by M. D. Massey
We walked past several buildings. The sound of moaning became painful. It had the same effect as crying babies: a tug at your heart and soul, motivating you to do something. I felt relieved that I was a nurse. I couldn’t have handled being at that camp had I just volunteered to help with accounting or cooking or something not directly related to patients.
Dr. Tovar halted in front of the fourth building, turquoise with white shutters, dried mud splashed along the bottom of its outside walls. “OK, volunteers. I’m going to divide you into groups of five. Each group will be assigned to a different team in a different building. Each team is supervised by a different doctor.” Then he pointed to one of us at a time, repeatedly assigning us a number from one to five: “One…Two…Three…Four…Five…You all work in Building Number 1. One…Two…Three…Four…Five…You’re assigned to Building Number 2.” He did that five times, so it turned out there were exactly twenty-five of us.
A red-headed woman, freckles splashed across her face, sensibly dressed in shorts and a tank top, started heading toward her assigned building. Dr. Tovar stopped her. “Whoa! Where do you think you’re going?”
“To my building? To get started?”
Tovar opened his eyes wide in exaggerated shock. They were deep brown, warm. I felt about to swoon, and not just from the tropical heat. He said, “OK. I cannot impress enough upon all of you: you’re not to go wandering off anywhere alone. Exploring or finding your own way around our facilities is strictly forbidden. We’re dealing with Ebola Virus Disease here. You can’t possibly know which areas have been contaminated. Here…I want to show you something…” With that, he turned his back on us and waved us forward.
We followed him around the side of Building 5, the building to which I had been assigned. There were touches of cheer: two pink flower boxes under small windows, a single yellow flower poking its head out of one of the boxes, polka-dotted curtains in the windows.
Then we entered the backyard.
Workers dressed in protective gear surrounded a human-shaped mound covered by a white sheet. A foot, twisted at a weird angle, stuck out the bottom edge. Dr. Tovar said, “Under that sheet is a dead woman. Before expiring, she bled out from Ebola. The ground where she’s lying has no doubt been seeded with her sloughed-off gut and bowels. In a few minutes, she’ll be cremated and the backyard sanitized. You wouldn’t want to unknowingly walk across that stretch of land between the time the body was removed and the ground sanitized, now would you?” Gesturing toward Zoe, he added, “And you’re all to wear shoes at all times, hear me?”
We shook our heads in agreement.
Dr. Tovar instructed us to gather in front of our assigned buildings and wait for our supervisor to invite us in. He gave strict directions on the exact path each group should take to get to their destination.
Sadly, Dr. Tovar wasn’t my supervisor. He ran Building 1.
We left the backyard. My team walked around to the front and waited, wondering about the conditions inside.
A few minutes later, a woman in a white coat came through the front door. She had piercing blue eyes and a halo of frizzy black hair. “Hello. I’m Dr. Angela Steele.” She didn’t smile. “Thank you all for volunteering your service. We’re on the frontline here, battling an outbreak of Ebola. It has only recently arrived in Liberia. Our job is to contain it. As a result, we’ve been given license to administer experimental drugs sent to us by several countries, developed by a variety of pharmaceutical companies and approved by both the World Health Organization and the CDC for this purpose. I’m going to take you over to another building where you’ll be instructed on how to use protective gear. Then we’ll return here and you’ll be introduced to your patients.” No small talk. Right down to business. My heart raced. My palms grew sweaty.
Crossing the dirt road, we entered a building with a sign over the front door designating it: Safety Station 5. Inside, the walls were lined with shelves marked Personal Protective Equipment (PPE) and benches. The shelves were filled with things I recognized from my infectious diseases training back home: yellow protective overalls, clear aprons, white hoods, masks, goggles, respirators, turquoise gloves, overshoes, and turquoise rubber boots.
Through a door in the back, Dr. Steele led us to a separate building marked: BIOHAZARD: Disinfecting Station 5. She pointed out a path that led from the road directly into this building. She said, “Never, ever pass through a Safety Station Building, sometimes referred to as a Protective Personal Equipment or PPE Building, to get here. Only use the outside path for your Disinfecting Station after being in a patient treatment facility or coming into contact with Ebola in any way.”
