Directly from the airport in Angola I drove to the Lubango Evangelical Medical Center and made hospital rounds. Almost immediately I was summoned to the ER, where I met little Nibombe. Coughing and less than alert, it was clear that Nibombe was suffering from pneumonia that encased his entire left lung. On closer inspection, I was also alarmed to find that his condition was complicated by heart failure. I treated him with ampicillin IV, which is about the only highly active antibiotic we have at the med center, as well as furosemide for his cardiac insufficiency. Nibombe initially improved and I was feeling such relief. What a sad encounter the following morning to discover that Nigombe died suddenly during the night. Working out here, we face so very many unknowns. Unknown languages. Unknown behaviors. Unknown diseases. I keep thinking of what else from which this kid may have been suffering that I totally missed.