Sometimes it is a reflection of a high fever, like the 106F/41.1C recorded for Jesca, a sweet three-year-old who looks a lot like my granddaughter. Fortunately, her mother brought her to the hospital in time for us to put her on IV fluids and quinine for malaria. Mama Jesca's once-convulsing child is recovering and will go home tomorrow.
Sometimes it is an expression of pain. Joab, 9, was dropped off at the outpatient department yesterday after he had all but severed his baby finger with a panga while cutting grass. Showing no physical signs of shock, he walked quietly to our minor (operating) theatre for a tetanus shot, amputation and discharge.
Sometimes it precedes (and follows) the death rattles we witnessed in a two-year-old admitted yesterday. "She was perfect when God gave her to us," explained her father. "Now God wants to take her back." He then described a year of Nora's recurrent "boils," fevers, weakness -- and her intermittent treatment with herbal remedies. Three weeks ago, he said, Nora developed another fever, plus a stiff neck, but no boils. She died an hour after admission.
Silence is a time to pray. We didn't make it to church yesterday, but we certainly prayed.