Miasma

Ten

Steven opened the safe in his flat and took out the 9mm pistol he had been issued with. He sat looking at it for a few moments with a heavy heart before conceding the need for it in his current situation. He loaded it, slipped on the Burns Martin shoulder holster he had asked for and adjusted it for fit before inserting the weapon and putting on his jacket to see how well it would be concealed. It would do.

Although he was really no stranger to firearms and what they could do, he hated having to carry one on the streets of London. It was so contrary to what British life should be about. It seemed to him that we had done so well for so long with an unarmed police force enforcing law and order and, in doing so, avoiding the mayhem seen so often on the streets of so many other countries, but he had to accept that things were changing, and for the worse. It was no longer unusual to see news reports featuring heavily armed police officers bursting into premises like Star Ship troopers on the rampage. Holiday makers had become accustomed to seeing them patrol the concourse at UK airports, seemingly carrying enough firepower to take over a small country. Just what they imagined they were going to do with these weapons in a crowded airport escaped him.

It had not been pleasant to hear that the attempt on his life last night had been targeted and deliberate and not the over-the-top action of a trigger-happy heavy to a snap-happy jogger, but — and it was a big but — he reckoned the attempt had been made to prevent the photo he’d taken leading to the identification of Sergei Malenkov and the announcement of his presence in London and now it was too late to do anything about that; the cat was well and truly out the bag. All the security services would be working overtime on Mr Malenkov. He personally and his phone pics were no longer relevant.

Steven thought about what John Macmillan had said about not knowing if what Malenkov was doing was illegal. It seemed an odd thing to say, considering the number of bodies and shed loads of cash swilling around, but it did open up a new avenue of thought.

Assuming that money was at the very heart of it — an easy assumption to make in a world where it was at the heart of practically everything — it was still possible for something legal to be so startlingly good and life-changing that it generated fear and antipathy in others to a degree that they would wish to destroy it. He was thinking of stories of engines being invented that ran on water and cost nothing to run — wonderful, except to those who had billions of dollars tied up in the oil and automotive industry. It was reasonable to assume that, one way or another, the water-fuelled engine would not see the light of day.

It wasn’t difficult, but certainly uncomfortable to think of similar situations. Should someone come up with a simple, universal cure for cancer, it would undoubtedly be a threat to the many millions of dollars tied up in cancer research. Thousands of people across the world depended on the presence of cancer for careers, salaries, car loans, mortgages, school fees etc. It might pose an awful moral dilemma, but it would be hard to jump for joy in the street after seeing your job and your house disappear.

Could Malenkov have come up with something so novel or so brilliant that it was worth so much on the one hand but threatened others so much on the other that it might lead to violence and murder? It seemed unlikely, but continuing along these lines, Malenkov had needed the contributions of the murdered people, Field, the expert in remote drug delivery, Pashley, the expert in micro-control systems, Petrov, the vaccine designer and Lagarde, the WHO strategist in eliminating disease. Malenkov, who wasn’t a medic or a scientist, but a brilliant businessman, had seen an opportunity not obvious to others but requiring the skills of these people.

Steven could sense that he was about to start going around in circles again and put a stop to it. He didn’t want to think any more about Malenkov and what he was up to; he needed to take his mind off it all for what remained of the evening. To that end, he’d seek the assistance of Miles Davis and a couple of drinks. It was as he was pouring the first of these and Miles was launching into, Kind of Blue, that he remembered he had intended to find out a bit more about the Democratic Republic of Congo and its troubles. Wikipedia would give him a start.

Tally had no trouble in getting a good night’s sleep after learning that she would soon be returning home to the life she had put on hold — much sooner than she had ever imagined. She had no regrets about volunteering and believed that she had done the right thing in responding to the request for help in setting up a new crisis management scheme, but on the other hand, she felt she had done her bit and had no wish to repeat the experience. The system was up and running and had proved itself. It would undoubtedly be used again, but please God, not for a while: the people of DRC, and Equateur Province in particular, deserved a break. She would return to doing her very best for sick children in her own country.

She lay for a while thinking about what she personally could take from the experience and concluded not much. Most of what she had seen and heard had been as expected. The volunteers she’d met along the way were thoroughly decent people responding, as she herself had done, to that desire to help others in times of need, a human trait to be much admired but seldom satisfactorily explained, especially when it was pursued against all the odds. She personally had been working with figures and calculations, moving pieces around on a map but she remembered all too well seeing nurses emerging from long shifts on Ebola wards, the tired smiles on their faces as they removed their protective goggles and visors to breathe in fresh air and wipe the sweat off their faces. That was truly something else.

