When Mariam hesitated he quickly explained. ‘I’m one of the doctors that’s helping Arissa at the clinic. Dr Aronaz. Do you mind if I take a look at your daughter?’
Mariam’s brow creased, instantly worried. ‘Do you think there’s something wrong?’
Philippe’s voice was steady. ‘Why don’t we just give her a check to be on the safe side?’
Prickles ran down Arissa’s spine; she didn’t like the sound of the scream any more than Philippe did, but it was clear he had something else on his mind.
She gestured across the road and slid her arm around the woman’s waist. ‘Come on, Mariam. The clinic’s open and there’s no one there right now. Let’s give Rosni a check and see if she’s about to come down with chicken pox.’
Arissa was sure that Philippe wouldn’t be reacting like this over a case of chicken pox, but she didn’t want to alarm Mariam.
Mariam held out Rosni with slightly shaking hands and Philippe took her quickly and pulled the blanket down that was tucked around her. He gave a nod of his head. ‘Let’s go over to the clinic.’
It only took a few moments to reach the clinic and set Rosni down on one of the examination tables. Arissa pulled out a tympanic thermometer and pulse oximeter as Philippe gently peeled back Rosni’s clothes, speaking to her in a soothing manner.
But Rosni was clearly agitated, her legs and arms flailing wildly and the high-pitched scream continuing.
‘Has she fed at all?’ he asked Mariam.
Mariam shook her head. ‘I tried to feed her all night but she just wasn’t interested. I eventually gave her some water this morning—it was all I could get her to take.’
‘Have you given her any acetaminophen?’
Mariam shook her head. ‘I was just about to buy some. They sell it in the grocery store.’
Philippe continued his examination. When the temperature gauge sounded a few seconds later she turned the screen towards him. The baby’s temperature was dangerously high and her heart rate rapid. Rosni continued with the high-pitched wailing as Philippe checked her over. The baby appeared to have bouts of agitation, between periods of sluggishness. Philippe murmured to Arissa, ‘Look.’ He ran his fingers over the baby’s fontanelle. It was bulging slightly.
She started and walked quickly over to one of the locked clinic cupboards. She grabbed some IV antibiotics, some acetaminophen, and some other equipment from the cupboards.
Philippe narrowed his gaze in question. He was still examining Rosni, checking the palms of her hands, soles of her feet and eyes. There was no obvious rash right now, but sometimes in Malaysian children rashes could be difficult to spot. He shook his head.
Mariam was getting more anxious by the minute. ‘What’s wrong with my baby?’
Arissa gave Philippe a quick nod of her head. It didn’t matter that this was her clinic. She’d never had a child with meningitis before and it was clear that Philippe had got this.
He bent to speak to Mariam. ‘We have to act quickly, Mariam. I think Rosni might have meningococcal meningitis. I can see from her chart she’s had her first vaccination but not the rest.’
‘She’s been sick. There hasn’t been time...’
Philippe put his hand on Mariam’s shoulder. ‘This isn’t your fault. We don’t normally see meningitis in babies as young as Rosni. She’s just unlucky.’
‘You’re sure that’s what it is?’ Mariam’s voice was trembling.
He gave a sorry nod. ‘I’ve heard this scream only once before.’
Arissa stepped up alongside him. ‘It’s important we give Rosni antibiotics as soon as possible. We have them here—for emergency circumstances like these.’
‘Shouldn’t she go to hospital?’
Arissa nodded. ‘Yes, absolutely. But if we call an ambulance now it will still be over an hour before you reach the hospital. We’ll start the antibiotics now before we call the ambulance.’
Philippe picked Rosni up and put her on the baby scale for a second, taking a quick note of her weight. It only took a few moments to work out how much of the medicines to give the baby and Philippe found a tiny vein quickly to slide in an IV portal. ‘Just as well you’ve got these,’ he said quietly as Arissa bent beside him to assist.