Looking for Betty

Mothers line the corridor of the pediatric ward of our rural hospital in Uganda, holding up their babies and waiting for the physician to begin their visit. The lowering of hospitalization fees has had a major impact on our already overburdened daily work. As I try to find a passage through the crowd, I notice a woman holding a young girl who is obviously very sick. A few questions and a brief physical examination make me think that the girl—her niece, Betty—suffers from meningitis. The lumbar puncture reveals cloudy spinal fluid, and the laboratory results suggest tuberculosis. I start her immediately on antituberculosis medications through a nasogastric tube and streptomycin injections. Three days later, her temperature has dropped and the patient has begun to talk in a lively …