Ebola K: A Terrorism Thriller (8 page)

He asked, “How is it possible that so many
could contract it so fast?”

“We don’t know.” Mary-Margaret shook her
head. She looked defeated. “That’s why Dr. Littlefield thought at
first it might be typhoid.”

Austin looked down at the bucket to make his
point. “But now we know that’s not true.”

Nodding on autopilot, Mary-Margaret softly
confirmed, “We know that’s not true.”

Austin squatted to stretch his legs—in a
way—to get closer to the ground, so when he passed out and fell
over it would hurt less. “So, somewhere between sixty and ninety
percent of all of those people are going to die?”

“Depending on which strain of Ebola this
is.”

Austin thought about all the people he’d seen
on the streets, everyone he’d talked to, and those he’d befriended
since coming to Kapchorwa—most of them were going to die. And not
just die, but gruesomely waste away as their bodies painfully
disintegrated from within. He looked at his gloved hands as though
he might see something there—evidence that he was alive, or
evidence that he might stay that way. “I don’t know.”

Mary-Margaret turned to Austin, confused.
“What? What don’t you know?”

“I think I’m numb.” Austin shook his head
slowly as he spoke. “I never expected anything like
this
. I
feel like I just need to keep moving, you know. I’m afraid to
stop.”

He thought about when he’d been sitting on
the plane at Denver International Airport prior to take off. He’d
been excited about coming to Africa. It was the grandest adventure
he could imagine. But it wasn’t just that. He felt a passion to
make a difference in the world. He didn’t harbor any illusions
about making it better for everyone. Those kinds of thoughts were
idealistic silliness. Austin’s aspirations were much simpler. He
wanted to make the world better for
someone
, or maybe
several people. So when he stood in front of his class of a dozen
kids in the free school and felt the enthusiasm they had for
learning, he knew he was helping them—if only just a little—toward
a better life. In some ways, those days were among the best of his
life. He was happy. He was making a difference.

But just as life in America has a way of
killing the soul with vapid pleasures, life in Africa broke the
heart through random brutality. Austin closed his eyes and choked
back a tear as he saw a parade of smiling faces of those who lived
in the village. Many of those people were in the clinic, and he had
been carrying out buckets of their fluids all day. Their eyes were
desperate with pain. They knew they were dying. Few of them had any
hope.

Ebola was that kind of killer. Through its
deadly reputation, it killed hope first. Without hope, victims only
wanted the suffering to end. They gave up. And in lingering moments
of consciousness, they stared at the ceiling or the dying person in
the cot next to them. Some cried. But most were past tears.

Austin couldn’t think about it anymore. He
needed to get moving. No matter how much he hurt, the work helped.
“I’m running out of bleach to clean these.”

“We’re running out of everything.” And that
was the end of Mary-Margaret’s hope. She put her face in her hands
to catch her flowing tears.

Staring at her didn’t seem awkward. In weeks
past he’d have turned away, distracted himself with a misplaced
comment on something unrelated, random, and maybe even funny. But
that’s what people he knew back at school did. Back in that
sterile, painless world, emotions were hidden—something for keeping
behind bedroom doors or in darkened rooms. Emotions were shameful
things that were only put on display in books and movies, when
fictional characters with imaginary problems had the right to cry,
making moviegoers feel their pain so thoroughly that they cried,
too.

But painful in America? How bad was that
really? Losing a boyfriend? Getting a parking ticket? Missing out
on a job? A long line at Starbucks? Getting behind on a credit card
payment?

Pain in Africa was getting thrown off of a
roof for the sin of being an orphan. It was being castrated in the
street and left to bleed out. It was standing in a ward, stinking
of death, watching every familiar face lose its smile, lose its
hope, bleed its tears, convulse, and die.

Dr. Littlefield walked across the deserted
dirt street, still groggy from his insufficient nap. Wind from a
coming thunderstorm kicked up a red dust that blew down the road.
Littlefield shielded his eyes as he noticed a truck parked near the
hospital entrance. Had help finally arrived?

He mounted the steps and just as he landed a
foot on the porch, a tall man in full protective gear opened the
door and came out of the hospital. “Dr. Littlefield?” He had a
thick Italian accent.

