Cotonou, Benin
Six days
ago
Dr. Arjeta Hlasek sat back in her chair, her
pointed chin resting on the tips of steepled fingers. Her
expression was a patchwork of doubt, concern, and alarm. The two
doctors who sat on the other side of her desk looked road worn and
deeply stressed, their eyes hollow with exhaustion. Both of them
sat straight in their chairs, their hands fidgeting on the stacks
of test results and lab reports they each had on their
laps.
“I. don’t know what to say,” began Dr.
Hlasek. “This is disturbing to say the least, but what you’re
describing. Well, I don’t know.”
The younger of her visitors, Dr. Rina
Panjay, leaned forward, her voice low and urgent. “Dr. Hlasek.
we’ve done the tests. We’ve had blind verification from two
separate labs, and they verify what our own tests
show.”
“She’s right, Arjeta,” agreed Thomas
Smithwick. “And I can understand your hesitation. I didn’t believe
it, either, when Rina first told me. I ran every kind of test I
could think of-most of them several times. The lab work doesn’t
even vary; it’s not like there’s a margin for error
here.”
“But,” Dr. Hlasek said, half-smiling, “a
genetic disease that has mysteriously mutated into a waterborne
pathogen? There’s no precedent for something like
this.”
Smithwick paused, then said, “There wouldn’t
be. not outside of a biological warfare facility.”
“You think that’s what you’ve found? A new
bioweapon that somehow escaped quarantine and has gotten into the
water supply in Ouémé? That’s a lot to swallow, Thomas. Who would
do such a thing? Moreover, who would fund research of that kind?
It’s absurd; it’s fantasy.”
“Haven’t you been listening? We have over
three hundred infected people right now,” snapped Dr. Panjay, and
then suddenly regretted her tone of voice. Dr. Arjeta Hlasek was
the Regional Director for the World Health Organization and a major
political force in the United Nations. She was one of Switzerland’s
most celebrated doctors and had three times been part of teams
nominated for the Nobel Prize. Hlasek was not, however, a patient
or tolerant person, and she wilted Panjay with a blast from her ice
blue eyes.
Dr. Panjay dropped her eyes and stammered a
quick apology.
“Arjeta,” said Smithwick in a mollifying
tone, “my young friend here is exhausted. She’s been in the thick
of this, caring for dozens of patients at her clinic and doing
fieldwork to collect samples and helping to bury the dead. She’s
running on fumes right now.”
“I appreciate the diligence and dedication,”
said Dr. Hlasek with asperity. “Still. I find this rather a lot to
swallow. Our organization is built on veracity. We’ve had bad calls
in the past that have weakened public trust, and weakened financial
support.”
Smithwick shook his head, his own patience
beginning to erode. “This isn’t like the cock-up with the Ebola
scare last year. This is a real crisis backed by irrefutable
evidence.” He took his entire stack of notes and thumped them down
on Hlasek’s desk. “This is immediate and it requires immediate
action.”
The Swiss doctor blew out her cheeks and
studied the papers and then the two doctors.
“Understand me, Thomas. and Dr. Panjay,” she
began in a measured tone. “I will act. But this needs to be handled
with the greatest of care. What you’ve just put on my desk is a
time bomb. If you’re right about this-and I warn you now that I
will have another laboratory verify these test results-then we will
act, but this could blow up out of control very easily. Between
political and religious tensions and the shoddiness of the public
health and education systems, we are going to have to plan how to
release this information.”
“But people are dying!” urged
Panjay.
“Yes, they are,” agreed Hlasek, “and more
are going to die before we verify the results and map out a
protocol for handling this. However, if we don’t move with the
greatest care then many, many more will die in the ensuing panic.
Thomas, you’ve seen this happen; you tell her.”
Smithwick nodded and patted Panjay’s hand.
“She’s right. A panic breaks down the lines of communication that
are, quite literally, the lifelines for the people. You’ll not only
have masses of people fleeing blindly, which would make effective
treatment impossible, you’ll also see warlords and criminals
raiding our supplies for treatments, food, pure water. no, Dr.
Hlasek is quite correct. This needs to be handled correctly or
we’ll have thrown gasoline onto this fire you’ve
discovered.”
Panjay turned away to hide the tears that
jeweled her eyes. Her mind was filled with the faces of all of the
people in the village where she ran her clinic. Half were already
dead, the rest sick. She understood what Hlasek and Smithwick were
saying, could accept the reality of it, but just as certainly she
knew that it was a death sentence for everyone in the village.
Maybe for everyone in the region.
She could feel the eyes of the other doctors
on her, and though it cost her to do it, she nodded her
acceptance.
“Very good,” said Hlasek. “I’ll make the
necessary calls to get things in motion. We need to make sure that
everyone else who knows about this is brought into our confidence.
It’s important that everyone be made to understand the vital
importance of keeping this quiet until we’re ready to move. Who
else have you told?”
“Just the people in the village,” Panjay
said thickly. “And my two nurses. They’re at the
clinic.”
“I don’t mean to be indelicate,” said
Hlasek, “but what race are they? This disease affects sub-Saharan
blacks, as you know. We’ll need to rely on those persons who are
not likely to become infected; otherwise we’ll lose our workforce.
Our ground troops, so to speak.”
Panjay cleared her throat. “Both of my
nurses are African. Black African. One from Angola, the other from
Ghana. We’ve taken every prophylactic measure-”
“I’m sure that will be fine. I’ll call them
myself at the clinic. And we’ll get a truckload of supplies out
this afternoon.”
She stood up. “Dr. Panjay, Dr. Smithwick,
you probably think I’m a heartless monster, but please let me
assure you that I appreciate the seriousness of this, and I respect
the work you’ve put in here. I also want to thank you for bringing
this directly to me. We will work together to do whatever is
necessary to get in front of this dreadful matter.” She extended
her hand and they all shook. Hlasek remained standing as Smithwick
and Panjay left.
When they were gone, Hlasek sank back into
her chair and stared at the stack of lab reports for a long minute.
Then she picked up her phone and punched a long international
number.
“Otto?” she said when the call was answered.
“We have a problem.”
“Tell me.”
She told him everything that Panjay and
Smithwick had told her. The man on the other end of the call, Otto
Wirths, listened patiently and then sighed.
“That was careless, Arjeta. We shouldn’t be
at this point for three days.” He made a clucking sound of
disapproval. “You’re sure that only four people know about this?
The two doctors and the nurses?”
“Yes. They came to me
first.”
“How long before anyone else is likely to
make the same kind of report?”
“I don’t know. it’s still confined to the
Akpro-Missérété Commune. I can quarantine it quietly. Say, two
weeks. Three at the outside.”
“We only need a week,” he said, “but we need
the full week. Find out what hotel the doctors are staying
in.”
“I don’t want any of this to land on me,
Otto. Headlines won’t help.”
Otto laughed. “An electrical fire in a cheap
hotel in Cotonou will barely make headlines even in Cotonou. And as
for the nurses. something will be arranged.”
“Do whatever you have to do, but keep me out
of it.”
Otto chuckled again and
disconnected.
Dr. Hlasek hung up the phone and stared at
the stack of reports. Then she stood up, straightened her skirt,
picked up the reports on the sickle-cell outbreak, and carried them
over to the paper shredder.