The quadruplets looked wonderful two weeks ago when Lisa (an Australian Pediatrician and dear friend) and I, along with a community nurse and a nutritionist visited them at home. We turned off the main road at the small green mosque and then stopped to ask directions from a neighbor who pointed toward a small mud brick house with a line of baby clothes flapping out front. We found Patuma and her mother sitting on a mat next to the quads who were all bundled in layers of blankets and covered with a single sheet. Slowly Patuma and her mother lifted each one and unwrapped them for inspection. Everyone laughed when I identified each baby by name. Happily we found that Mohammed, Hassan, Hussein, and Hamida had all gained weight. We took pictures and four of the other children joined us. The three year old twins sat in front of their mother, the little girl considering us seriously and her brother hiding behind his hands. Patuma walked us to the car and as we drove away I watched her sweep the twins into her arms and head towards home.
On November 10th Lisa told me that Hassan had been admitted to Kamuzu Central Hospital with fevers. He was the smallest of the four at birth. She said he was on several antibiotics and that they were feeding him through a nasogastric tube. She visited him daily and monitored his care. On the 12th she told me the fevers persisted. I stopped by the hospital on November 13th. When I saw Hassan in his mothers arms I tried not to appear visibly shocked. He looked like withered leaf; I could see his sutures clearly through the thin skin of his scalp – a clear sign of dehydration – and I sadly remembered Gabriel. Patuma handed him to me and as I cradled him, watching his chest rise and fall quickly, his eyes open and close slowly, she told me that he was improving. She said he was inconsolable at first but now he was quiet and eating well. I wondered if he was quiet only because the exhaustion was becoming more than his little body could bear. He made sucking movements with his mouth and I returned him to Patuma’s arms. Mildly astounded I watched him finish about 100 mililiters of formula from a cup and I felt hope rise again. I told them I would return on the 15th, I said goodbye and left.
Lisa called me on November 14th, my 32nd birthday, and told me Hassan had died at 9am. He was one month and two days old.