by M. D. Massey
My head was fuzzy, but no more than I’d expect from jet lag or, actually, from having just woken up.
I made a pot of coffee in the small kitchen area next to our library. Then I carried two cups over to the nightstand between my and Zoe’s beds and nudged her. She opened her eyes; then sat up with a look of blind terror on her face.
I handed over a mug with a monkey face on the front and a brown handle shaped like its tail. I said, “Zoe, I’m fine. I’m not sure what was in those pink drinks, but I’m not hurt or anything. I checked myself in the bathroom. There’s a full-length mirror in there.”
Zoe set her coffee cup back down on the nightstand, sloshing some of the sugar-and-cream concoction on the polished mahogany, and ran off to the bathroom. I cleaned up the spill. When she returned, she seemed calmer. She simply said, “Tovar is weird. I’m glad I don’t work for him.”
I took two sips of coffee, looking at the gorilla watching over the library. I said, “How about that kid in the clearing and the soldiers? That was way weirder.”
Sophia Weber, blue-and-pink hair tangled across her pillow and tattooed tigers creeping down both arms, slept in a bed across the room from us. Rolling over in nothing but underpants and a tank top, she exposed two dragons fire-breathing at each other on her lower back.
Zoe looked at Sophia, then back at me. “Hey, she works in Building 4. We should ask her about the little girl from last night.”
I whispered, “Good idea.” Then I cleared my throat as loudly as I could.
Sophia opened her eyes. I asked if I could get her a cup of coffee. She mumbled, “Yeah…Great…Cream and sugar, lots of sugar,” and pulled her quilt up to her chin.
I returned with the coffee, set it on her nightstand and sat at the end of her bed. Sophia rolled over, squinting at me in the morning light. She looked grumpy as hell. In a curt tone, she asked, “What’s up?”
Zoe came over and stood beside the bed. Before I could say a word, she blurted out, “We have an important question for you. Is there a little girl among the patients in Building 4?”
Sophia sat up, alarmed. “Yes, there is. Why? Is she OK? Did she die?”
I placed my hand on Sophia’s leg. “No…No…she’s definitely not dead. I’m sorry; I didn’t want to scare you. I just wondered: are there any other little girls in Building 4, or just her?”
Sophia told us, “No, just her. She’s the only child, male or female, in our building. Our other patients are all adults, no one younger than thirty. All the nurses love her. God, I really hope we don’t lose her.”
Zoe asked, “How are you guys treating her rash?”
Sophia answered, “Well, she doesn’t have much of a rash. Her skin’s actually the least of her problems. She has a few patches of eczema, something she’s had for months, according to her chart. Her biggest problems right now are fever, chills and muscle aches…She tests positive for Ebola, so those symptoms are from the Ebola.” Sophia reached for her coffee and took a sip. “Why would you want to know about her eczema?”
Zoe was quicker on her feet than me. She lied without a moment’s hesitation: “I forgot my eczema cream back home. Just wondered if what you were using on your patient was effective, that’s all…and if I could get some.”
Sophia replied, “We’re just using some stuff that’s sold over-the-counter back home. I’ll get you a tube. We have plenty of them.”
Zoe answered, “Thanks,” then walked away as though she had nothing else but eczema on her mind.
Stepping outside to talk, we verified that we had both seen sheets of bloody skin falling off the little girl’s face. I sighed. “What a relief, Zoe. I felt drugged last night. Those pink drinks were strong. I thought maybe I had hallucinated that little girl’s skin.”
Zoe’s jaw tensed. “Yeah, well, who’s to say we didn’t both hallucinate the same damn thing? Do not trust Dr. Tovar. I mean it. That guy gives me the creeps.” She stormed back into our residence hall, leaving me to wonder what I had ever seen in that guy to begin with.
After showering and getting dressed, all the volunteers headed over to the dining hall. Zoe was wearing boots. I couldn’t resist teasing her. “I see you’ve decided to protect your feet.”
She snapped at me. “So, is that supposed to be funny? We ought to be careful. Do you still not get that?”
