Last night I was listening to an African family sing softly as I examined their young relative with severe abdominal pain. He was deeply jaundiced, so hepatitis was my primary diagnosis. But his abdominal tenderness was steadily increasing. Could this be an intestinal perforation from typhoid fever? Was I bold enough to operate and find out? If I delayed, would he die in the meantime? But surgery in this context carries its own inherant risks! Later in the night, his abdomin revealed 6 dime size perforations of the small intestine – so very characteristic of typhoid fever. My compelling question today is why, in the Internet age, are children like this suffering from diseases that result simply from contaminated water?