The farmer wanted to know why his three-year-old son couldn’t walk or talk.
I sat opposite him in a dark, cold classroom converted into an examination room for a four-day medical clinic last spring in the village of Lapa, high in the Himalayas.
Wind whistled through the stone walls; rain pounded on the tin roof. The room’s single ceiling bulb kept flickering and dying; I had to use a camping headlamp to see my notes. And communications were hampered, to say the least: We conversed via two translators–from English to Nepali, from Nepali to the local Tamang language, then back again. It sounded a bit like the telephone game, and had similarly uncertain results.
Still, one look was all I needed to make the diagnosis: Down syndrome. I found the telltale single hand crease, eye folds and wide gap between the first and second toes and asked about the boy’s medical history: he’d never seen a doctor; sometimes he had diarrhea, fever or a cough.
I thought back to my journey here, the last leg of which had begun five days earlier. With two other doctors, I had left Nepal’s capital, Kathmandu, on a winding, bumpy, eight-hour Jeep …