“Yes.” Littlefield glanced down at his own
inadequate bundle of protective gear—a surgical mask, goggles,
gloves, rubber boots, and a plastic apron.

“I’m Dr. Dante Giovanni. I sent the girl to
wake you.”

“Thank you for coming, Doctor.”

“You’re an imbecile.” Dr. Giovanni sounded
like a father who’d lost all his patience with a child who didn’t
want to learn. “You are going to kill everyone in this town.”

Dr. Littlefield’s immediate impulse was to
lash back, but he didn’t have the energy for it. Too many
twenty-hour days had worn all the fight out of him.

“I’ve only been here a half hour, and I can
already see this is Ebola—or maybe Marburg—if you’re lucky. And
what have you done? Your nurses wear plastic aprons they’ve been
reusing for days. They clean the aprons in a common bucket instead
of burning them. They are not protected from this outbreak. You’re
going to kill them
and
yourself. You don’t have a
containment area. You let people walk out of the hospital and into
the street, carrying the virus with them. You’ve made this whole
town a hot zone. How can you be a doctor in this country and not
have the good sense to take the proper steps to contain this?”

Dr. Giovanni was on the edge of the porch by
then, Littlefield having backed down a few steps in the face of the
scolding.

But Giovanni’s rebuke found a quick end.
“Have you
nothing
to say for yourself?”

“Yes. Are you ready to listen?” Littlefield
replied.

“Of course.” It sounded like a platitude.

“I’ll skip right over the part where I tell
you I’ve been on the radio, and you’re the first person to show
up.” Littlefield retreated down the last few steps and put himself
on level ground. The Italian could come down and talk to him
face-to-face.

Dr. Giovanni proceeded down the steps and
took up a position on the dirt road in front of Littlefield,
towering over him anyway. “I came to investigate as fast as I
could.”

“When were you told to come?” Littlefield was
not impressed, and his tone made that very clear.

“Yesterday morning?”

“Why so long?”

“West Africa.” That was the simple answer,
and both Littlefield and Giovanni knew that. West Africa was
experiencing the largest Ebola outbreak in history, and it was
accelerating. “Whoever is not there is running around the rest of
Africa chasing rumors of more outbreaks. Most of them are just
fear.”

Littlefield nodded to the hospital. “But this
one isn’t, is it?”

“No. But if you know it’s Ebola, why haven’t
you taken the steps to contain the disease?”

Dr. Littlefield laughed harshly. “It’s so
easy to judge, isn’t it?”

Dr. Giovanni took a moment to pull himself
back from the edge of losing his temper. “Tell me, then. What
happened here?”

“As far as containment goes, well, you can
see the outbreak is bad. It’s already everywhere in the town.”

“When did it start?”

Littlefield did some mental math. “People
started showing up with symptoms a week ago.”

Dr. Giovanni asked, “How many?”

“A lot more than there should have been for a
normal outbreak. Nearly two dozen that first day.” The fog of
missed sleep clouded his memory.

“Twenty-four?”

“Yes.” Littlefield looked down, nodding for
emphasis. “Twice that number, the next. On the third day, when I
started pleading for help, we had around a hundred. That is a lot
for a town this size.”

“And you’re the only doctor?”

Littlefield gestured down the street. “This
is not a large town. Even so, maybe a hundred thousand live in the
district. There are two other small clinics in the area, but this
is the only one that passes for a hospital. There
were
two
of us, but Dr. Ruhindi is inside. He fainted last night. He has the
virus, and can’t even stand now. Two of our nurses went to Sierra
Leone two months ago to help. Some of the college students teaching
at the free school volunteered to help. All but one is sick. We
have Nurse Mary-Margaret and a couple of girls from the town who
help us.”

“When did you first suspect Ebola?”

Littlefield thought for a moment. “The third
day. Before that, patients had the usual headaches, fever, nausea,
and diarrhea that accompany just about any common outbreak.
However, this outbreak was so widespread and sudden, I initially
suspected typhoid. I drew blood samples and sent them to the lab in
Kampala.”

“What came back?”

“Nothing.”

