He sloshed his hands in a basin, slid gloves on, and put on a surgical mask and a fresh apron, then walked over to what once had been someone’s kitchen table but now served a higher purpose as an operating room surface. It was covered by squares of disposable white paper on which a baby girl lay screaming as a nurse inserted an IV needle in her arm to start a drip. The mother shrieked nearby, echoing and amplifying the suffering of her one surviving child.

“It looks like another cholera,” a nurse replied. “Once you set the broken arm, we will begin the antibiotics.”

Ledford nodded. “We have any patient history or X-rays for her?”

“No. She’s about six months old, has a one-oh-one fever and coughing. Cries are weak. The mother just arrived this morning and said a big rock banged into the child during a mudslide two days ago.”

The doctor wasted no time complaining about what they didn’t have, because they could only work with what was available. He was thirty-one, an even six feet tall, had longish dark hair that reached his collar, and possessed impeccable credentials: University of Iowa for premed, then the Carver College of Medicine there, followed by a three-year internal medicine residency at the Mayo Clinic in Minnesota. He’d been ready for the next step toward a successful career when he decided to take a holiday from his studies and go see the world. He did not like what he found out there. He had a rugged, handsome face, but the eyes were those of a combat veteran, for he had seen horror after horror in refugee camps from Haiti to Africa. The emergency calls for help from Pakistan when the floods struck had come as he was wrapping up an assignment in Bangladesh, and he did not hesitate. This was who he was now, at least for as long as he could stand it.