by Bobby Adair
Olivia said, “Both are en route to Nairobi or already there.”
“No shit.”
Olivia nodded. Her face was serious.
“Do we have any reason to believe these guys know each other?” Eric asked.
“None. They didn’t even take the same flights.”
“All right,” Eric paused for a moment. “Send me those names when you get back to your desk. I’m going to tell Barry Middleton to drop what he’s doing and lend you a hand.”
“I don’t know if I need help yet.”
“He has extensive experience with different types of data. Bring him up to speed. I want regular updates on this. I’m going to send the info upstairs.”
They were on the third floor of a three-story building. Olivia understood what upstairs meant. “You think there’s something going on?”
Eric nodded.
Chapter 42
When Austin woke, he was lying on his side on a cot. Everything was still confusing, and thoughts were hard to string together through the fog and gaps in his brain. How long had he been out? Hours? A day or two? More?
One of the plastic buckets that he’d become so familiar with over the past days sat on the floor not ten inches from his head. It stank. The cot stank. The room stank.
On the other side of the bucket, on the floor, Margaux lay on her side facing him. Her face was slack, her eyes open—blood-red, not focused. They were doll’s eyes, horrible for their lifelessness. Her mouth dripped a brownish mucus—the remains of her last regurgitation. Except for the twitching of two fingers on the hand that lay by her face, she looked dead.
On Margaux’s other side, a young African woman was sprawled, with blackish red blood smeared on her face. A trickle of blood ran from her ear down to the floor where her head lay, well off her mat. One of her arms was resting across Margaux. The woman’s fingers were curled back over her palms, pulled closed by dead tendons. The woman’s chest didn’t rise, nor did it fall. There was no breath in her. Only the flies on her skin were alive, animated in hunger for her remains.
The absence of Benoit on a mat at Margaux’s side put a clear and certain thought into Austin’s mind. Benoit was dead. That meant his body was piled by the waste pit behind the hospital, waiting for somebody with enough commitment and energy to burn it.
A tear rolled out of Austin’s eye and tracked across the bridge of his nose, down the slope on the other side and across his cheek. The pain of Benoit’s death, mixed with all the other agony trapped in the confines of his skin, seemed too much to bear. And in moments of clarity, Austin knew the pain that lived behind the sallow, dejected eyes of all those third-world children on all those television commercials that begged for his latte money when he was back in Denver. With the pain branded so deeply on his own soul, he’d never look at those eyes again and keep his tears to himself.
In the next moment of lucidity, he recalled the prognosis of his predicament. Benoit was dead. Margaux was dying. Austin would soon see them on the other side and never again have to look at diseased children with big eyes and distended bellies.
It occurred to Austin in that moment that he should be dead already.
Austin felt the weight of someone sitting down behind him on the cot. With all the slow care he could use to keep his stomach from spewing whatever remained there, he rolled onto his back. One of the guys in yellow Tyvek was sitting beside him, looking down.
Through the goggles Austin saw medium brown skin, black eyebrows, and familiar black eyes. “Rashid?”
“You are Austin.” It wasn’t Rashid’s voice, but his brother’s older, harsher voice.
“Najid?” Austin asked. “Why?”
“You did me a kindness.”
Austin was confused. He was asking why Najid was in Kapchorwa with gunmen, why he’d killed Nurse Mary-Margaret—not for a moment of warm, fuzzy emotional shit. What the hell was he doing?
Najid said, “You are a friend of Rashid’s. You telephoned me out of concern for him. I returned the kindness by not having you killed.”
Austin tried to put the words “fuck you” together, but was having trouble getting his mouth to cooperate.
“Not that it matters. You’ll soon be dead I suspect. It seems that nearly all who are in the advanced stages of the disease are dying.”
Austin looked to his left to see the ward.
Guessing the question, Najid answered in a detached voice. “Forty-eight so far.” He looked to the other end of the ward. “The doctor says another ten or twelve will go within the hour.”
