Smoke That Thunders

Mosi is a Zambian beer. It’s named after Victoria Falls, one of Africa’s greatest wonders. The locals call the massive falls "Mosi-oa-tunya," which means "the smoke that thunders." It’s odd to be here in Kazembe, where I spend most of my day hanging out with a couple dozen orphans and an hour here or there whacking a “foot-bolla” around with the village kids—including Nicholas, a 10 year old who has had a deep wet cough and vomiting spells for four weeks now; Calvin, the “diver” (goalie) with a ringworm infection covering most of his head and face;  and Albert, the 12-year-old neighbor kid who keeps one eye on the ball and the other on his two-year-old orphaned niece Wyness who moved here from Lusaka last week (more on that story later)—and such a paradise seems only to epitomize the harsh contradictions of life in Africa. Every rose has it’s thorns. Sometimes I’m just not sure which part of the rose I’m holding onto.

Mbita, the medical officer from the village, was at the orphanage taking care of under-5 requirements for the kids. Some needed vaccinations, de-worming, etc. As I was running back and forth bringing him whichever kid he wanted to poke next, Peter—one of the guys who works here—rattled off something to me.  I had a screaming baby in my arms and only caught part of what he said, but I caught that he was asking for a Mosi. I told him to find David and ask him.

It wasn’t until two or three screaming kids later that I actually stopped to listen to what Peter wanted.  His 17-month-old son had gotten his hands on some “methylated spirits” (methylated alcohol) and drank an unknown but significant amount. Methylated spirits is highly nephrotoxic and hepatotoxic. It also causes blindness. In short, this little boy drank a poison capable of frying his liver, his kidneys, and his eyes. Two of those three things are necessary for survival, and the third is pretty vital in this environment. Mbita told Peter to give the child a few sips of Mosi, saying that the “good” alcohol would neutralize the “bad” alcohol.

I thought that sounded a little sketchy.

We tried to make an international call to Poison Control, but David’s phone wouldn’t dial out. We borrowed Jasmine’s phone and called her mom, who was in Mansa getting groceries. Amy didn’t know what to do for the kid either but said she would try to get Poison Control on the phone. The nice man who answered the phone was exceptionally unhelpful. He refused to give her any information and kept saying that she had to take the boy to an emergency room.

“But we’re in the African bush! There is no emergency room!”

He refused to answer any of her questions about what might help—Should we give him milk? Make him vomit?

“NO! You have to take him to an emergency room!”

Well isn’t that helpful.

David was able to get a text through to his father, who called Poison Control to try again. By this time, David and I had filled a sippy cup full of milk and sugar (milk because it neutralizes some poisons, and sugar because methanol can cause severe hypoglycemia) and sprinted down the hill to the clinic.  David made a short detour to the chapel; we figured we needed all the Help we could get.  Peter was sitting on a rickety wooden bench, his tiny son sprawled limp across his lap. The child’s eyes were glazed over. He was listless and moaning slightly, and his abdomen was rigid. Peter said he had just vomited. All of the “medical personnel” at the clinic were off on lunch break (you don’t even want to know how I responded to that little gem of information…), so Peter was just sitting there helplessly with that sick baby boy in his arms…

David’s phone rang. By the grace of merciful heaven, his father was able to conference call us in with Poison Control. He had already explained the situation to the Poison Control lady, Sheri, and she had put him on hold to try and find some information.  A few seconds later she came back on the line.
“I just looked up the methylated spirits, and it is incredibly toxic. You need to take the child to an emergency care center immediately.”

Resisting the urge to simply implode out of frustration, I explained that Lusaka was 16 hours away by bus and South Africa was three countries away. I didn’t mention that the Mbereshi Mission Hospital is just a few kilometers down the road, because they would probably just give the kid a nice dose of Tylenol and send him on his way.  I told her there were simply no doctors or decent medical care available; whatever I had to offer was all the care this child was going to get. (Later I realized that David’s poor dad had to hear my rant about the dangerous unavailability of healthcare here; while everything I said was true, the sad and simple truth of the matter is that emergency healthcare would be significantly more available to us than it was to that child because we would be more able to get to Ndola, or Lusaka, or Cape Town, or wherever we needed to, but it is financially impossible and impractical to do that for every sick village kid… All that to say that I felt a little guilty later for causing David’s father any worry.)

There was a long pause on the other side of the line as Sheri wrapped her head around everything. Then she launched into action. She quickly explained the mechanism of methanol metabolism in the body. She said that Stateside, a child who consumed a significant amount of methanol would be ICU hospitalized on dialysis for several days and kept on a constant ethanol drip. The ethanol (or “good” alcohol) basically distracts the body. The enzyme that breaks down alcohol in the body targets ethanol first before methanol, and so if the amount of ethanol in the blood is greater than the amount of methanol, then the body won’t process the poison.

But we didn’t have an ICU.

Or a dialysis machine.

Or the capability to run an IV ethanol drip.

Or blood tests to track the serum levels of ethanol and methanol.

So we did the next best thing: we got the baby drunk.

I was a bit humbled at this point. Mbita had been right—the kid did need “good” alcohol—but now I understood why. It was going to take more than a little though. A few sips of beer certainly wasn’t enough to keep the methanol from destroying this little boy’s system. In retrospect, I am so deeply thankful that Mbita was there at all, and that his knowledge surpassed my own even if my pride would not allow me to see that at the time.

Sheri said to keep him drunk for the next several days until the poison had time to clear his system.  We climbed back up the hill with him. Just the day before, David and I had bought a bottle of cheap white wine in Mansa. After whispering a prayer of thanks for that impulse buy, I asked Peter what the child’s name was. Peter smiled.

“His name is Miracle.”