by Nick Louth
‘Outrageous!’ roared Friederikson, knuckles tight on his stick. ‘Before you were born I was devoting my life to this…’
‘Please, everybody. Calm down.’ Milward nodded towards the doorway, where a bearded man in jeans and a press pass pinned to his polo shirt was scribbling notes furiously. Tanya was doing her best to block him from getting any closer.
‘Mike Penstein, Newsweek,’ the journalist barked. ‘Is it true that Stroud-Jones has gone missing?’
Zoe, Max, Friederikson, Loebe and Milward looked at each other for a moment, then chorused ‘No comment’. The journalist looked heavenward as Tanya closed the door on him. They ignored the further questions shouted through the door.
Loebe was laughing softly to himself, his scars flexing. ‘Perhaps Erica has been kidnapped?’
‘Minister,’ said Milward. ‘This is Amsterdam.’
‘Hunchbacked and silent, it gorges itself on the blood of its victims as they sleep. The disease it carries kills more than 1.5 million people a year, and reduces three hundred million to a shivering, sweating terror. For fifty years humanity has tried to wipe it out – and failed.
The name of the beast is Anopheles, the malarial mosquito. It has adapted brilliantly to all mankind’s worst habits. It delights in rainforest destruction, climate change, and pollution. It adores population and refugee movements, which give it new and vulnerable populations on which to feed. It revels in war in common only with the rat and the maggot.
The adaptable mosquito can breed in a few drops of clean water in an old tyre or tin can or a wheel rut, and has readily taken to urban areas. In India there is even a species of Anopheles which breeds in rooftop airconditioning tanks.
Of course, Anopheles is only the steed that carries malaria. In this Apocalypse there are also Four Horsemen: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. Their names are familiar only to the few dedicated and underfunded scientists who fight them, but their effects are known to billions in the tropical world. These are the tiny parasites which cause the disease in man and mosquito, the deadly cycle of death and sickness.
The parasites have foiled all attempts to develop a vaccine against them, and are increasingly resistant to the drugs used to treat them. There is a desperate need for funding to find new drugs, but major pharmaceutical companies have largely turned their backs on a market where the victims have no money.
Beware! We are the four horsemen’s greatest ally. Global warming may bring them back as killers to the temperate world, in which we, the complacent wealthy, have taken our shameful refuge.’
(Extract from the speech of Professor Jürgen Friederikson to the United Nations conference on health in less developed countries, 1994.)
Chapter Ten
Henry Waterson hadn’t meant to fall asleep, but waking on a Sunday afternoon with the young woman he loved still asleep and entwined around him was a warmth to savour. As gently as possible he slid his fingers along her shoulder, under the bedclothes until he found the heavy flesh of her right breast. Barely touching, he circled towards the centre until the nipple rose hard to meet him. Still she slept as he traced a line under her ribs along the slight curve of her belly and along her thigh down to her knee.
She sighed and looked up at him, smiling. Her legs parted and she spoke. ‘Go on.’
Henry caressed her inner thighs, feeling the slick stickiness of their earlier lovemaking on her skin as he moved higher. He pressed a flat hand against her sex, and she thrust her hips, describing a moist, hot lick on his palm. He pressed his fingers inside, and hearing her ragged exhalation felt a stiffening jolt in his own groin.
They embraced and he slid on top, her hand grasping then guiding. ‘Not such an old tired man then, Henry?’ she said.
He chuckled as he slid into her heat and rhythm. ‘You’re supposed to be somewhere else now, aren’t you?’
‘Not for an hour. I’ve done what I need to for him, and this,’ she gripped his buttocks hard, drawing him deep into her. ‘ …is for me.’
Henry, trying to slow the pace, glanced across at the next bed, spread with plastic bags and wrapping paper. ‘You shouldn’t do…all that for…him, Penny.’
‘I know. But if I hadn’t …been buying more presents for his wife, I would… have been stuck in meetings all day.’ They abandoned conversation as her urgency overtook his slower rhythm, and the headboard began to tap tap tap against the wall.