She had not made contact with many of the local population, but, when she had, it had reinforced her view that people are people all over the world. Language could be a barrier, and nowhere more so than in DRC, but so much could be conveyed through looks and smiles. People sensed who meant well and who didn’t. There had been fear and suspicion to overcome, but the patience of the volunteers had triumphed in the end, although... Tally remembered the teacher she had met shortly after arriving, Monique, the charming, educated girl who spoke English well. Tally smiled when she remembered her joking that she had to as she was teaching it to the local children. But then, there had been a strange moment when she had brought up the subject of reluctance among some locals to accept vaccination against Ebola. Rather than agree with her in decrying the influence of superstition and nonsense from witch doctors, Monique appeared to share the people’s concerns and had put an abrupt end to the conversation. It still seemed strange in retrospect. Tally thought she might go seek out Monique again before she left, hoping that she might learn more.

Tally went through the morning reports from the groups in her area, humming to herself when she saw the recovery trend continue.

‘Well, girl,’ she murmured to herself, ‘If you were allowed to pick an Ebola outbreak to volunteer for... you couldn’t possibly have done better.’

Although there had been a five-month delay before an official declaration had been made by the Health Authorities in May 2018, it was beginning to look like it was all going to be over before the end of July. The death toll looked like it would come in at under fifty as opposed to the thousands who had perished back in 2016.

It occurred to Tally that she might suggest a little celebration for the volunteers in her area but wasn’t sure how to go about this. She thought she might contact Marcus Altman, the WHO regional controller who had come to visit her at the outset and ask for his advice.

‘Great idea,’ said Altman, ‘they deserve a bit of relaxation, but maybe you should wait until the official announcement is made...’ He answered Tally’s questioning pause by adding, ‘otherwise certain gentlemen of the press — who seldom venture outside their hotels — will jump on you. You know the sort of thing, Aid workers party while sick people suffer.’

Tally did not recognise that sort of thing — quite the reverse in her own experience at Great Ormond Street where the press had always been so supportive — but she understood the reasoning. It sounded as if Altman had had quite a different experience. She asked a few questions about how she could go about obtaining food and drink for her little get-together — she had been psyched out of calling it a party — and Altman assured her he could take care of that when the time came. He would be in touch when the official announcement was made. Tally thanked him but felt deflated. Why on earth would the press want to paint a bad picture of people who had put their lives on the line to help others?

With decisions made for the routine of the day — only one request to issue for a follow-up to a family recorded as being missing when the team had last visited the village — Tally felt that they would soon be entering the more or less automatic wind-down phase of the area operation and took advantage of the current lull in demand to go through the WHO report on the 2014-16 outbreak.

She started by writing down the official date of the start of the outbreak in 2014, when Ebola had been confirmed in a small village, although she reminded herself that all dates were unlikely to be accurate because of slowness in reporting — the more remote the village the longer it would take to attract attention — and also slowness in getting lab confirmation that the disease a patient was suffering from was actually Ebola.

Tally found herself drawn into the full horror of a major Ebola epidemic, the tragic stories of whole families being wiped out because of their insistence on looking after their own rather than accepting professional help and consequently all of them becoming infected and dying. Even then, the tradition of close personal contact with the deceased in a last display of love and affection from friends and neighbours caused yet more infection. Villagers fled with predictable consequences for neighbouring villages and so the circle widened.

Tally plotted the spread to new locations using dates and checking the locations on a map of the province, checking if the limited availability of vaccine at the time had made a difference. Not much, she concluded as she watched what she saw appear as a traditional spread of an epidemic on the rampage and then... it all went wrong.

Tally couldn’t believe her eyes. Ebola suddenly appeared to have broken out all over the place... all over the country... and in neighbouring countries. She checked the dates over and over again and then the locations and then re-checked the numbers, but, unless there had been a monumental screw-up in the data she was looking at, there was something awfully wrong. There had to be some simple explanation but she couldn’t think of it. It really looked as if the people responsible for the report statistics had stopped collecting data and made the whole lot up.

Tally could feel a pulse beating in the side of her neck. She shook her head and searched for that simple explanation she felt must be lurking somewhere. ‘What am I not seeing?’ she murmured, throwing her head back as if searching for inspiration. Start with the facts! Always start with the facts, Tally.

She was looking at an epidemic that had ended two years ago; there were lots of facts. It was true that the epidemic had spread far and wide and into neighbouring countries. These facts were beyond dispute, it was the kinetics of the spread that had thrown her. They were all wrong... but two years had passed since the end of the epidemic. She didn’t know when the report she was looking at had been released, but surely someone else must have noticed this... or didn’t it matter? Maybe it didn’t, was her awful conclusion. This was Africa... eleven thousand people had perished in an outbreak of disease... eleven thousand African people to add to the thousands who had died of starvation... the thousands who had died in civil unrest... drought, famine... the list was endless. Perhaps the only thing to concentrate on in the WHO report was the fact that that particular epidemic was long since over. She should move on. None of the eleven thousand were coming back, least of all to re-plot themselves on the graph.

