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The Sand Pearl, also known as the Sand Ruby (also formatted SandRuby) in earlier releases, is an item that appears in Final Fantasy IV. It is used to cure desert fever, which Rosa came down with in Kaipo. The party is tasked to go into the Antlion's Den and retrieve the Sand Ruby. To obtain it, the party must defeat the Antlion, and after doing so, they must return to a couple's house in Kaipo. There, Cecil must give the Sand Ruby to Rosa to cure her of desert fever, after which she decides to join them on their adventure.