Kairaluchukwu suffered what appeared to be light head injuries when thrown from her horse. The way she fell caused her to land on the back of her head. She was initially somnolent and confused but soon her family expected she would recover. Unfortuneately, over the next few days her level of consciousness declined. Later, through the heroic efforts of her family and friends, doctors were able to examine her in a hospital with imaging equip.ent. It was discovered she had hemorrhages in both temporal lobes from “contrecoup” brain injury. She died of this and other complications. Having suffered this unexpectedly bad injury, good surgical care would not have saved Kairaluchukwu, but at least in a hospital with proper equipment she received the diagnosis required and demonstrates the value of competent observation in a hospital. Kairaluchukwu is not her real name. However she is representative of the thousands of brain injury cases that get no medical attention until it is too late, in the poor communities of Nigeria.