outlying villages still don’t have access to clean water. So the women mix the powder with water from the river. And what you see before you is the result.’

      ‘Can’t we do anything about it?’ Kirsty asked. ‘Surely it’s just a matter of education?’

      Greg smiled, but there was no humour in his eyes. ‘Education and clean water. That’s what is needed. In the meantime…’ He let the words hang in the air for a moment. ‘In the meantime we do the best we can. Come on, Kirsty, as you’re about to see, there is plenty more for us to do.’

      ‘But doing the best we can isn’t enough. Is it? Not if children are still dying?’ Surely he wasn’t going to tell her there was nothing they could do to prevent this? He didn’t strike Kirsty as a man who let anything stop him from doing what was right.

      ‘We’ll talk about it later,’ Greg said quietly but firmly. ‘Right now we have work to do. You take the consulting room next door. I’m just across the hall. If you need me, give me a shout, but try the nurses first. I think you’ll find that there is precious little they can’t help you with.’ And without waiting for a reply, he turned on his heel and left the room.