by Bobby Adair
Dr. Littlefield looked up the road, hoping to see a medical convoy. It was a hope that was dashed each time he left the ward to take some time to breathe fresh air and rest his bones on the porch.
He wondered what happened to the blood samples he’d sent through Mbale and on to Kampala. The man charged with the task never returned. At the time Littlefield had sent the samples, he didn’t know if the nightmare that crawled up out of the jungle slime and attacked the poor, ignorant farmers of Kapchorwa was Ebola. He suspected it, but told himself for at least a few reasons that it couldn’t be that particular virus.
Ebola, that little bastard of a bug, had popped up earlier in the summer in Sierra Leone in the worst outbreak in history. Was it possible that global warming had changed something important about the ecological balance in Africa and turned it into an optimal, continent-sized petri dish for breeding that virus?
No.
As much as Dr. Littlefield liked to toy with that suspicion, he knew in his heart that a catastrophic Ebola epidemic in Africa was inevitable. With advances in medicine and farming, the population density in Africa had tripled in the past sixty years. Now there were three times as many poverty-stricken people in large swaths of the continent, with a culture and living conditions seemingly designed to increase the body count during disease outbreaks.
And as far as the outbreak in Kapchorwa, it was likely the case that some local native had been working in Sierra Leone and had quietly fled when the disease took root there, unwittingly bringing the Ebola home with him.
Littlefield looked across the rusty roofs of the houses spread down Mt. Elgon’s slope as the sun slowly rose over them. He wondered in which of those houses the plague carrier lay—if not dead already—in the final stages of the disease. He knew that the plague carrier couldn’t be among those dying in the hospital behind him. He knew most of those by name or by sight. None of them had been in Sierra Leone.
But in all of that, the thing that just didn’t make any sense was how fast the disease had taken hold in the small population of Kapchorwa. How could any disease transmitted through bodily fluids have spread so quickly, infecting so many in such a short time? It didn’t make any sense at all.
Perhaps there was some secret ritual peculiar to these people that helped spread the disease with such comprehensive rapidity.
Or, it was airborne. In that case, a single carrier could infect a few or maybe a dozen, and those people would infect others, and the process would domino across the small farming community in no time. Ironically, the only thing that gave Dr. Littlefield hope was the chance that the disease wasn’t Ebola but some kind of particularly contagious flu. Kapchorwa lay in the tropics after all. Who knew how many nasty bugs lingered under the bushes and in the local monkeys’ blood?
And no one in the village had yet bled out and died.
With no deaths as of yet, Dr. Littlefield had to reconsider how he’d arrived at the conclusion that Kapchorwa’s little epidemic was Ebola. Was it just fear of the disease, due to the outbreak in West Africa that put the thought in his mind? Possibly. The symptoms were consistent with Ebola so far: raging headache, fever, nausea, diarrhea, red eyes, rash, unexplained bruising, but no external hemorrhaging—not yet. Had the roadblocks set up by an overreacting Ugandan government influenced his diagnosis? Possibly.
Perhaps his Ebola fears were just that—fears.
Dr. Littlefield told himself that he was not a fearful man, not a reactionary.
Movement down the street caught Dr. Littlefield’s eye. He looked up. His heart sank. A guy—that kid who was teaching the street children for the summer—was carrying someone else up the center of the deserted road. The day’s count of new infections was starting early.
Chapter 11
In the hospital’s exam room, Austin looked out through the open door of the ward as the sun shown in through the east-facing windows. He lifted Rashid’s satellite phone and dialed Najid Almasi, Rashid’s older brother. On the third ring, someone answered.
“Hello?” said Austin.
A terse voice said something in Arabic.
“Hello? Do you speak English?” asked Austin.
The irritated voice said, “Who is this?”
“Austin Cooper. I’m a friend of Rashid.”
“You are American.”
“Yes.”
“Why are you calling me on Rashid’s telephone?”
“Is this Najid Almasi?”
“I’ll ask again. Why do you have this telephone?”
Austin was reluctant to divulge his information without knowing whether the person on the other end was Najid or not. But what choice did he have? “I don’t know how much you know about what Rashid is doing in Uganda, but I am his roommate. We work together with the street kids.”
A long pause followed before the voice said, “You are the one he talked about.”
“Yes. I’m Austin.”
The voice repeated, “Austin.”
“Yes. If you are not Rashid’s brother, Najid, I need to speak with him. Please, it’s important.”
“Has something happened to Rashid?”
“He’s sick.”
There was a silence that lasted for a long time. That was to be expected. Sick could have many meanings—many deadly ones—with Ebola on the loose.
“Can he talk?”
“Not right now. He’s not conscious.”
“What does that mean?”
“He had a fever when I found him this morning. He wouldn’t wake up.”
Another silence.
“You are in Kapchorwa?” asked Najid.
“Yes, in the hospital there.”
“I will be there in six hours.”
“What? How?”
“That is no concern of yours. It would be a great favor to me if you saw to my brother’s care until I arrive.”
“Um.” Six hours? Najid must have been on his way already. “Of course.”
