The season for malaria

The Gardener's Daughter has malaria. She lies under curtains of mosquito netting in the postpartum room with a night fever of 104. Her daughter, an eager child, breastfeeds even as her mother slips into a fever induced delirium.

They say here, " Ah yes. It is the time of malaria" It is the season for the big, black mosquitoes that cause malaria. The little ones of summer, however annoying have gone and now with the rainy season the malaria mosquito has come. They say when the mangoes ripen the cholera season will begin.

It is also the time for congo peas and okra cooked into a spicy sauce that is simmers for hours over a charcoal fire. It is also the season for grapefruit sold in piles on the road for only a few gouds.

And so it would seem that the seasons are marked not by changing leaves or snow storms but by the rains and the fresh fruit and by the tropical diseases that claim millions of lives each year around the world.

I had not prepared myself really for this season of malaria. I do sleep under a mosquito net and take my malaria pills, when I remember, but I was not prepared for it in the clinic. I was not prepared to test and treat and wait with it. I was not prepared for the way the women walk and sleep and the high fevers.

The Gardener's Daughter is the second case this week. She did not sleep with mosquito nets nor did we give her chloriquin and she suffered from severe malnutrition and so, in this season of malaria, perhaps I should not have been surprised.

I look it up when the internet is working. I read every book we have laying around. There are several kinds of malaria and Haiti has the worst and most damaging. We should be passing out a malaria net, a bar of soap and malaria pills to every pregnant woman but we are not. We give iron pills and pills to kill hookworms. We set priorities and make choices.

Her fever scares me but we give her clean water and food and vitamins and a place to bathe and the medicine and watch the fever spike and come down and take its course. I learn to adjust my fear and to replace it with faith and knowledge and a simple prayer.

I have a new understanding of seasons. It once meant the coming of fall leaves or spring flowers but now I know that people note the seasons by the diseases they bring.

The nights are beautiful here and the days have a breeze. It is a beautiful season here- a perfect season - if only it wasn't also the season for malaria. Mosquitoes breed quickly where there is standing water, where there is little clean water and few latrines.

Morning spreads over the mountains, a cow calls to be milked, roosters crow all around and downstairs the babies stir and a mother works her way through labor.

I think of all the songs about seasons and hear Pete Seeger gently sing "a time for every season under Heaven" So I will quiet these words for now and go down to feel her forehead and begin the day.