Our tour of Disinfecting Station 5 revealed garbage cans ominously marked Biohazard, showers, sinks, dispensers with soap and alcohol-based hand rubs, and single-use towels. Outside the back door of the station were other areas for showering, removing and discarding protective gear. Dr. Steele stated in a sharp tone, “Do not ever attempt to remove your own protective gear. Trained assistants will help you, so that you don’t risk contamination from the outside of your gear. Do you understand me?”
We all answered yes in a variety of ways: nodding our heads, mumbling agreement, or in my case, replying, “Yes, Ma’am!” a little too loudly.
Dr. Steele and two interns (God, what a place to intern!) demonstrated how to put on and take off protective gear. Then assistants helped us suit up. Protected from virus, we looked more like astronauts on an alien planet than medical personnel about to help patients. We no longer seemed human.
Dr. Steele said, “Today, you are going to meet patients. Tomorrow, your medical training and direct work with patients will begin.”
As we lumbered across the path toward Building 5, Zoe’s Oriental eyes loomed large through her clear plastic face mask. She reminded me of a gargantuan insect with dark nervous eyes.
Inside the treatment facility, patients lay listless on hospital beds spaced evenly along both side walls and separated by plastic curtains. Several female patients wore brightly colored dresses. No hospital gowns, apparently just whatever they had been wearing when they arrived. Reading from a chart at the foot of each bed, Dr. Steele explained each patient’s condition and how they were being treated.
Medical personnel moved about the room in suits identical to ours, administering to patients. One stuck an elderly man with a hypodermic needle and drew a blood sample. The sight of that thick red blood, teeming with Ebola virus, twisted my stomach into knots. I felt terrified that I would throw up inside my suit.
The last patient we encountered was a little boy named Akachi Anikulapo-Kuti. Dr. Steele said, “His first name means ‘hand of God.’ Ironic, don’t you think? I don’t believe any God would ever do this to a little boy.” After studying him a moment, she continued, “He’s four years old. Arrived here this morning. He tests positive for Ebola. We started him on an experimental drug from the CDC two hours ago.”
Akachi opened his eyes, noticed us hovering about him in our alien insect suits; then rolled over, away from us. In his arms, he clutched a stuffed bear—so new and clean, it must not have come from home, probably a comfort gift from staff.
Expecting the sick to be writhing in agonized torment, I asked why everyone appeared listless. Dr. Steele explained, “We have them heavily medicated for pain. That’s one of our primary treatments, to ease their suffering.” Her blue eyes brightened behind her face mask. “And we have access to the most powerful pain meds in the world. Our patients are almost always under our control.” I figured she meant “our patients’ pain is almost always under control,” but that’s not what she said. I chalked it up to the sweltering heat under those plastic suits.
Then she took us back to the area behind Disinfecting Station 5 where we learned the hard way how to get disinfected and have our protective gear stripped away.
Back in our normal clothes, we were taken to one of the rectangular yellow buildings, which turned out to be the residence halls. Our buildi
ng was clearly marked: Female Residence: Teams 4 and 5. It was laid out like our treatment center, but had more homey touches: normal twin-sized beds, pastel sheets, brightly colored African quilts; and a reading section in the back with bookshelves and a desk, loads of books, a couple of overstuffed chairs and hassocks, and framed photographs of African landscapes and animals. The photograph of a silverback gorilla was a bit disconcerting. I was glad it was in the reading area, and not above my bed. Behind the reading area was a bathroom with several showers, sinks, toilets. Our residence hall was clean. Even the cement floor shined. We had six women in our building, from Teams 4 and 5.
All of us ended up collapsing on our beds and falling into a deep sleep. Hours later, we were awakened by a loud gong reverberating somewhere out in the jungle. Then a speaker inside our room announced: “You will be escorted to the Meet and Greet in one hour. Please get ready.”
As I stepped from our residence hall into the night, a full moon dropped slivers of light through the bald spaces between jungle branches. The rest of the land was black and indecipherable. Monkeys chattered and screeched. Frogs croaked. Out in the darkness, several big cats roared. Blinded to their form, I could only hear their rumbling threats.