To his right, Austin saw Rashid lying on the cot next to his. A HAZMAT guy—the doctor, Austin guessed—sat beside Rashid doing some kind of exam.
Najid’s voice grew sad, and he shook his head. “Rashid has a better chance than the rest of you. He is getting the best medical treatment available under the circumstances.”
“But—” That was the entirety of the question Austin had the energy to put together.
“It’s not fair?” Najid shook his head, exaggerating the gesture. “No, it’s not fair. Rashid gets care that will double or triple his chances of surviving, and you—“ Najid paused, “lying right next to him, in fact, lying right next to a box that contains enough drugs to treat you and maybe a dozen others—get nothing. Do know why?”
Because you’re a piece of shit. But those words couldn’t find a voice either.
“That is exactly what is going on now. American doctors with Ebola have been flown out of Liberia and are responding well to a new American miracle drug. The supply is small and the price is high. So poor Africans don’t get it. They die. That is the world, Austin. You don’t understand it because you have been a rich American all your life, and you have had more of everything than you ever needed, while others suffered to provide it for you. At this moment, that is no longer the case. Rashid has more drugs to treat this disease than he will ever need. And you have nothing. The sadness of the world’s reality looks different from this perspective, doesn’t it?”
Austin slowly shook his head.
Najid laid a gloved hand on Austin’s arm. “I know you will not believe this, but I do hope you live. That is why I had my men carry you off the mountain. Do not run again. Our activities here must be kept secret and the value of the kindness you showed does not compare to that need.” Najid took his hand off Austin’s arm, turned to the doctor in the yellow Tyvek suit, and started speaking in Arabic.
Chapter 43
“Will he live?” Najid asked the doctor, using the convenience of his native tongue to hide the conversation from Austin.
“There is no way to tell. I do all that I can. There is no cure for Ebola, you know that.” Dr. Kassis stood up, took a syringe, and injected some medicine into Rashid’s IV. “All I can do is treat the symptoms and try to keep the symptoms from killing him.”
“What is that drug you just injected?”
“It is an anticoagulant,” replied the doctor.
“An anticoagulant? That does not make sense to me. It is my understanding that hemorrhagic fever causes one to bleed until he dies.”
“Yes, but it is more complex than that.”
“How so?” Najid leaned forward. He needed to know as much as he could about the disease he was hoping to unleash on the West.
Dr. Kassis sat back down. Without waking Rashid, he checked his temperature with an infrared scanning thermometer. “The process is complex. In the early phases of the disease, blood clots form and float freely in the bloodstream. These clots clump together and clog small veins.”
“Like a stroke?” Najid asked.
“Exactly like a stroke. That explains the dementia symptoms we see in Ebola and Marburg patients. Parts of the brain are deprived of oxygen and cease to function correctly. When the oxygen supply is cut off for too long, that part of the brain dies.”
Najid shook his head and laid a gloved hand across Rashid’s forehead.
“Just as importantly, the clots form in the liv
er, the kidneys, the lungs, the intestines—all of the organs, even the heart.”
Najid nodded. “That is why you give him the anticoagulant, to stop that process?”
“Exactly right.” Kassis said. “If we can stop the clotting, we have a chance when we reach the next phase of the disease.”
“The bleeding?” Najid asked.
“Yes. The bleeding occurs because the blood has run out of coagulants. That coincides with tissue death all over the body. Where the tissue has died, eventually it bleeds.”
“Everywhere,” Najid concluded.
“Yes. Everywhere. It flows from every orifice, catastrophically. However, if we can use the anticoagulants to limit the damage from the clotting, we can later use coagulants to limit the bleeding. We keep him hydrated in the mean time and hope what we are doing helps.”
“So, anticoagulants to reduce the damage, and later coagulants to keep him from dying,” Najid summarized, more to get it straight in his own mind than to let Dr. Kassis know he understood.
