by Nancy Kress
“Go ahead,” Cavanaugh said.
“Somebody tried to use T. rutilus to stop the infected Anopheles even before the CDC was called in or the epidemic became public knowledge. That suggests to me that whoever started the plague tried to stop it before it got out of hand.”
This wasn’t consistent with her usual genocide theories. Obviously she had put professional objectivity in the forefront. Finally. Cavanaugh listened more closely.
“Now, by mid-June every infectious-disease unit in the Western world was crawling over the epicenter in Newburg. Most of them were only here briefly, to get specimen samples and victims’ blood samples to take back home. But a few stayed at least a week—people from WHO and from Antwerp, to name just two. They combed the place. Even concentrating on A. quadrimaculatus, there’s no way everybody could have missed the unusually high numbers of T. rutilus, or not known what those numbers implied.”
“Go on. So?”
Suddenly she put her purse down, straight onto a pile of salt marsh mosquitoes. She didn’t seem to notice. “So I don’t know yet. I want to check something. Meet me at my bed-and-breakfast after you go to dinner. I’m not hungry.”
“Neither am I. I’ll stay with you.”
“Robert, your stomach is grumbling. I can hear it from over here, for God’s sake. Go eat and come back after. I’ll be there.”
He left her at the bed-and-breakfast, raced to a McDonald’s, and ate a Big Mac in the car on the way back. A pickle spilled across his tie. The trip took him sixteen minutes and forty-two seconds.
Apparently it was enough time. Melanie’s computer was turned off. She sat quietly at her desk, her eyes blank, her mind someplace else.
“Melanie … Melanie?”
Slowly she focused on him. “Robert.”
“What were you checking? What did you find?”
“I was checking the weekly World Health Organization report to the CDC. It’s just bald data, a summary of what’s happening around the world. Health-wise.”
Melanie never used nonwords like “health-wise.” She continued to gaze at nothing. Robert stepped closer. “And what did the weekly report show? For what week?”
“I scanned six months’ worth of reports, by key word. We have the software to do that. I looked for malaria outbreaks. Of course, there were dozens. Did you know that nearly three million people die every year of malaria worldwide?”
“No. Did you find any … anomalies?”
“Yes. A set of data that graphs to an anomalous epidemiological curve. In Africa. The Democratic Republic of the Congo, that used to be Zaire. That’s what they’re calling it now. There was a revolution, you know.”
“I know,” Cavanaugh said. She was rambling. “Go on.”
“The anomalous epidemiological curve shows a much smaller number of infectees than usual. And it just breaks off abruptly, as if it were brought under sharp control very quickly. In a little over a month.”
“Maybe the public health service in Congo got right on it. Like we did.”
“There is no public health service in Congo, except in name. There was one once, but it collapsed during the corruption before the last revolution. And nobody brings a malaria epidemic under sharp immediate control in Africa. They don’t have the resources. We only did it so fast here because the army mobilized, with money and expertise and manpower and supplies! The United States isn’t Africa.”
“Okay,” Cavanaugh said. “Then what did cause their malaria outbreak to end so fast? And was it malaria reading or a normal kind.”
“There’s no way to tell from the data. Or from here. You’d have to go to Congo.”
Cavanaugh stared at her. Through his head whirled a number of little pictures, like icons on a demented screen saver: Visas. Vaccines. Languages. What languages did they speak in Congo? He didn’t even know. Money. He’d been spending too much lately, what with moving house every fifteen minutes, and he was suspended without pay. And the Bureau had forbidden him to work on this case. A visa to Congo was traceable … and what about Fort Detrick. He needed to go there, follow up on the voice analysis …
“Melanie,” he said, “I can’t go to Congo to investigate.”
For the first time since he’d come in, he had her full attention. She swept him a look of utter scorn.
“Not you—what good would you be in Africa?” she said. “Not you.
“Me.”
Fifteen
The climate of Zaire is especially conducive to germs, fungi, and carriers of numerous pests and diseases.
—Compton’s Encyclopedia
* * *
Africa could break your heart.