Fifty minutes later Penny Ryan knocked gently and pushed open the door into Jack Erskine’s hotel suite. The hallway reeked of stale sweat. She went through to the bedroom. Curtains shut out the late afternoon light and the air was foul. She clicked on a bedside lamp and flicked on the air conditioning. The chief executive was staring at her through bewildered and bloodshot eyes, his breathing a gentle rasp. The bed covers were dishevelled and damp, his pyjama jacket open. Beads of perspiration stood out on his top lip and his hair was like a dark, damp stain on his head.
‘Jack you look terrible!’
He said nothing. Penny carefully set aside the gifts she had bought for Jack’s anniversary on the dresser, and to calm herself tidied up the room, picking up and folding clothing, bringing him fresh water to set by the bedside, fiddling with the air conditioning. Jack’s eyes followed her around the room, but somehow the Jack she knew wasn’t in them.
‘Momma.’ The voice rasped out from the bed.
‘Jack, it’s me, Penny. You’re sick, Jack, and we’re going to get you a doctor.’
‘Please Momma. Open the window. It’s real hot.’
‘You’ve got a fever, you’ll be fine. I’ve turned up the aircon.’ Penny dialled reception. They promised to send a doctor and a thermometer.
Once the thermometer arrived it took Penny three attempts to keep it under his tongue while Erskine called out in his delirium. He was convinced he was back at his boyhood home in Abilene, Texas. Finally, Penny lost patience and held his jaw shut with one hand. ‘Honey, Momma gonna spank you ’ness you keep still!’
It did the trick. She wondered what Pharmstar’s 78,000 employees, every one of them scared of Iron Jack, would make of this performance.
Then she took out the thermometer and gasped. 105.5 Fahrenheit. She didn’t know a human being could get so high and live. She put the thermometer in a glass and grabbed the phone to call reception.
‘This is suite 417. We are still waiting for the doctor you promised. If he doesn’t arrive in five minutes I want an ambulance. Yes really.’ She dropped the receiver back on the hook, and then snatched it up again. Five minutes later Quiggan was standing in the room as Penny harangued him.
‘And you mean to say you just let him come up here alone.’
‘Sure,’ said Quiggan. ‘He’s a big boy now.’
‘Why didn’t you check on him? Why didn’t you call a doctor immediately?’
‘He wouldn’t let me, Penny,’ said Quiggan. ‘He said he just needed an hour shut-eye and we have a conference call with the minister at five.’ He looked at his watch. ‘Well, I guess he’s not going to be better by then. Best make it tomorrow.’
‘For Christ’s sake Don, he’s running a fever of over a hundred five. He is not going to be better for a week. This ain’t flu, I’ll tell you that.’
The knock on the door made them jump. Quiggan opened the door. A beautiful dark-skinned woman stood there, with a cheeky smile and the smell of wine on her breath. She was a little taller than he, in her mid-twenties and slender except where her full breasts and and bulging cream dress revealed her pregnancy.
‘Hello.’ Her brown eyes danced with intelligence as she watched Quiggan’s gaze move slowly back up to her face. ‘Well, you’re not the sick one are you?’
‘No, he’s inside. I’m Don Quiggan, pleased to meet you.’
‘I’m Saskia Sivali. I just happened to be at a reception downstairs when the manager asked me to help. I’m a graduate student from the Randstad Medical Centre.’
He showed her into the room. ‘This is Dr Sivali,’ he said to Penny.
‘Not yet I’m not,’ Saskia said. ‘One more piece of paper required. I’m just plain Ms for now.’
‘Hell, but I’m sure you’ve done all the work just the same.’ The moist, avaricious grin on Quiggan’s face followed the woman’s long legs into the bedroom. Penny had seen the same expression when Quiggan assessed the balance sheets of rival companies, ripe for takeover and dismemberment.
Saskia Sivali looked into Erskine’s eyes, took his pulse and checked the glands under his jaw. ‘So how are you feeling?’ There was no response except a sigh. She looked up at Penny. ‘Has anyone taken his temperature?’
‘Yes. One-oh-five. Fahrenheit, that is.’
Saskia let a sceptical half smile slip as Penny handed her the thermometer. She checked the bulb carefully and shook it repeatedly. Then she eased Erskine over on to his front, and eased his pyjama pants down while she probed with the instrument. Quiggan grinned, wishing he had a camera to capture this precious moment.