Chapter 12
“Dr. Littlefield thinks it might be typhoid.” Nurse Mary-Margaret led Austin into the exam room, then stopped in front of a wide stainless steel sink. “Wash. Use that soap and plenty of it. See that poster above the sink?”
Austin nodded at the poster. “You mean this one that tells me how to wash my hands?”
“Yes. Follow the directions exactly. Just because you’ve washed your hands a million times since you were little doesn’t mean you’ve ever done it correctly.”
“Yes, ma’am.” Austin asked, “If it’s typhoid, it would be in the water, right?”
“We have our own cistern. We only use well water as a last resort.”
Austin leaned over the sink and turned on the faucet.
Nurse Mary-Margaret pushed a thermometer into Austin’s mouth. “I know you think you feel good enough to help, but if your temperature is too high, you need to be in a cot.”
“A cot?” Austin tried to smile. They both knew there were no cots available, nor places to put them.
“A pallet on the floor, then. Keep your mouth shut, so I can get a temperature.”
Austin scrubbed his hands and arms up to his elbows, and then raised them to let them dry as he’d seen doctors do on TV.
Nurse Mary-Margaret hung a blue apron over his head and turned him around to tie it. “Let’s hope this is typhoid. Thieves stole most of our supplies the day after the outbreak started here.”
“You’re shitting me.”
“I’m not.” Nurse Mary-Margaret took the thermometer out of Austin’s mouth and looked at it with a frown. Without looking up, she asked, “And how do you feel?”
Austin figured it would be best not to mention the four aspirin he’d taken an hour earlier. “I’ll live.”
Nurse Mary-Margaret shook her head and directed her frown at him instead of the thermometer. “Those figures of speech are funny when you miss a day of school back in Detroit or wherever you’re from—”
“Denver.”
“—but they mean som
ething real here. You should know that now.”
Austin accepted the scolding without comment. She was right. “I don’t feel good, but I feel good enough to help in the ward. If I get too sick, I’ll let you know and take a spot on the floor.”
She put a surgical mask to his face and hooked the elastic bands over his ears. “Don’t take this off. We don’t know for sure yet that you’re sick with what they’ve got, and if you are, we don’t want you infecting anyone who isn’t.”
“Yes, ma’am.”
She instructed him on the complex process of putting on surgical gloves. After that, Nurse Mary-Margaret put her hands on Austin’s shoulder and held him in front of her, demanding one hundred percent of his attention. “You need to understand, Austin, if this is Ebola, odds are—with what little protection we still have to put on—you’ll catch it and you’ll die. Most do.”
Austin nodded.
“I know you think you have whatever everybody else has, but you don’t know that. If you don’t, and you come in here to help with this inadequate protection, you’ll get what they’ve got.”
“But it could be typhoid.”
“Don’t do that. You know that hope is as thin as I know it is. Ebola is sixty to ninety percent deadly. You’re young and healthy, so that may increase your odds of survival, but if you walk into that ward, it may be the decision that costs you your life.”
“You’re helping,” he replied.
Mary-Margaret huffed. “This has nothing to do with me. I’ve already had a good, long life. I have sons older than you. I have grandchildren.”
“If I go in, will I be helpful? Will it give some of those people a chance to live? Or will I be wasting my time?”
“You’ll be helpful. There aren’t enough of us to help these people already, and if more come today, we’ll be overwhelmed.”
“Is there any help on the way?” Austin asked.
She smiled weakly. “We sent word to Kampala, and we’re praying.”
“What about the short-wave radio?”
“The radio man is down with the disease. He can barely remember his own name.”
Austin looked off in the direction he’d seen the shortwave radio antenna attached to a building in town. “I think—”
Mary-Margaret shook her head. “The real world isn’t like a Gilligan’s Island episode, Austin Cooper. Operating a shortwave radio isn’t as easy as flipping a switch. It’s not a telephone.”
Chapter 13
With a tremendous effort, Margaux propped herself up on one elbow, held the position for a moment, and fell back on her pillow. “Oh, God.”
From where he sat on her cot, Austin looked down at Rashid and Benoit on their blankets on the floor and asked Margaux, “How are you doing?”
In her French accent she said, “That’s a stupid question.”
“I know. I’m being polite.”
“You shouldn’t be in here,” she told him.
“I know. I’m being polite.”
Margaux started to laugh, but it turned into a painful cough, and she rolled onto her side. “I feel like I’m dying.”
Austin put a gloved hand on her shoulder. “You’ll be okay.”
“That doesn’t mean anything coming from you.”
“Not medically.” Austin looked around the stinking ward. There was barely room to walk. The influx of patients throughout the day had filled most of the space. “It’s what people say to sick people.”
“Why?”
“You know why,” he answered. “It means I’ve nothing meaningful to say, but I hope you get better.”
“Why not say that?”
“I hope you get better. When you’re sick, you’re kind of a bitch.” Austin smiled behind his mask.
Margaux smiled back. “I know. I’m sorry.”
Austin noticed reddish splotches on her face and arms.
“Is Benoit awake?” Margaux asked.
“He was up earlier.”