Melanie stepped off the plane at N’Djili Airport in Kinshasa and walked toward the cinder-block terminal. The heat was no worse than summer in Mississippi, but the quality was different. She couldn’t put it into words: it was a combination of smell, vibration, some ineffable sense of portent. It was different. It was Africa.
As soon as she walked through the terminal door, the “officials” descended. They clamored in French and broken English that she give them her tickets, her luggage, her passport. Later they would demand “fees” for the return of all these items. Behind them came the fixers, with promises to guide a foreigner through this maze of “travel fees”—for, of course, a fee for themselves. Melanie waved the whole crowd away, gripped her two carry-ons, and backed herself into a corner to study the situation.
Congo was between wars. The airport held foreigners she judged to be businessmen, refugees, even a few tourists. Or maybe they were mining financiers. At its lowest points, Congo lost its international financiers, its sole means to foreign trade in copper, diamonds, cobalt, and manganese. Like robins in an American spring, returning financiers were a good sign.
A television set high near the ceiling was actually working, although only audio, which was in French. The screen showed a fixed title: “Communiqués et Messages.” A few shops inside the terminal displayed perfume, Belgian chocolates, and jewelry. This was encouraging. The last time Melanie had come through N’Djili Airport, with a CDC team, the only things in the terminal were bayonet-carrying soldiers and wrecked furniture.
Kinshasa itself was less encouraging. After expertly negotiating the upturned palms at N’Djili, she took a taxi to Mama Yemo Hospital. The taxi inched slowly and painfully over streets with broken pavement and deep potholes full of fetid water. Several times the taxi had to detour. Through the cab’s open windows—it had no air-conditioning—Melanie surveyed the capital she had seen four times before, in various states of functioning under various regimes in various degrees of civil strife.
Women filled the main market, selling cassava, bananas, sugarcane. Business looked brisk.
The zoo was still a charred rubble, the buildings burned and the animals dead.
The Intercontinental Hotel gleamed amid its fountains and gardens, guarded by army soldiers, a luxurious haven for the rich. A uniformed valet parked Jaguars and Mercedes.
At Lovanium University, students climbed briskly up and down neatly whitewashed steps.
Beggars thronged the edge of La Cité, Kinshasa’s vast slum. Many looked sick or deformed. But they didn’t all move with the terrible shuffling dullness of misery and malnutrition that Melanie had observed on her last trip.
And even the beggars wore plastic shower thongs. Mostly.
The fishermen living in tin-roofed shanties by the great river now possessed nets.
Best of all, Melanie saw a woman in a bright cotton dress on her knees, weeding a dozen stalks of corn growing beside her hut. If corn could grow that tall in Kinshasa, without being stolen or vandalized, Congo had come a long way since the last war.
Mama Yemo Hospital, however, reminded her that compared to the rest of the world, Congo’s “long way” was measured in inches.
There were still more patients than beds. Sick people lay on flaking white metal beds, on sheetless gurneys, on straw pallets, on the floor. Some she could diagnose with on
e glance: that’s malaria, that’s malnutrition, that’s gangrene, that’s dysentery. She clutched her two valises and kept on walking. The only medicines she had with her were ones that any knowledgeable American could be expected to carry for personal use: a few antibiotics, first-aid supplies, the antimalarial prophylaxis mefloquine, some Lomotil for diarrhea, which she hoped to hell she wouldn’t get because Lomotil cross-reacted with mefloquine.
“M’sieu le docteur Ekombe Kifoto?” she called loudly. No one paid any attention.
She wasn’t here as a CDC representative or even as a private doctor, which would have required notifying half a dozen different agencies in and out of Congo. She was here as an anonymous tourist. She couldn’t help the suffering people jammed into the stinking corridors. She kept on walking.
“M’sieu le docteur Ekombe Kifoto?”
Finally a Congolese nurse directed her to the ward where Kifoto was administering chloroquine to malaria patients. The minute he spotted Melanie, he rushed over to her. “Melanie! Vou êtes ici!”
“But where is ‘here’?” she answered in French. “Hell?” An old joke from a previous epidemic, a previous joint CDC-WHO-Zaire Health Ministry campaign. During an epidemic, Ekombe Kifoto was among the best.