She needed only one shocked glance at the thermometer. ‘I’ll get an ambulance immediately.’
We stayed up in Etenzi’s hut this evening, listening to the hissing of the hurricane lamp and waiting for Georg’s translations of the headman’s conversation. A beautiful girl called Cecile waited on Etenzi, moving gracefully with food and drink. I assumed she is Etenzi’s grandaughter, but Sister Margaret corrected me. She is his wife, and just fourteen years old. Etenzi’s first two wives died several years ago.
Etenzi didn’t even look at Cecile when she gave him something, but just reached out and carried on talking. I got quite annoyed about that but Sister Margaret put me straight. She pointed out Cecile’s jewellery: jangling metal bracelets on wrist, neck and ankle. Then she told me. Etenzi has never seen his beautiful wife. He contracted river blindness thirty years ago, and now he sees her with his ears. To him that is as beautiful as anything in the world.
River blindness is endemic in Zizunga. Blackflies swarm by the river, and their bite infects humans with a tiny worm which can live for eighteen years. They produce their larvae in the eye, but do not in themselves harm the body. The blindness is caused by the progressive damage to tissues such as the cornea from dead larvae.
Sister Margaret struggles to treat the disease. She was recently delighted to get hold of a batch of Ivermectin on the black market in Kinshasa. The drug is used to kill livestock parasites in the developed world, but ended up in Africa being used on people only because it was past the expiry date. Ivermectin kills the adult worms, but Sister Margaret reserves its use for those patients who pass an eye test. The drug must be husbanded for those who still have some sight to save.
Such is Africa, I am learning.
(Erica’s Diary 1992)
Chapter Eleven
Milward took the microphone and addressed the conference. ‘Thank you all for being here at the twelfth annual Parasitology Forum. I’m sorry we’re running a little late, but before Professor Friederikson gives his introductory speech I would like to draw your attention to the addendum on the conference agenda. The five p.m. paper will be The clinical efficacy of artemisinin presented by Dr Felix Wu of Washington State University. Dr Stroud-Jones’s paper, which was to be presented at five, will be held over until Thursday at the same time. Thank you.’
The conference dissolved into hubbub. Max and Zoe, sitting towards the back, watched a row of portly Sikhs in front of them start stacking up their papers and shouldering bags. A steady stream of delegates began to head towards the exit.
The Newsweek journalist, down in the front row thrust his arm in the air and shouted something. Milward listened for a moment then returned to the microphone.
‘As I say, we apologise to delegates for the delay in Dr Stroud-Jones paper. We know how many of you have come to hear it. We have every confidence that she will be available to present it on Thursday. In the meantime I would like to draw your attention to some very exciting work being done on Chaga’s disease, which will be presented by Dr Emily Tissington in the Singel Suite at 5.30.’
Tanya emerged from the scrum near the podium and strode up to Zoe in her high heels. ‘We have to say something about Dr Stroud-Jones’s absence. Perhaps you and Max could help? Friederikson is calling a press conference in half an hour.’
‘Oh not him, he’ll twist it,’ Zoe wailed.
‘Well perhaps, but someone has got to do it. We’ve had fifteen new requests for journalist accreditation in the last two hours, and they aren’t remotely interested in malaria or chaga’s disease. All they care about is your disappearing doctor.’
‘Why do we have to say anything?’ Zoe asked.
‘Because the press will write the story anyway,’ Tanya said. ‘If we can have an input on it at least it might be only half wrong by the time it emerges.’
‘Okay. I’m up for it,’ said Max. ‘At least the cops will have to take it seriously once the papers get hold of it.’
‘Can you ask Milward to exclude Friederikson from the press conference,’ asked Zoe.
‘I could, but there’s no point. The press wants his assessment of Erica’s work, and he wants to give it. It would be better in a forum where you can contradict him than out in the corridor where you can’t.’
‘But he hasn’t even read her paper,’ Zoe exclaimed.
‘So?’ Tanya said. ‘He’s the world’s greatest expert on malaria. Beyond that they don’t care.’
