Out in the countryside beyond the small town, the wind had picked up and bit through even Maxence’s leather motorcycle pants and jacket that he wore. They’d been gaining in elevation with the last few villages that they had visited, and the air had grown increasingly frigid. The sun didn’t seem to warm the black leather on his back and legs at all as they rode.
Earlier, when they’d ridden the motorcycles into town around noon, Dree had the shivers, but she’d seemed to warm up as soon as they’d gotten inside and started the clinic. The ski suit she wore had been sufficient to keep her warm for a while, but Maxence was becoming worried about her as the daily temperatures dropped.
At their campsite, Father Booker and the two engineers were tending to the fire and the food as they drove up. Alfonso had already made a main dish for dinner, and Batsa had arranged for delivery of bread, rice, and some side dishes, overpaying the lady handsomely.
The guys had built the night’s campfire larger than previous ones because the freezing wind had turned biting.
Dree’s teeth were chattering when she got off the motorcycle, and she stuck her gloved hands under her armpits as she surveyed the night’s campsite.
Maxence ushered her over to one of the best spots around the campfire, not downwind where the smoke would choke her, but just off to the side where she would get the most radiant heat without the smoke coming right at her.
After a few minutes, her posture relaxed, and she took her hands out from under her armpits when Alfonso passed her a plate of warm food.
Around the campfire, Maxence ate and tried not to think about Dree’s curvy body as he prepared to sleep beside her and keep his hands off of her for yet another night.
Dree received her plate from Alfonso and piped up, “You would not believe the day we had, guys. Father Maxence solved a medical mystery.”
Maxence chuckled.
Isaak grinned at him. “Oh? Considering Maxence’s proclivities in school, did he recognize the symptoms of a rare venereal disease known only in Turkish prisons and Brazilian brothels?”
Maxence stared down at his plate and refused to rise to the bait.
Dree said to Isaak, “No,silly,and I would really hope that something like that hadn’t made its way to remote villages in Nepal. Nope, we had a kid with advancedscurvy.I’ve never seen a case, and I think you haven’t either, right, Max?”
Max shook his head. “No, I’d never seen it. I’ve done most of my fieldwork in eastern Africa or Latin and South America, where fresh food is available the vast majority of the year, if not all year-round. I’d never seen scurvy before. It’s hideous.”
Dree nodded. “It’s a terrible disease. When England was trying to explore and exploit the Polynesian and Indian Ocean islands, those ships would lose half their crews or more to scurvy. It’s deadly.”
Alfonso asked, frowning, “But, how do you know it was a vitamin C deficiency?”
Dree turned to him. “Once we figured out that’s what it was, it was obvious. The symptoms matched. The kid wasn’t drinking milk, and raw milk is a minor source of vitamin C. It must be pretty important here during the winter, though. All the other kids were getting at least some vitamin C from milk and maybe some from preserved foods like these hot pickled chutneys that the lady delivered, so they didn’t get scurvy. This particular kid, though, wasn’t drinking the milk. I didn’t even think aboutmilkbeing a source of vitamin C because, you know, it’s not orange juice. He didn’t have symptoms of calcium or protein deficiencies, so I think it’s the vitamin C.”
“But you didn’t assay for it,” Alfonso said. “You don’t have a definitive diagnosis until you take blood and assay for ascorbic acid levels.”
Dree laughed, and Maxence saw where this was going. She said, “We can’t draw blood and send it off to the lab for a vitamin C concentration assay.”
“No,” Alfonso said. “But you can’t treat a deficiency unless you are certain that the nutritional deficiency is the cause of the disorder. Otherwise, you may miss the true cause.”
She said, “We don’t have a gas chromatograph and trained technicians at our beck and call in this hill village. If it’s not scurvy, then it’s something that I don’t know how to diagnose. I told his parents that if he doesn’t get better to take him to the nearest city, but I don’t think they can.”
Alfonso was scowling. “These hill villages need medical laboratories, too, in addition to the NICU micro-clinics. How are we supposed to treat premature babies without access to modern medical techniques?”
Maxence smiled, sensing an opening. “That’s an excellent question, Alfonso. If we build these NICU micro-clinics all over the mountains of Nepal, how will the staff perform routine procedures on these premature babies?”
Alfonso glared at his plate. “We’ll just have to build medical laboratories, too.”
Maxence kept his voice quiet. “Trucks don’t come up here during the winter. How will we get supplies to them?”
“We’ll mail them.”
“There’s no mail up here, Alfie. The store doesn’t even get supplies for months. The clinics will need oxygen canisters and pharmaceuticals.”
“We can get it to them,” Alfonso growled.
“And where will we find medical technicians to work in these medical laboratories? Or pediatricians with neonatal specialties to work in the micro-clinics and send the tests to the medical laboratories staffed with technicians?”
Alfonso glared at Maxence with more anger than Max had seen from him since they were on the playground at boarding school. “Then what do you suggest we do? Are we just supposed to let these premature babies keep dying just because we can’t doeverything?”