A guy had been waiting. Pockmarked skin, thick glasses and twitchy eyes. He stated brusquely, “I’m to deliver you to the Meet and Greet.” When we tried to engage him in conversation, he said only, “I’m doing my job. I’m bringing you to the Meet and Greet. You won’t regret it.”
Zoe and I exchanged glances. She covered her mouth to stifle a giggle. I wasn’t sure why she found this funny.
The six of us from our residence hall followed our guide to a dirt parking lot. He instructed us to climb into a waiting jeep. Then he hopped in and drove us up a steep hill to a large concrete building where yellow light poured out of rectangular windows. Shadows of tree branches danced in macabre shape-shifting tattoos along the walls of the gray structure.
Inside, the atmosphere was decidedly more festive. Music rocked the inner walls. African hangings and throw pillows adorned the main room. Mahogany furniture and lamps warmed it up. Waiters with trays of food and alcoholic beverages kept the party going.
We met everyone. All the regulars introduced themselves to all us newbies and made sure we met each other. The night was a kaleidoscope, swirling shapes and colors and patterns. I remembered everyone’s names, and yet I felt as though I had been drugged.
Needing a breath of fresh air a couple of hours after arriving at the Meet and Greet, I stepped outside. Zoe followed closely behind me. We knew we shouldn’t; but feeling intoxicated by the night and the party, we headed back to our residence. As we entered that part of the road upon which the long rectangular buildings hunkered down like behemoths in the dark, we saw figures moving in the distance.
I lifted my fingers to my lips to signal Shhhhh! to Zoe.
Two figures cloaked in shadow had come out the front door of Building 4. They weren’t wearing protective gear. Carrying something in their arms, they began walking very quickly.
Zoe and I followed them. When they stopped in the middle of a grassy field, we hid behind trees along the perimeter.
We watched.
I wasn’t prepared for what I saw. My mind couldn’t piece together what seemed to be mismatched parts of a picture.
The couple carrying a package wrapped in a stained blanket were a black man wearing a brightly patterned shirt and a black woman wearing a brightly colored dress. I assumed they were African. When they laid down their burden and unwrapped it, it turned out they had been carrying a small girl. She was maybe the same age as Akachi, the last patient we had seen in our own Building Number 5, maybe four years old. She was as limp as a dish rag and covered with flesh that was literally falling off her body. Her mottled skin retained some of its natural black pigment, but more of it was red, bloody, and hanging from her face and extremities in sheets.
As the couple set the body on the ground, they wailed in such sorrowful distress, I thought maybe I should run to get help. But then from the jungle directly across from us, an old African woman in an orange turban and a fiery orange dress with turquoise-and-black geometric patterns walked over to them. Surrounding her were U. S. soldiers. Dressed in olive green uniforms and helmets, they carried machine guns and assault weapons. Each and every one of them had respirators strapped over their nose and mouth. Behind them, a trio of armored vehicles bobbed up and down over the uneven terrain.
I stifled a gasp. They were going to shoot the people in the field, I was sure of it. A million thoughts went through my mind, tearing me apart while I froze against a tree trunk. I should run to help them. No, I’d get shot. I should run for assistance. No, I’d get caught. If the soldiers shoot holes into the Ebola patient, infected blood will go everywhere.
As I wrestled the flood of thoughts cascading through my brain, the soldiers stopped. The woman in the orange turban nodded to them. They surrounded the four people in the middle of the circle and stood at attention, as though guarding them.
As the full moon passed overhead and slipped from behind clouds, bathing the open field in silvery light, the old woman knelt down next to the child. She chanted in African tongue and waved her arms about. Burning incense, she passed it over the little girl. Then she applied some kind of ointment from a glass jar to the child’s forehead.
I felt ill. The little girl’s bloody skin would be sloughing off onto the old woman’s fingers, Ebola virus entering her own body and replicating there, also mixing with the ointment in the jar every time she thrust her fingers back into it. Would she then administer the salve to another person?
