Roger Casupang was working in a coastal clinic on the north side of Papua New Guinea, an island nation of 9 million in the southwestern Pacific Ocean, when a pregnant woman burst into his facility. She was in labor, moments away from delivering twins. She also had a severe case of malaria, a life-threatening mosquito-borne illness common in tropical countries.
Casupang, an obstetrician, quickly took stock of the situation. When the parent is healthy, a twin pregnancy is twice as risky as a single pregnancy. Meanwhile, severe malaria kills nearly half of the people who develop it during pregnancy. The woman was exhausted and delirious. Because many of his patients walked for days to get medical care for standard ailments, Casupang didn’t know which province she had come from or how long she had been traveling before she reached his clinic.
