Sandbags are not enough
The night the river rose, the emergency room became a waiting room for the country’s failures.
Children arrived shivering, their shirts sour with canal water. A pregnant woman clutched a bag of expired medicines bought on credit. We improvised because that was what the ward demanded of us. An IV bag dangling from a borrowed umbrella, a desk lamp when the lights faltered, a storeroom door swollen shut. By dawn, the water slipped back into the banks, as if to remind us who really governed the lowlands.
Medicine taught me the anatomy of floods by touch. We palpated swollen bellies, listened to rattling chests, and traced rashes like forgotten creeks. We managed dengue on plastic chairs, leptospirosis in a corridor where mop water never quite dried, and diarrhea with oral rehydration solutions mixed beside a whistling window. Ambulances did not always come, and the road outside often turned into a shallow river. A tricycle driver ferried a laboring mother and her courage. We caught the baby on a cot while rain dropped through a leak we could not seal with tape.
None of it felt accidental. The poorest patients did not only live near creeks; they lived inside decisions made far from the floodplain. Culverts postponed, dikes poured too thin, drainage channels half dug and fully paid. The choices of people who shook hands on a stage arrived to us as fevers, breathlessness, and bills a family could not carry. The water carried receipts the way it carried leaves: quietly, obviously, and undeniable if you cared to look.
I remembered a boy whose fever refused to break. His mother had waded through brown water to bring him, holding him like a salvaged book. We suspected severe dengue. By morning, the IV tape had slipped in the humidity, his lips cracked from breathing too fast. He asked if the water would come back. I told him he would get well. I did not add the truth I carried. Water returns to what we leave undone.
Another day, a father needed dialysis and chose rice instead. He counted options on a damp scrap of cardboard. The flood had taken their pantry and then their savings. He signed the refusal form with a trembling hand and asked if the pain would ease if he slept sitting up. That night, on my makeshift bed at the quarters, I tried to name what failed him first. The wall that collapsed upriver, the contract that cut corners, or the habit of looking away that turned loss into routine.
After every storm, leptospirosis came back like an old debt. We gave prophylaxis when stocks allowed and reminded neighbors that post-flood fevers were not just “pagod.” The triage board became a map of the watershed, clusters blooming from streets that always drowned first. A midwife warmed a towel with her own hands. The tricycle driver waited outside, ready to ferry a new mother home through water up to the tailpipe. When the access road became a river, we sat on benches and whispered reassurance over thunder.
If governance had a chart, we could have caught the deterioration early. Airway: were communities heard before blueprints hardened? Breathing: did canals inhale and exhale rain as designed, or choke on neglect? Circulation: did funds reach the tissues they were meant to perfuse, or pool where they fed nothing but appetite? Patients crashed this way—hint, pattern, crisis—while officials said no one could have known. The country deserved the same vigilance we gave a crashing patient.
I did not stay in those wards forever, but the river kept writing in my bones. On hot afternoons, the city smelled of sun-scorched asphalt, and I remembered the boy asking about water and the father counting coins on a damp ledger. Corruption was not a headline to me; it was a clinical picture. It behaved like sepsis, spreading through shortcuts and kickbacks until organs failed; clinics, bridges, classrooms, faith. You do not treat sepsis with perfume and press conferences. You find the source and drain it. You cut away rot. You flood the system with what it needed in the first place and monitor like a life depends on it, because it does.
Sandbags are not enough. I wanted dikes that hold and audits that bite. I wanted budgets to behave like water in the best way, flowing to every low place, not pooling in the deepest pockets. I wanted receipts pinned to daylight so children could read who built what, and whether it still stood when the river rose. The river remembered, so did we. And memory, spoken together, can be a current strong enough to move the ground itself. Call it prognosis. Call it refusal. Call it a beginning that does not ask permission.
If we want our communities to dry, we need more than sandbags. We need to dam the plunder that turns every storm into a catastrophe and keep telling these stories, because silence has never saved a patient, and it has never saved a river either.
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John Dexter Canda, 27, is a medical doctor and former educator who used to teach college students about cells and biological systems.