He led her to a tiny, vacant break room with chairs and a small refrigerator, but no table. They drank Primus beer while they caught up on old friends, new epidemics. In Congo, you drank bottled water or beer. You even brushed your teeth with beer. Or with the equally ubiquitous Coke, which somehow appeared everywhere on Earth even during violent wars. If WHO were as efficient as Coca-Cola, Melanie figured, antibiotics would turn up in the deepest rainforest.
“Ekombe, I need a favor,” she said, when the social chat was finished.
“Yes?” He watched her carefully.
“I need to go into the rain forest. To a village called Yamdongi, in Kisangani Zone.”
“Ah. Where the last malaria epidemic was. I hear it was mercifully brief. But why come to me? The CDC—”
“I’m not here on behalf of the CDC. I’m unofficial and alone. But I need a medical visa to get through to Yamdongi without delay. And I need you to radio both the Catholic mission in Lubundu and whatever medical facilities remain in Yamdongi from the epidemic.”
“There remains a tent hospital and a physician from Doctors Without Borders. Mopping up.” During his work with the Americans, Kifoto had delighted in translating American slang into French, Bantu, and Tutsi. “But why, Melanie? The epidemic is over.”
“I know. Did you see the curves?”
Kifoto shrugged. “You know how it is. So much work here, always.”
“I know. Please do this for me, Ekombe. Without questions.”
“I will. You know I will. Melanie—” He eyed her valises. “Do you have medicines with you? We are so short. No, of course you don’t. Not if you arrived in Congo without official notice.”
“I’m sorry,” she choked out. “I couldn’t—”
“I know. Do not concern yourself about it.”
As if, surrounded by malarial and worm-ridden children, that were at all possible.
Armed with the papers from Kifoto, including a medical travel pass that he’d gotten signed by the new minister of health (now there was a hopeless job), Melanie’s identity changed again. She was no longer an anonymous tourist. Now she was a doctor. The medical pass was the only thing that allowed her to travel into the rain forest unaccompanied by an “escort” of army officers asking questions and demanding bribes and intimidating villagers. A medical pass allowed you to go anywhere, although not necessarily safely.
She took another cab to N’Dolo, Kinshasa’s smaller airport, and then took a very old, much-painted prop plane to a small airfield in Kisangani, seventy miles from Yamdongi. She was met by Sister Marie-Stephanie, a Catholic missionary who had been in Congo for thirty-five years, teaching three generations of Bantu girls to sew, boil drinking water, and stumble through the writings of Saint Theresa, the Little Flower. Nothing could surprise Sister Marie-Stephanie. She had witnessed epidemics, revolutions, paramilitary bandits, crop failures, floods, famines, and witch doctors. Her sun-creased face under its traditional white coif sized up Melanie in thirty seconds and kept the results to herself.
After a night at the mission, Melanie was driven by Land Rover to Yamdongi, which took eight hours. The driver was the most cheerful person she’d ever met. He whistled for the entire eight hours, alternating atonal native tunes with outdated American and British rock. Melanie thought she recognized “Can’t Get No Satisfaction,” but over the motor of the Land Rover it was hard to be sure. Between songs, the driver kept his vocal chords moist by sipping beer as he bounced and bumped along rutted paths through the lush rain forest.
Maps in Congo were always a hopeful fiction. Indicated roads did not exist, and never had. “Highways” turned out to be rutted dirt that flooded after each explosive rain. Bridges had been washed away, or burned, or dismantled for the metal.
Throughout the trip, Melanie watched for monkeys in the trees. Monkeys were a key economic indicator. In good times, they swung and chattered. In bad times, they’d all been eaten. This time, Melanie saw monkeys.
Eventually, just before her teeth felt about to be rattled out of her gums, they reached Yamdongi. “Hello! Dr. Spencer?”
He came out of the tent hospital, smiling. “Dr. Anderson?”
“Yes.” Shakily she climbed down from the Land Rover. The driver looked at her expectantly, optimism undimmed. She gave him five American dollars—a fortune—and watched his face light up. He tossed down her bags and drove off, singing.
Brian Spencer said, “Dr. Kifoto radioed that you were coming. But the epidemic is quite over, you know.” His accent said the north of England.