“Out of bed?”
Austin pointed at the door in the back of the ward. “I helped him to the outhouse.”
“Good. I’m glad he was up.”
“Yeah.” In truth, Benoit had barely made it. Austin had half carried him on the way back, but didn’t recall seeing a rash on Benoit’s skin at the time. Looking down at Benoit from his position on Margaux’s cot, Austin saw it now.
He’d seen those same splotches on the skin of others in the ward—others who were much worse off the Benoit or Margaux. They’d regurgitate and soil themselves and lie in their excretions. Half delirious, too fatigued, or in too much pain to do anything about it or even ask for help.
Once Nurse Mary-Margaret had put him to work, he started by helping to change the bed sheets under a young woman, one of the first to arrive, down at the end of the ward. She seemed to have lost all control of her bodily functions. Her temperature had set her blotched skin afire. Her blood-filled eyes rolled around, unable to focus on anything. Her vomitus was bloody and black. Her gums and nose wouldn’t stop bleeding. She moaned whenever touched.
Austin didn’t know much about death, but he was sure that girl was dying.
Heavy slow breathing from Margaux told Austin that she had fallen asleep.
“Hey.” It was Rashid.
Austin looked down at Rashid and grinned behind his mask. “I thought you were dead.”
“Is—is this the hospital?”
“Yeah.” Rashid drew in a long, painful sounding breath. “I feel terrible.”
“Yeah. You look like shit, too.”
“I’m thirsty.”
Austin stood up a little too fast and felt light-headed. It was time for more aspirin. “I’ll get you some water.”
A couple of large white plastic barrels were on tables against one wall. They’d been brought in a few hours earlier along with a case of disposable cups. The disposable cups were a good thought, but unless there were lots more somewhere close by, they’d run out before the end of the day.
Austin filled a cup and brought it to Rashid, who drank slowly at first and then gulped.
“Thank you,” said Rashid.
“I’ll get you some more in a minute.”
“How did I get here?” Rashid asked.
“I carried you,” answered Austin. “You wouldn’t wake up this morning.”
“So it was this morning. I was almost worried that I’d been out for a week or something.”
Benoit squirmed, but didn’t wake up.
Austin said, “No. Just today.”
Rashid reached down and felt his pocket.
Austin said, “I took your phone and called your brother, Najid. At least I think it was him. How many brothers do you have?”
“Just Najid.”
“Okay,” said Austin. “He’ll be here in a while.”
“He shouldn’t come.”
“I know.” Austin shrugged. “Tell him that.”
“I will. Where is my phone?”
Austin leaned over Rashid and fetched the phone. It was lying on the floor above Rashid’s head.
Rashid didn’t raise his hand to take the phone from Austin, but instead stared up at Austin for a few long moments. “Is it Ebola?”
“They’re not sure. Nurse Mary-Margaret said it might be typhoid.”
“That’s great.”
Austin chuckled. “Yeah, that’s what I thought. I’ll bet you never thought you’d be happy to have typhoid.”
“So they’re sure, then?”
Austin shook his head. “They don’t know yet. They think because so many people got sick so fast, it can’t be Ebola.”
“Why don’t they test?”
“I don’t know. Maybe they did but the results aren’t back yet.”
Chapter 14
Paul Cooper wasn’t the worrying type, not even close to it. Neither did he wear rose-colored glasses. He saw himself as a pragmatist. But one worry that did lurk in his little closet of childhood bogeymen was Ebola. He was a kid with a
paper route when the 1976 outbreak hit the news. Every day when he folded his papers prior to delivering them on his bike, he read the headlines. He saw frightening stories of bleeding, suffering, and of whole African villages wiped out. And an American media, in the infancy of its sensationalist tendencies, taught him a new phrase for fear—hemorrhagic fever.
In those days, nobody knew what caused Ebola. Nobody knew how it was transmitted. There was speculation about something in the water or the air—an old contagious evil that had been hiding in the jungle’s damp shadows, awakened.
Paul clearly remembered sitting on the living room floor one evening while his parents and grandparents watched the TV with silent mouths and wide eyes. Ebola was the kind of disease that scared the shit out of everybody.
But Africa was a far away place in those days. The deepest jungles of Zaire were even further away. For a disease that killed everybody, there seemed no way it could make its way out of the jungle in a jeep on a rutted dirt road, onto some bush pilot’s little plane, onto a commercial flight to Europe, and eventually to America. The world wasn’t as thoroughly interconnected by jets in those days as it was going to become. Anyone unlucky enough to be carrying the Ebola virus in his blood was likely never to make it out of the jungle alive.
Forty years later, things were different. Anyone sitting in a thatch-roofed African hut infested with Ebola could make his way out of the jungle and onto an airplane that would drop him in any of America’s busiest airports within twenty-four hours.
As paperboys do, Paul eventually finished school. He went to college, married, had kids of his own, and eventually got divorced; a regular kid who grew into a regular American life. As life passed, that scary disease’s name came up occasionally in the news, and just like that other scary word from his childhood—thermonuclear war—it always caught his attention and tugged at his fears.