On Dec. 31, 2017, Ms. Heiderman and some other friends went to a hotel in Moroni to celebrate the coming new year. But that evening, she was not feeling well, and complained of nausea, said Luke Garfield, a fellow volunteer. The next day, she texted her mother to say that she “could not stop shaking from the chills,” and felt like she was “in a fog,” according to a narrative prepared by the family’s lawyer.
The Peace Corps had one doctor in Comoros, Dr. Said, who had been hired by the agency several years earlier. He had an assistant who holds a nursing degree but had also worked as a pharmaceutical and dental technician.
According to the inspector general’s report, Dr. Said’s notes from Jan. 2 show that Ms. Heiderman’s pain level “was noted as 8 out of 10.” The doctor “suspected a headache disorder,” and gave her acetominophen for her headache, as well as medicine for nausea, an antacid and a decongestant, and “told her to drink more water and rest.”
The next time she saw Dr. Said, on Jan. 4, her symptoms had only grown worse. The doctor put her on a “medical hold,” and sent her to stay in a hotel, where he could remain overnight in a nearby room. He gave her intravenous fluids “to control her nausea and vomiting.”
The records reflect that Ms. Heiderman did not have the kind of high fever that is typical of malaria, but the Peace Corps requires its health professionals to “always consider a diagnosis of malaria” in any volunteer, especially one serving in an area where the disease is prevalent, such as Comoros.
On Jan. 8, with Ms. Heiderman suffering from what Dr. Said believed was
”dehydration due to severe vomiting,” the doctor appealed to Washington for help and Dr. Alison Colantino, the director of the Office of Medical Services for the Peace Corps, became involved, the inspector general reported. It had been a full week since Ms. Heiderman fell ill. Dr. Colantino told Dr. Said to do lab work the next morning, and to call a regional medical officer in South Africa if Ms. Heiderman’s fever spiked, and to do blood work the next morning.
That day, Ms. Heiderman’s mother and sister sent a flurry of frantic texts asking her to check in. They never received a reply. At 5:33 a.m. in Comoros on Jan. 9, Dr. Colantino raised the possibility of a medical evacuation. Less than 30 minutes later, Ms. Heiderman was dead.