Max shrugged, and his fingers found the engagement ring which had been sitting in his pocket for two days, a weight reminding him that the woman he loved was gone. He no longer cared about the paper or the conference or which scientist said what about which theory. Screw’em all. Every hour that Erica had not shown up had been a water torture, starting with the excuses and irritation that everyone goes through: she got lost, she stayed with a friend, she forgot to let me know, she’ll be back soon and then I can be angry. At that stage the big fears were easily rationalised away. Now, almost twenty-four hours after she disappeared there were only terrors left. Erica had been prevented from attending the most important event of her professional life, she had been abducted, kidnapped. No other reason made sense, except maybe the worst one of all. The unthinkable, awful possibility. That Erica was dead.
Penny Ryan and Don Quiggan were sitting in the corridor outside the intensive care unit on the third floor at the University of Amsterdam’s Randstad Medical Centre. Don was leafing through a thick pile of Pharmstar documents and Penny was considering stepping outside for another cigarette.
The door through which Erskine had been wheeled opened and Saskia Sivali emerged, now wearing a green gown, her long wavy hair pinned up under a surgical cap. She waved a clipboard in front of her. ‘The doctor asked me to get some information about Mr. Erskine.’
‘How is he?’ Penny asked.
‘Very feverish, but we hope he’s stabilised now,’ Saskia said.
‘What’s he got?’ Quiggan asked, raising his eyebrows over his papers.
‘Extremely high fever, delirium, anaemia, hypoglycaemia, and his spleen is working flat out to fight infection. The main thing at the moment is to keep him comfortable and make sure he doesn’t dehydrate.’
‘Yes, but what’s he got?’
‘We should be getting back blood and urine tests soon…’
‘I see. You don’t know what’s the matter with him,’ Quiggan said, returning his gaze to his papers.
Saskia sat down and balanced the clipboard on her long, mocha coloured legs. ‘A lot of diseases cause these symptoms, Mr Quiggan. It could be anything from septicaemia, typhoid fever or meningitis to gastro-enteritis, viral encephalitis, or hepatitis. It could even be something he’s eaten. You could actually help us a lot if you know any of his medical history.’
‘I have a summary ready to be faxed to you, just get me your number,’ Penny said. ‘Jack’s physician in Atlanta is available on this number or I can arrange for him
to call you.’
Saskia made some notes. ‘When did he first complain of feeling unwell?’
‘This afternoon, about two, wasn’t it Don?’ Penny said.
‘Did he describe his symptoms?’ Saskia asked.
Quiggan replied: ‘Yeah. Mother of all headaches, sweats, and a kind of breathlessness.’
‘Vomiting or stomach upset?’
‘I don’t think so.’
‘Is he a diabetic?’
‘No,’ Penny said.
‘Does he take any regular medication?’
‘Not that I know of.’
‘Was he known to be an intravenous drug abuser or engage in unsafe sexual practices?’ Saskia held her pen above the form, and did not look up.
Quiggan smirked and looked at Penny.
‘We don’t believe so,’ Penny said carefully. ‘We understand he is a normal, active heterosexual. I believe his record shows a recent HIV test, which was negative.’
‘Has he been to the tropics in the last three months?’
‘Maybe.’ Penny flipped open her organiser. ‘He visits about seventy countries a year. Yes, he was in Mexico City for a day last month. That’s all. Otherwise it’s been solid North America, Europe and Japan since April. He was in Vietnam and China in February…’
‘You are certain he hasn’t visited Africa, not even changing planes or making stopovers there, in the last three months?’
‘Yes, I’m certain. I book all his travel for him. He never goes anywhere I don’t know about.’
‘That saves about fifty tests then,’ she said, scribbling out a long list of boxes on the form, and making an emphatic full stop with her ballpoint. ‘I’ll still take a look at his blood. They’ve got me slaving away for the tropical diseases people this month, and there is nothing they enjoy more than squinting down a microscope, looking for the lowest forms of life.’
This morning I lay in my hammock and watched Tomas. He got up quietly and stood silhouetted by the door, with the first shafts of the sun pouring around him into the hut. I could see the golden down on his chest and the curly hairs on his legs. Padding around with a little cigar hanging out of his mouth while he checked his cameras, he looks like a youthful Ernest Hemingway.
