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Captured, a Story from Liberia

by Ken Magee

Skeleton-size arms and legs dangled limply as his mother carried him to my small table. Flomo Nueto was my fourth patient at Kingsville Camp for Internally Displaced People, right after a little girl named "Surprise." Pulling a thin blue and yellow blanket down from his chest area revealed rapid but shallow right-sided respiratory effort. Massive swellings bulged from both sides of his neck. As I took my light and with help of a tongue blade looked in his dry mouth, his dull eyes opened. He did not whimper or protest. Death waited nearby. Flomo had been brought by his mother and grandmother to this camp only a few weeks earlier. They had fled Lofa County where the Rebels had killed many people and where life was yet a gamble. I can only imagine what had happened to Flomo's dad. Their escape had been a hard trip, full of grief. Flomo increasingly complained of "hot skin," and tiredness. In spite of the ministrations and loving care of mother and grandmother, he ate little and had progressively weakened over three months' time. His large neck masses were firm. My stethoscope found absent breath sounds in the left chest and crackles of moisture at the right lung base. Percussion of chest walls intoned dullness on the left. His left thorax was fluid-filled. Possibilities were several. Mostly not good.

Hospitals in Monrovia had been devastated by the fourteen years of civil war. Now resources were extremely limited and beds were few. We had been instructed to bring in from the camps only patients who would die without help, but not to bring ones who would likely die anyway. My thoughts were weighted by the sudden death the night before of an eighteen-year-old hospital patient with severe heart inflammation. I talked with a fellow team member, Mary Van Veen from Canada, and decided to hospitalize Flomo.

His mother left her little son lying on a small bamboo bench and went down the path of slick red mud toward their tiny thatched hut, one among hundreds. She would gather a small plastic bag of necessities for them both. Later that day, after seeing many other patients, we loaded them in the back of our Toyota van for the trip to ELWA Hospital. Flomo lay on his mother's lap, breathing rapidly. His twelve-year-old body looked much smaller than one would expect. I sat nearby watching closely.

The following evening, after a busy working day, Mary and I returned to ELWA Hospital wondering what we would find. Flomo was alive! His left chest had a tiny needle mark surrounded by a large bruised area. Much fluid had been drained by a Liberian doctor. He was being given IV fluids and antibiotics. He looked a bit better and air was now moving in his left chest. I wondered what tests they had been able to run on the fluid and his blood. (I did find later that they had been able to do a simple chest x-ray. Indeed, it confirmed his left chest to be fluid-filled which, under pressure, was pushing his heart to the right.) They concluded that tuberculosis was the likely culprit. Flomo did get better. Soon with each visit he repeated over and over, "Go with you? Go with you?" Mary did a grand job of encouraging his mother, and a week after admission they were ready for transport back to Kingsville Camp. Flomo was eating, gaining strength and walking. His lungs sounded markedly better. He was given a month's supply of anti-tuberculosis meds. More were to be secured later.

As we departed down the pathway toward our waiting Landcruiser, I felt a small hand reach up and grasp mine. Flomo and I walked together.

In subsequent IDP camp visits we saw Flomo several times. He continued to improve. On my last visit he stood outside a window cut in the blue tarpaulin walling of my tiny examining room and watched us most of the day. Sometimes, when privacy was needed, we would shoo him away for a bit. At the end of the day he stood with other children and waved as we left the roadway of sticky red mud.

Flomo, you captured my heart. Oh, God, take care of Flomo.