I shut my mouth. I felt frighteningly alone.
The dining hall was another long rectangular building, this one painted white. Inside were little more than white cement walls, a gray cement floor and rows of wooden tables and chairs. The food was outrageously good, however. I had a stack of pancakes, sausage links, orange juice and more coffee.
The clatter of silverware on plates and the chatter of human conversation subsided as heavily armed soldiers marched onto a wooden stage to the rhythmic, jackhammer sound of their own boots. Dr. Tovar came out from behind a curtain. He stood in front of the soldiers and announced through a microphone clutched in his right hand: “You are all to assemble out front in your designated groups. These soldiers will escort you to your Safety Stations. We do not want any slipups in your safety procedures. You are going to practice them again before working with patients.”
Outside, there was a terrible silence. Even the monkeys had gone mute. We heard only the shuffling of our feet upon the dusty African soil, our own blood pumping through our ears and military guns clacking into position. The soldiers finally yelled loud words at us, but only to give instructions.
At Safety Station 5, my personality disappeared. I watched Zoe being dressed in protective clothing, changed from a beautiful girl into an anonymous plastic robot. Only her eyes blinking behind goggles and a few inches of facial skin revealed anything about her. We had become robots…or monsters.
Escorted by the soldiers with machine guns, we lumbered over to Building 5. The soldiers remained outside as we entered one by one, receiving assignments at the door from an assistant to Dr. Steele. I was delighted to discover that I had been assigned to work with the four-year-old boy, Akachi Anikulapo-Kuti, as well as an old woman in a flowered dress. My direct supervisor would be an African medical school graduate doing her residency at the camp, Dr. Chibueze Koroma.
As Dr. Koroma approached the bed of Akachi, he shivered from fever. From behind her face shield, she spoke to him. “Akachi, how are you today?”
Her eyes were kind. They were also unique: light brown with specks of gold. When Akachi didn’t answer, Dr. Koroma continued, “I have brought you some friends.” She smiled behind the clear plastic shield.
Akachi’s eyes grew wide, black marbles in a fevered face. He managed to whisper in a hoarse voice, “No machine spirits! I want Mama. Please…Mama!” Then he collapsed back into sleep, shaking with chills.
Dr. Koroma gestured for us to watch her. Her hands insulated by thick turquoise plastic gloves, she fumbled with a hypodermic needle, managing to stick it into Akachi’s arm and draw blood without sticking herself.
I felt dizzy from a combination of intense heat trapped inside my suit and forgetting to breathe while I watched Dr. Koroma handle that needle and draw blood teeming with Ebola Hemorrhagic Fever from the frail arm of the child. I pictured the filamentous, single-stranded RNA viral threads swimming through that liquid life force inside the hypodermic syringe barrel, ready to attack a host body where it could replicate.
Forcing my feet to lift and my legs to move, I followed Dr. Koroma over to our next patient, a tiny old woman with skin the color and texture of walnut shells, outfitted as though in her Sunday best in a brightly colored dress—purple and yellow interlocking flowers—now folded up into a fetal position, as though the hospital bed with its white sheets and wrinkled blankets were the womb for birthing her into some new world. She never moved. She lay completely still and silent as Dr. Koroma drew blood. When the patient’s eyelids briefly fluttered—wrinkled, leathered window shades into a soul—I saw it: the whites of her eyes had filled with blood. She had begun to hemorrhage.
Thirty minutes after entering the treatment facility, we volunteers were ushered out, soldiers surrounding us, but keeping their distance. In tropical heat, thirty to forty minutes is all the time workers have fresh air inside their suits. The “machine spirits,” as Akachi referred to us, are humans trapped inside protective suits made of woven plastic fiber coated in laminate. Impervious to fluids, they also block fresh air from entering. Dr. Koroma had dismissed us: “Before you all pass out in those moon suits, you’re going to be escorted to your Disinfecting Station. Be very careful. Follow all the directions given to you. On your first day here, you’ll work thirty minutes on, two hours off. We want you to acclimate to the climate and to the suits. I’ll be here a few more minutes and then I’ll take a break outside as well.”