After closing a lid on the jar and chanting for a few seconds more, the woman stood. She allowed herself to be escorted away by two heavily armed soldiers.
At that moment, someone cleared their throat behind Zoe and me. I nearly jumped out of my skin. We turned around.
There, holding two pink drinks decorated with purple umbrellas, was Dr. Tovar. He grinned widely. “So, girls, what are you doing here? Did my warning about not wandering off by yourselves not sink in?”
I could not control my body. I shivered. My voice quavered and broke. I managed to say, “We just needed a walk. Some fresh air.”
Dr. Tovar smirked. “And have you had enough fresh air now?”
Zoe and I shook our heads up and down, like puppets on a string.
Tovar said, “Good. Have these drinks then.”
Zoe pointed with her thumb toward the clearing, as though hitchhiking with a death wish.
She had her back to the clearing. I didn’t. I took a good, hard look. The child had sat up. She had regained her energy, although her skin continued sloughing off as though it were nothing more than bloodied flesh-toned Band-aids. In the moonlight, I saw her tearing off pieces with her teeth from what looked like a human leg from the knee down, a foot still attached but bent at a weird angle. I turned around. I concentrated on the purple umbrellas to keep from retching.
Zoe looked Tovar in the eye and asked, “Are you aware of what’s going on behind me?”
A combination of fear and disgust turned my stomach inside out. I heaved. Everything I had eaten that night gushed up and splashed over the ground. Noticing the vomit landing on a nest of ants, I threw up again. The sound of retching caught the attention of the soldiers. They cocked their guns with clacking sounds like the gnashing teeth of a robotic monster.
Tovar raised his hand and shouted to the soldiers. “It’s OK. Stand down. I got this one.”
He shoved a drink into my hand. “Drink this,” he instructed.
To Zoe, he answered, “Yes, I know what’s going on. You’re not in Kansas anymore, Dorothy.” He smirked. “This is Liberia. We have the best medical treatment for Ebola available anywhere in the world right here in this camp. But this is still Liberia. In other parts of West Africa, people have attacked clinics. In Guinea, an Ebola clinic run by Doctors Without Borders had to be evacuated after an a
ngry mob attacked it, locals accusing the organization of having brought the disease into their country. Elsewhere in West Africa, doctors and clinics have been attacked for the same type of superstitious beliefs. In Sierra Leone, locals think that Ebola is just a gimmick used by medical staff in order to perform cannibalistic rituals in isolation. Imagine that!”
I thought of the kid eating what appeared to be a human leg.
Tovar continued, “So, to prevent locals from storming our camp and dragging their loved ones back home, thereby spreading Ebola within their communities, we allow the most emotionally desperate to come here and perform their superstitious healing rituals over their sick family members.”
I found my voice. “But won’t they go back home and spread the disease themselves?”
Dr. Tovar answered, “No. We vaccinate everyone who performs these rituals with the most promising experimental Ebola vaccines. We negotiate with them: a vaccine in exchange for their rituals.”
My heart pounded against my rib cage. “But the vaccines are only experimental.”
Dr. Tovar leaned forward. Baring his teeth, he spoke only a few inches from my face. “You, Emma, are also not in Kansas anymore. West Africa is basically a petri dish at this point in time. A petri dish and an experimental lab. West Africa provided the petri dish. We provided the lab. You are going to have to get used to how things get done here.” He backed off, shoved his hands into his lab coat pockets. “Now, drink up, you two.”
We did. We drank down the sweet pink poison, our lips moving against the wooden stick of the purple umbrellas.
That is all Zoe and I remembered until the next morning when we woke up in our beds. We had chosen to bunk next to each other in our residence building. I awoke first in a complete state of panic. I thought I was back home in the United States. Then I remembered that I was in Africa…and what had happened the night before…and the missing chunk of time.
I ran into the bathroom. I locked the door. Slipping out of my nightgown and dropping it to the floor, I checked myself from head to toe for bruises in the full-length mirror. I lay down on the floor, lifted my butt up until I could see my private parts in the mirror and then inspected myself for tears or bruising. I picked up my underpants and smelled them. I didn’t appear to have been raped. And nothing hurt.