Putting the pieces of the puzzle together,
Giovanni replied, “You didn’t receive the results?”

“I’m still waiting.”

“You may not ever get the results. Rumors of
Ebola and fear of the disease have caused the government to
blockade the roads in most of the eastern districts.”

“Great.” Dr. Littlefield stepped over to lean
against the side of the porch’s foundation, and put himself under
the shade of the roof that slanted out in front of it. “On the
third day, maybe twenty of the people who’d come in over the
previous days with other symptoms came back with blood-red eyes.
Others followed. The rashes started showing up, and that’s when I
knew.”

“But all at once? How do you explain it?”

Dr. Littlefield shook his head. “It didn’t
make any sense. You obviously see that, too. Ebola has a death
chain. Usually you can trace it back one person at a time. Perhaps
a man comes in with symptoms, but you know he got it from his wife,
who was in two weeks ago, who got it from their child, who
contracted the disease a week or two before. And maybe that child
got it from a childhood friend. Ebola is a nightmare—a slow-motion
nightmare that grows through personal contact. It thrives in this
culture because they feel a social need to touch. They even touch
the bare skin of the dead in their funeral rituals.”

“Not that different than us in the West,” Dr.
Giovanni said.

“I guess not.” Dr. Littlefield took a moment
to collect his thoughts and get himself back on track. “We didn’t
have a death chain here. That’s the reason I didn’t even suspect
Ebola at first.”

“Because it exploded across the population
rather than growing in it?” Dr. Giovanni asked.

“Yes. That’s exactly what happened. It
exploded for no apparent reason. People were getting infected by
the dozens, with no apparent link. Of course, that was at first. By
now, everybody in town who didn’t flee is in some stage of the
disease. The hospital is overflowing.” Dr. Littlefield pointed to a
cluster of three rectangular buildings a short distance across the
mountain slope. “The school buildings are full.”

“Everybody is infected?”

“I don’t know that for sure.” Dr. Littlefield
pointed down the road in both directions. “Two days ago I walked
through town and tried to get people to come out of their houses
and talk to me.”

“And?”

“Most wouldn’t come out. The ones who did
kept their distance, which was smart. A few admitted that at least
someone inside was sick. In some houses, everyone is sick.
Everyone. But they were afraid to come to the hospital.”

“Do you blame them?” Dr. Giovanni asked.

“No. There’s little we can do for them. Most
of our protective equipment was stolen early on.”

“That’s what happened to it?”

Dr. Littlefield nodded sadly. “What you see
is what we have.”

Dr. Giovanni started to raise his hand to
shake, but quickly put it back down. “I’m sorry. I owe you an
apology.”

“You do,” Littlefield agreed. Giovanni had
been unnecessarily harsh.

“I admire your dedication and bravery.”

Dr. Littlefield glanced at the hospital doors
over his shoulder. “I’m just trying to help.”

“Are
you
symptomatic yet?”

“I have a headache and a fever,” Dr.
Littlefield admitted.

“I’m sorry.”

Littlefield shook his head. “It was
inevitable.” And for so many caregivers in Africa that was indeed
the case. He walked around Dr. Giovanni, climbed the six stairs up
to the hospital’s porch, and went to his favorite spot to lean and
look at the small farming community. “I’m afraid.”

“Of dying?” Dr. Giovanni asked.

“Something worse.”

The Italian doctor waited silently for the
explanation.

“Are you familiar with the Ebola Reston
strain?”

“Of course. Named for Reston, Virginia. Did I
say that correctly?”

Dr. Littlefield shrugged at the accent.
“Close enough.”

“There was a company there that quarantined
monkeys imported for scientific research. I believe they had five
hundred monkeys on the premises.”

“Yes, that’s the place. In the monkey house.”
Dr. Littlefield’s heart sank just to be talking about it—the
thoughts had been haunting him for days. “Maybe fifty or a hundred
monkeys died before they figured out it wasn’t Simian Hemorrhagic
Fever, but Ebola. The Army came in and destroyed all the monkeys. I
think four people became infected, but didn’t die. That strain was
damned lethal for monkeys, but it let humans off easy.” He stood up
straight and looked out across the town.