“Yes,” replied Kassis.
“How do you know when to stop using one and start using the other?”
“That is my job, Najid.”
“I trust your judgment.” Najid looked down for a long time at his brother, imagining the sorrow his father would feel to lose him. It would be worse because his father was the one who had forced Rashid to spend his summer in Africa, seeing what life looked like from the other side.
“When Ebola has spread the world over, do you have a plan for how we will survive?” Dr. Kassis asked.
Najid looked up at the doctor. “The Western countries will develop a vaccine or an effective treatment. They have the technology and the experience. As we discussed, it is only a matter of time. When that time comes, we will buy enough for ourselves.”
Dr. Kassis raised an eyebrow, hidden under his goggles. “And if the Americans won’t sell it?”
“The Americans likely won’t, but I am converting my father’s fortune to gold. There will never be a time in this world when I won’t be able to find a man willing to sell his soul for a handful of gold.”
“Gold? How so?”
“I have instructed our man in Switzerland to sell everything, purchase gold bullion, and have it shipped to my father’s compound within the next few days. Gold will be the only currency with value when the world economies fall apart. My family may come out of this as the wealthiest on the planet. I have little doubt that I can pay corrupt Americans for all we need.”
Dr. Kassis adjusted his mask. It was becoming a habit, along with the fear of not knowing which was worse, an ill fitting mask, or a snug mask being touched by contaminated hands. “It is possible that gold will be worthless? It may be that only bullets, water, and food will have value.”
Najid laughed out loud. “Your faith in men runs deeper than mine, doctor. In all of man’s history, except for the age of electronics, gold has never had any intrinsic value. At best it was made into trinkets that didn’t rust. But men have always traded weapons, water, food, even their lives to possess it. It will be so in the future. The value men place on gold has never been rational. So it will continue.”
“Wiser than proceeding down this road with only a hope for a cure would be to have a backup plan.” Dr. Kassis laid a gloved palm across Rashid’s forehead. “I will speak candidly.”
“Of course.”
Dr. Kassis turned to face Najid. “In case I fall ill and am unable to offer it at a later date, I wish to tell you now?”
Najid scrutinized the doctor. “Do you think you might fall ill?”
“I don’t know. The risk is great. Our clean room is not so clean. I don’t know whether every man follows the procedures as required. It only takes one lazy man failing to remove a bit of contaminated protective gear for all of us to become infected.”
Najid’s anger rose. “Have you seen someone do this?”
“No,” Dr. Kassis shook his head slowly, showing his fatigue. “When men get tired, they make mistakes. That is all I am saying.”
“If one has made a mistake and we become infected, or if we simply aren’t protected well enough and we fall ill, what is this alternative?”
“I know you educated yourself a great deal about this disease before we came here. Did you read about the outbreak in Kikwit in 1995?”
“I am not familiar with that outbreak,” replied Najid.
“More than three hundred fell ill. Eighty percent died.”
“Not as bad as some outbreaks.”
“No.” Dr. Kassis stood up and stretched. “Let’s walk a bit.”
Najid stood up and the two men waded through the prone townsfolk, with their distant, empty faces and near-lifeless bodies. They followed the center aisle to the front doors and went out to stand on the patio.
The doctor leaned on the porch railing. “Near the end of the outbreak, one of the nurses fell ill, a Zairian woman. This disturbed the Zairian doctors greatly. They had all been taking precautions, including this nurse. They wore goggles, masks, gloves, and suits. They disinfected themselves with bleach, sprayed it on the suits, and waded through pools of bleach on the way out of the sick wards. All procedures were followed, but still, she fell ill.”
“That is a frightening prospect,” said Najid.
“For one thing, it tells us how dangerous this disease is. It takes a dozen or fewer virions—”
“Virion? I do not know this word.”
“It is an individual virus—a strand of RNA or DNA wrapped in a shell of proteins. An individual package—the infectious particle designed for transmission of any virus is called a virion.”
