Miles M., 1

Miles is the second-born in a family of two children. He lives with his parents and sibling in a single-room mud-walled house without electricity. Neither parent has stable employment, and the family depends entirely on occasional casual jobs, which are increasingly difficult to find. Their irregular income is barely sufficient to meet basic household needs. Miles had been unwell for two days with high fever, persistent cough, difficulty breathing and repeated vomiting. As his illness progressed, he became increasingly weak, irritable and unusually quiet, with poor appetite and reduced fluid intake. His breathing became more laboured, and he could no longer play or engage normally with those around him. His mother initially gave him paracetamol syrup at home but his condition continued to deteriorate. Although she had previously heard about Helpster Charity at the market, she had no money for transport to the hospital. When Miles became visibly worse, she asked a neighbour with a motorcycle to take them on the promise that she would pay later. On arrival, Miles was febrile, markedly weak, visibly distressed and very sick-looking, requiring prompt medical assessment and

Miles was diagnosed with severe malaria and severe pneumonia, a serious combination that can rapidly deteriorate in a young child. Severe malaria may cause anaemia, seizures, altered consciousness or organ dysfunction, while severe pneumonia can lead to hypoxia, sepsis and respiratory failure. Urgent inpatient treatment with appropriate antimalarials, antibiotics, supportive care, oxygen when indicated and close monitoring is necessary. A good clinical response is expected.