Invisible

It’s a hot night in Sukhumvit. Muggy, too. Ninety degrees with seventy percent humidity is an oppressive atmosphere—after a few minutes, a light rain begins to fall.

Bangkok is gearing up for the evening as I climb the walkway stairs onto the pedestrian bridge. The road is twelve feet below me, and I look down at the traffic— bumper to bumper chaos across all six lanes.

It’s strangely light on the footpath, because of the flashing neon and the glaring headlights below. At the north end of the walkway, I spot a small figure moving around, a moth caught in a flame.

The dark end of the street. A child plays alone over a busy Bangkok thoroughfare.

The little girl is perhaps three years old—she may be older, because malnutrition is rife in this part of the world. She jumps over the other three kids, holds the railings, and starts to rummage inside a plastic bag.

Everyone else is exhausted, and her mother is the very image of hopelessness. I imagine the child perched on the handrail, slipping and falling onto the traffic while the whole family sleeps.

I should do a hundred things, but all I do is take this picture. I feel shitty, helpless, and desperate. I think of the family now, as I write these words. It’s early evening in southeast Asia, and this infant will be settling down for the night on the footbridge.

Is she still alive today? Who knows! What brings a mother to such utter exhaustion that she can sleep, comatose against the hard steel railing, while her child dabbles with death? Where’s the father?

Every year, every day, mountains of people die in developing nations, and no one knows why. Children, adolescents, they just vanish. The families mourn, life moves on.

I’m not talking of kidnapping, or kids who run away—they vanish in the sense that one moment they’re alive, and the next they’re dead. In the West, we have a far better grip on health care, despite our constant gripes—if a child is ill, shows symptoms of illness, there is a safety net.

In much of SE Asia, in most of Africa, there’s no net. Take me back five centuries to medieval Europe, and that’s where they are today.

Maybe you think mountain is a poor choice of words. The WHO estimates 5.6 million children die every year before their fifth birthday—the cause of death is known only for three percent. Where does this happen? You guessed it—mainly Africa and south Asia.

How would it sit with Western nations if ninety-seven percent of deaths for the under-fives in France, California, or Ontario went unexplained?

More desperately, a lot of kids who die in faraway countries were never born in the first place—legally, that is. So there’s no traceability—no one knows you were born, no one notices you vanished.

Shame, shame, shame, as the West discusses Trump’s salacious stormy snafus, or the innards of When Harry Met Meghan.

The Bill and Melinda Gates Foundation’s CHAMPS project includes research on MITS—Minimally Invasive Tissue Sampling, a way to quickly determine cause of death with high accuracy.

Humans are like ecosystems—you can know their health based on what goes in, what’s inside, or what comes out. Pee is one of the best indicators—doctors have used it for four thousand years. In Shakespeare’s Henry IV, urine’s praises are sung by the bard.

FALSTAFF

Sirrah, you giant, what says the doctor to my water?

Page

He said, sir, the water itself was a good healthy
water; but, for the party that owed it, he might
have more diseases than he knew for.

Nowadays, a medic is no longer forced to sip your piss to diagnose diabetes, but run-of-the-mill blood and urine tests are not so many decades old. In CHAMPS, doctors extract tissue samples from brain, lungs, and liver. Add a little blood and spinal fluid, and throw the power of biomedical analysis at the ensemble.

The extraction itself takes under half an hour, and a non-specialist can easily be trained to do it. In some of the poorest countries in the world, home to many of these ‘Invisibles’, cutting-edge techniques are helping to bring a little closure to grieving families.

In Mozambique, the seventh poorest country in the world, public health is a dire problem—the nation is mired in environmental quality issues, poor medical services, and the twin evils of superstition and witch doctors.

In many communities, relatives will not allow a corpse to be autopsied—the reasons may be cultural or religious, but in a number of African countries, organ theft is a reality, so opening a body is simply taboo.

A biopsy needle leaves no traces, but perhaps the world can begin to have a little more traceability. By knowing why so many small children die, maybe we can start to care more about things that really matter.

And every time a kid plays on the railings above a crowded street, every person should at least have the courage to ask why.

The India Road, Atmos Fear, Clear Eyes, and Folk Tales For Future Dreamers. QR links for smartphones and tablets.

 

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