So much for epidemiology, Tally thought with a wry smile. Studying the spread of the disease had not helped at all in this case. She couldn’t explain what she was seeing, but, on the other hand, the rapid end to the current outbreak suggested that epidemiological help wasn’t needed. An effective vaccine and a well-organised force of volunteers had done the trick. But somehow, she knew that the numerical puzzle was going to stay with her.

Tally held her get-together two days after the outbreak in Equateur Province was declared over in the third week of July. It was an easy and relaxed affair with all the volunteers feeling both relieved that they come through unharmed and looking forward to returning home after a one-off experience or at least having a break before answering their next call as was the case with those who served with the major aid sources like Med Sans Frontierès, the Red Cross and World Health Organisation.

Tally managed to snatch a quiet moment just to observe the fifty or so people from her area laughing and chatting. It was a very long way from being a sophisticated cocktail party — plastic cups and plates, warm beer and various snacks brought over from the main WHO control centre by Marcus Altman — but no one was complaining; no one was bitching about anything. Everyone was happy.

Marcus Altman saw Tally standing alone and came over with his young colleague, Hans Weber.

‘A big success,’ said Altman.

Tally had to agree. ‘Thanks to you,’ she said. ‘You must tell me how I pay for everything.’

‘Forget it,’ said Altman. ‘I should have thought of doing this myself.’

‘But you have lots of areas to look after,’ Tally protested.

‘Please forget it,’ Altman assured her.

‘We need a celebration for the aid volunteers in the whole province,’ said Hans, ‘like the Munich beer festival.’

‘My God, the press would have a field day with that,’ said Altman.

‘Bastards,’ said Hans, quickly apologising to Tally for his language.

Tally dismissed the need for apology with a shake of the head. She could see that Hans was enjoying the beer, warm or not.

‘Are you finished with the WHO report on the 14–16 outbreak?’ asked Altman.

‘Oh yes, sorry, I didn’t realise you wanted it back,’ said Tally.

‘It’s just that it’s the only copy I have, but if you chucked it, don’t worry, it’s not important. I don’t suppose you had time to read it?’

‘I did, actually,’ said Tally, ‘did you?’

Altman smiled and said, ‘Reading reports is for politicians, not for people on the front line. Why? was there something wrong?’

‘I’m not sure “wrong” is the right word. Come, I’ll show you.’

Altman and Hans followed Tally inside to the table where her map was laid out. ‘The epidemic followed the usual rules of spreading up until this happened,’ she pointed to an end to concentric circles and the appearance of her crosses all over the map. ‘All the figures go haywire; they’re all over the place.’

Altman looked closer before announcing triumphantly, ‘Rivers.’

‘Rivers?’ Tally repeated.

‘You’ve overlooked the relevance of rivers. They are used as a major form of transport in African countries with little in the way of roads. Your early circles represent the spread of disease from the small villages where it started across land where there are often no roads at all. It’s quite slow, but people carrying the disease can be many miles away very quickly when travelling by river and new cases suddenly appear in the destinations of their river journeys.’

‘Ah,’ said Tally, ‘that would explain it. Thank you, Marcus. I’ve just learned that traditional epidemiology shouldn’t be employed when so many rivers are involved.’

‘Let’s join the others,’ said Hans examining his empty beer cup.

Tally did her best to circulate through the groups of volunteers, many of whom she hadn’t had to the chance to meet face to face with during the relatively short time she’d been here. She was pleased at the response she got when introducing herself. Everyone seemed pleased with how she’d done her job and spoke of how efficient everyone had been in interacting with each other.

Tally was pleased to come across Mary Kelly and they hugged before Tally thanked her for being so kind to her when she’d first arrived.

‘It was a pleasure,’ said Mary, ‘and you’ve been a big success.’ She asked about Tally’s plans for returning home.

‘I haven’t made any yet,’ said Tally. ‘There are one or two things I have to do before I get down to it. I thought I might go and see Monique Barbet and hear what she thinks about the way the latest outbreak was handled. I got the impression she wasn’t too impressed with aid efforts the last time Ebola struck.’

‘She’s just a troublemaker,’ said Hans who had joined them and whose speech was becoming slurred.

‘Who’s a troublemaker?’ asked Marcus Altman who had also joined them.

‘Monique,’ said Hans, without bothering to add a surname.

‘Nonsense,’ said Altman, ‘she’s just an educated woman who likes to question everything — a woman of her time.’

Everyone laughed and Hans slunk off to get a refill.

‘You sound cheerful,’ said Steven.

‘I’ve been giving a party,’ said Tally.

‘Ah,’ said Steven, ‘then it’s true what they’ve been saying about aid workers.’

‘And what’s that?’ Tally asked.

‘The press have been running stories about aid workers exploiting vulnerable people in crisis areas across the world.’

‘I must have missed that,’ said Tally, ‘I certainly haven’t come across anything like that here,’ she added, but thinking it would explain Altman’s hostility when the subject of the press came up.

‘When are you coming home?’

‘Soon, I promise. Just a few things to clear up.’