The sun is barely rising in rural Burundi when we begin our medical rounds in the pediatric ward. I am an American, doctoring in this central African nation, far away from my home in northern Ohio. An early start to our day is necessary since there are so many children here. They are all very sick—an inordinate amount of suffering crammed into their short lives. The mothers of these little ones sit sentry by their bedsides, some of them weeping, as we desperately try to save their babies from pneumonia, burns, and broken bones. Worst of all are the malnourished children, whose misery is caused by having so little to eat, their bodies shut down. Their swollen limbs, skeletal frames, and mewling cries of desperation are what keep me awake at night.

Last week, I was struck by the hollowed eyes and scooped-out belly of a four-year-old boy. He weighs just 17 pounds. He was so weak, he could not hold his head up when I examined him. We are doing our best to care for this child, but before rounds started, the nurse on the ward pulled me aside to whisper that we were down to our last 20 packets of ready-to-use therapeutic food. Therapeutic food is an amped-up peanut butter that is given to put calories, protein, and vitamins into children who are starving to death. The average malnourished child will need three packs of this miracle spread a day, which means I only have enough to give 6 children for one day. There are many more children who need it on the ward right now. All the training in the world did not prepare me to figure out this math.

I picked up a pack of ready-to-use therapeutic food to see if we could split it somehow. Would that qualify as being efficient under these circumstances? The sachet I held in my hand was emblazoned with the........

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