“Interesting that you don’t talk as though it is alive.”
Dr. Kassis nodded, “Yes, it is good that you caught that. Viruses exist somewhere between living and nonliving things, as we traditionally think of them. The point I’m making, though, is that given the unimaginably tiny amount of material it takes to make up a dozen virions, it takes only the imperceptibly smallest of mistakes to become infected.”
“That is not encouraging, Dr. Kassis.”
The doctor shook his head. “That is exactly what the Zairian doctors thought. And after seeing one of their own—the nurse—contract the virus, they knew that any one of them might be next. Who can say if it was that, or pure altruism motivating their subsequent choices? Regardless, they took a risk on an experimental treatment.”
Najid gave Dr. Kassis his full attention. “What do you know of this experimental treatment?”
“Some of the Ebola patients survived. Indeed, some were on the road to full recovery. They clearly had the antibodies in their blood to fight off the virus. That is how immunity works in humans.”
Seemed pretty basic to Najid. “I understand that.”
“The risk they took—against the wishes and objections from the American and European doctors—was to transfuse a measure of blood from one of the healthy survivors to the sick nurse.”
“What happened?”
“The nurse got better.”
Najid stood up straight and couldn’t hide the surprise in his voice. “That sounds miraculous.”
Nodding, Dr. Kassis said, “The Zairian doctors then tried the same treatment on seven other patients.”
“Against the wishes of the Westerners?” Najid asked.
“Yes.”
Najid thought for a moment. “Did they survive?”
“All but one of them did.”
“In seven out of eight, the treatment worked?” Najid confirmed.
“It appeared to have worked,” replied Kassis.
“What do you mean by that?”
“The decision to test the new treatment occurred at the end of the outbreak. There was no way to know whether or not the virus had mutated to a less lethal form of itself.”
“So no one knew for sure if it was the treatment that cured them.”
“No.” Dr. Kassis looked at Najid. “There may come a time when we are desper
ate enough to try this same treatment to save our lives. There may come a time when it is the only hope we have.”
“Then save Rashid. If I have to take another’s blood in a transfusion, it is Rashid’s I’ll have.”
“Are you of the same blood type?”
“I am.”
Chapter 44
Salim and Jalal’s team of four broke up early in their shift. They’d been carrying bodies out of houses at first, moving them to a shockingly large pile of human remains behind the hospital. They started at one end of town, working their way from house to house. Those who were sick, they helped or carried to the hospital or school.
Most houses had at least one corpse inside, surrounded by wailing family members. At many houses, the residents lied about sick family members. Some resisted physically. But a brandished AK-47 always brought an end to their resistance.
Most of the ailing couldn’t make it to a recently opened space in the hospital or school under their own power and had to be carried. In the humidity, heat, and stench, Salim’s shoulders, back, and arms cramped from the work. Two months’ training in Pakistan had left him in the best shape of his life, but he had found the limits of his physical abilities.
The saddest part of the whole endeavor wasn’t even the work. It was the hopelessness, made visceral by the bodies and the smells. Salim had touched the skin of many of the dead. He’d brought hollow comfort to the dying by holding their hands. He saw mothers weeping for dead husbands, children crying over their mothers, and fathers—men with wiry muscles and calloused hands—wailing over their dead children.
When he and Jalal were switched to the water detail, Salim thanked Allah for the change.
Salim was trying to wash the memories of the dying out of his mind with the sound of the water Jalal was pumping into the pails. He watched two men in yellow Tyvek, armed with AK-47s, standing lazily in the middle of the town’s only intersection, with red dust covering their feet and fading to orange up around their knees. Other freedom fighters were working their way in and out of houses by then. Some were carrying in water. Some were carrying out buckets. Some were taking out bodies. Some stood around in gaps between the houses, talking and gesturing. Their body language showed their suspicions and fears.