As I turned on the heels of my rubber boots, I angled my body in such a way that I could move around in my “spirit machine” and catch a parting glimpse of Dr. Koroma. I wanted to see whether or not she was fading, or if she still functioned with energy.
At that exact moment…and it’s burned into my memory like a photograph…I saw her pull back her arm in a lightning flash. She had been drawing blood from an old man. Her voice exploded with anguish and terror: “Shit! Shit! Shit!”
The soldiers pointed their guns at us and told us to get a move on.
My God. Dr. Chibueze Koroma had stuck herself with a hypodermic needle infected with Ebola blood.
My heart pounded. I thought for sure I would faint inside my suit.
The next day, Dr. Koroma was replaced by another intern, Dr. Waahib Ouedraogo. He was tall. Moving around the treatment center like Frankenstein, he had to bend over considerably to administer to patients. His deep black eyes darted around behind his face shield, taking everything in.
I tried to get information on Dr. Koroma. All anybody would tell me is that she was in quarantine. Nobody would tell me where quarantine was located.
That afternoon, I got to work with Akachi again. He was so sweet and cute, I just wanted to sweep him up into my arms, rock him in a rocking chair and sing him a lullaby. “Hush, little baby, don’t say a word…” He seemed to have stabilized. He hadn’t gotten any worse. I was assigned changing his IV bag, to give him more fluids. Dr. Ouedraogo said to me, “Dr. Koroma left notes on her observations of you. She said you’re qualified to draw blood and should be assigned to Akachi for that.” I was glad my first time drawing Ebola-infected blood would be from this child because I was scared to death to do it, especially after seeing what had happened to Dr. Koroma. Reminding myself that Akachi’s life depended upon me getting a grip and doing my job made it significantly easier. I steadied my hands and controlled my breathing. I managed to draw a vial of his blood without incident. I refused to think of all the virus lurking inside that red bodily fluid.
After I had followed through on taking care of Akachi, Dr. Ouedraogo told me I was dismissed for a few hours. He told me that my next assignment for the day would involve traveling to the home of Akachi’s mother.
Sweat trickled down my forehead behind my face shield. I started to lift my hand to wipe it away. I remembered that would be futile, as the plastic would block my hand. Adrenalin surged throughout my body. My fingers trembled. I could not believe I had done that! I had started to touch my face with infected gloves! I berated myself over and over and over again. That’s one of the main ways medical workers get Ebola. In treatment facilities where they don’t have full face shields and a nurse or doctor accidentally touches their own face after treating an Ebola patient, the virus enters their body through a mucous membrane and then begins replicating inside them.
I managed to ask Dr. Ouedraogo, “Why are we doing that? Isn’t it safer to stay here inside the camp?”
Akachi started to cry. “Mama! Mama!”
Dr. Ouedraogo soothed him. He said, “We’re going to find her, sweet one. Don’t worry.”
Then he turned to me. “Let’s talk after we get out of these suits and cleaned up. Just wait for me outside the Disinfecting Station after you’re finished there, OK?”
I waited, as instructed, in front of Disinfecting Station 5. I watched people go into the station, anonymous in their yellow and turquoise plastic suits, and come out looking normal and identifiable as individual human beings with their own tastes and styles.
Finally, Dr. Ouedraogo emerged from the station, dressed in white shorts and a pale blue T-shirt. He looked at me with sad, penetrating eyes. “Come, walk with me.”
After I followed him to a park bench where we sat down, Dr. Ouedraogo said, “In answer to your question that I didn’t want to answer in front of patients: it is definitely safer for us here than going into the home of Akachi’s mother. However, the situation inside their slum is deteriorating. People are staying inside their homes after they develop Ebola symptoms. Family members aren’t removing the deceased bodies for days after they die, sometimes just dragging them outside onto the street or burying them themselves. We’re looking at a potential pandemic here. Among the new responsibilities of our camp’s medical personnel will be outreach into our local communities and educating locals about how to care for their loved ones who get sick with Ebola. We’ve been asked by the World Health Organization to assist both them and the CDC in their efforts inside these communities, including the crowded slum where Akachi’s family lives. We have information that his mother may now have Ebola and another one of his relatives may have recently died of the disease inside their home. Ebola could spread like wildfire through the crowded slums. We need to get on top of this.”