“Yes, I know. I just have some follow-up questions.”
“Fine, fine. Glad to be of help. Possibly you’d like to eat.”
“Yes, thank you,” she said. He was very young—twenty-six? Twenty-eight? Brisk, idealistic, talkative. Over stew and beer he told her what he could about the epidemic.
“The usual thing, you know, except that the victims died unusually quickly. Much tertiary cerebral stroke, I rather suspect, although of course we haven’t the resources for autopsies. Time, mostly. And also, the epidemic ended quite abruptly. Odd, that, but we were all grateful. At the zenith we were giving three hundred shots of chloroquine a day. No time to do more than that. They were coming from as far away as Bienge. Fortunately I had top-drawer Congolese nurses. Only one left here now, Sebo Masemo. She and I return to Kisangani next week. I’ve put you up in one of the other nurse’s rooms. Not luxurious, I’m afraid, but tolerable.”
“Thank you. Dr. Spencer, while the epidemic was on, and especially just before it ended, did you notice any unusual movements in the village or the forest?”
“Movements? Of what?”
“Soldiers. Or resources for Anopheles control that aren’t usually available here.”
He lit a French cigarette. Melanie wasn’t surprised. In Africa, even for doctors, future emphysema looked better than present insects. The smoke wreathed his head.
“Dr. Anderson, there are no resources for Anopheles control available here. Not for the last epidemic, nor the one before that, nor the next one to come.” Suddenly he looked much older.
Melanie didn’t tell him that she’d joined her first epidemiological team before he entered med school. The less she gave away, the better.
He said, “I expect you’d like to have a look at the hospital.”
“Please.”
A small wooden sign outside the gray tent said MÉDECINS SANS FRONTIÈRES. Inside were the usual: wooden bedframes with palm-leaf mattresses, an electric generator saved for times of real need, autoclave and refrigerator, locked meds cabinet. A “lab” with cultures and reagents to find out what microbe you were dealing with, but no electron microscope to really find out what you were dealing with. Melanie didn’t see automat
ic rifles, but they were probably here.
This close to the equator, night fell at six o’clock. Brian Spencer lit a kerosene lamp and walked Melanie through the wards, of which there were two, men and women. Children were in with the women. The hospital was down to fewer than a dozen people in each ward; there were beds for all.
“Ça va, Mbuzu?” Spencer said to a woman, who smiled at him weakly. To Melanie he said in English, “Malaria. One of the last cases to fall ill.”
Melanie smiled at the patient, who let her do a quick examination. Enlarged and stiffened spleen; hard, hot belly; face and neck emaciated. The same symptoms Hippocrates had described accurately two and a half thousand years ago. Still here.
At the next bed, Spencer said, “Dysentery.”
“Malnutrition.”
“Malaria.”
“Miscarriage.”
“Malaria. Doing very well now.”
“Broken arm.”
“Dysentery.”
“Malaria.”
Spencer stopped at the last bed. A woman lay motionless, both her arms chopped off just below the elbows. The stumps were freshly bandaged, and the woman looked sedated, although not so much that the anguish had faded from her eyes.
“I don’t know what happened here,” Spencer said. “She staggered into the hospital alone, although I think someone must have helped her get this far. She speaks no French, and my nurse doesn’t know this dialect.”
Melanie knelt beside the woman’s bed and tried each of the languages she sketchily knew. Finally the woman murmured back.
Melanie stood. “She said soldiers did it. Because they wanted diamonds and she had no diamonds.”
“Probably paramilitary bandits,” Spencer said. “A few groups are still in the bush, although the army is doing pretty well at finding them. You speak several dialects, Dr. Anderson.”
“Badly,” she said. The woman on the bed had finally closed her eyes, as though the simple act of telling someone what had happened to her could bring sleep. Melanie watched, gut churning. Every time she came to Africa, she was overwhelmed by guilt. For not doing more for these people, for living in America, for carrying around in her own well-cared-for veins a dozen vaccinations against diseases that killed Africans by the millions. Every time she came to Africa, Africa pierced her heart, and she couldn’t wait to leave so she could yearn to come back again. Every time.