A few hours later, Dr. Steele, Dr. Ouedraogo, Zoe, a couple of other nurses and I were loaded into military vehicles. I was surprised that we were picked up by an armored vehicle, but I supposed it made sense to have as much protection as possible.
It was late afternoon. We rode, jostled back and forth against our seat belts, over rough terrain. With our seats lined up along the sides of the vehicle, we faced each other. The windows were behind our backs, so we couldn’t see much more than daylight flickering outside through the sections of glass visible between the shoulders of the people across from us. Every once in a while, I saw a blur of green outside, as we sped past small trees or bushes.
The driver pumped music through the stereo system, to keep us from going insane, I’m sure.
I napped on and off, but startled awake each time from nightmares. The worst was a horrible dream in which Akachi bit me with teeth as long and sharp as lion’s incisors and then tore away my skin, eating me alive.
Finally, the vehicle pulled to a stop. Dr. Steele said, “We must be there.” She waited until the soldiers gave us directions. Four soldiers were assigned to go along with us to Akachi’s house; two others would remain with the vehicle.
We had stopped in a wooded area at the edge of the slum. Our black armored vehicle was parked in a secluded area hidden by leafy trees. A soldier helped us out, one by one, offering a hand to each of us who needed it.
As we walked into Akachi’s neighborhood, I felt as though we had entered a war zone. Rot infested the settlement through the core. Buildings were barely held together, as though one breath from the heavens would topple it all. The smell was horrible, streams of sewage running down gullies. My heart seized for a moment. The sewage no doubt contained Ebola and a bunch of other serious diseases. I pulled a cloth mask over my nose and mouth, the most protection we could wear for any extended period of time in the heat.
We hiked dirt roads through a maze of ramshackle homes. Many were rectangular turquoise boxes similar in basic style to our residence buildings back at camp. Others were square and blue or green. But the walls were filthy, punctured by holes. Corrugated metal roofs were ripped off the walls in places, and tattered, as though some huge jungle cat had pierced the juncture of wall and roof with its sharp claws, peeling the tin-can roof back from its supports, looking for food that lurked inside.
Many doors were missing or were nothing but cloth curtains or left aj
ar. Inside, the floors were dirt.
Mangy dogs, cats and monkeys went in and out the houses. I felt crazed. All those animals could be carrying Ebola, and the people of Liberia ate them. They also hunted bush meat which included bats and monkeys, known carriers of the virus.
When we reached the center of the slum, we encountered a building that looked like something out of a post-apocalyptic movie. Made of concrete and iron, it had, like a dollhouse, no outer walls. It was ten stories high. People moved around each compartment, clearly visible to us, like actors on extra-live TV.
As we moved past the high-rise building, we startled two kids splashing in muddy puddles. The soldier stopped. He smiled at them. He played catch, throwing each one a small package of candy—gummy bears or something. I watched his movements closely. He never touched either of the kids. God…Splashing in puddles. I kept imagining the potential diseases swimming there: Ebola, Typhoid Fever, Hepatitis…and a million other things spread by mosquitoes, ticks and other biting insects: Malaria, Dengue Fever, Chikungunya. The list of potential diseases was very long for puddles in a West African country where sewage washed the streets.
It must feel impossible to parent children in such a part of the world. You could try to keep your child inside the bubble of your house. But even that bubble is contaminated as rats scamper from shack to shack, sewage seeps under your walls, and flying insects stick you with their dirty hypodermic-needle stingers.
Finally, we arrived at a one-room turquoise shack, corrugated metal roof torn away from the front wall at both corners. A woven rug that must have been pretty once—it had remnants of orange and gold threads shining through muddy splashes—hung from the top of the doorframe.