The ordinary citizen views the country as being without any internal authority, but this is not the case. There is still a strong federal presence. Certainly in health care. All surviving physicians have, for example, been recorded in a new central registry maintained by the Centers for Disease Control. Hospitals can, as of last year, report their supply needs to the Centers also, and get fairly rapid allocation of medicines and equipment. The loss of records and trained bureaucratic personnel that occurred when Washington was destroyed was certainly damaging to health care, but it has not proved fatal.
I work very closely with the Centers for Disease Control. My experience with the CDC has been very good. The Centers have grown tremendously since the war. There has been great advance in identifying the numerous mutant disease factors that have appeared among the American population. The progress with pseudo-monas plague, which has become a significant cause of death in the Southwest since the war, has been spectacular. The death rate from this illness has been reduced to forty-five percent, primarily as a result of the development of nonantibiotic prophylaxis, which was done at CDC. We have helped in educating the population to identify and report plague cases so that isolation and treatment can be effected.
In the past year we have not had the continuous round of problems that were encountered at first. Certainly nothing on the scale of the Cincinnati Flu in '90. Worldwide deaths from that disease are estimated at approximately two hundred and thirty million, twenty-one million of them in the United States and two million in Europe.
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But the U.S. population is better fed and stronger now, so we expect the next pandemic to be less damaging here than was the last.
We anticipate another expression of this hybrid flu, and are relying heavily on CDC results in the development of a treatment regime.
Actually, one of our major projects at present is to teach CDC
pneumonia prophylaxis, the construction of steam hats, the various means of assisting the breathing-impaired, control of circulation with hot and cold spots, and such things. CDC has really worked miracles with the very simplest materials and procedures.
The objective of their work is to develop effective medical treatment for serious disease, treatment that can be applied at home by family members and by the victims themselves. On another front, we are underwriting the medical faculties at the new University of Texas Medical School here in Dallas, and providing British doctor-professors so that local medical personnel can concentrate on hospital work.
Despite all this effort, we are not out of the woods. Frankly, however, the drop in U.S. as well as world population is also going to mean a long-term reduction in pandemic disease, if only because the remaining population groups are obviously going to be farther apart and have fewer contacts with one another. Despite this, it must be recalled that, worldwide, health systems remain frail. Supply lines are long and subject to extraordinary stresses. Fuel may be unavailable to move a shipment of drugs from the U.K. to America, for example. On the other hand, the lack of communications—a situation that is really improving fast, by the way—may simply mean that a disease outbreak goes unnoticed by us until it reaches an area where we have a permanent station.
This was the case with the cholera epidemic that created such suffering in South Texas last summer. We consider this to be a deeply damaged area, with the extensive residual radiation contamination from San Antonio, the uninhabitable zones, and the presence of an ill, malnourished, and restless Mexican population to the south. There was an unnoticed migration from Mexico into Texas all summer—more than three hundred thousand individuals were involved, virtually all of them starving. Many of these people THE WEST 39
moved right through the San Antonio Red Zone and began arriving in Dallas and Waco not only dying of starvation and radiation sickness, but carrying cholera. Neither of the first two problems is contagious, fortunately, but the cholera did spread to the local population. There were eight thousand deaths among registered inhabitants of the state, according to the Statistical Services Office.
Our treatment regime consisted of oral electrolyte replacement and treatment of exposed populations with tetracycline. The outbreak was quelled, but the real solution lies not in prophylaxis but in the restoration of sanitary facilities to prewar condition.
To communicate the extent of health problems in Texas, it is only necessary to talk about birth rates. The Southwest shares with the Northeast the dubious distinction of having a death rate four times in excess of its birth rate. And the number of mutations per 100,000 live births is 1,018, the highest in North America. In the Southwest we have placed birth mutations on the epidemic list and have put priority on obtaining working sonogram and amniocente-sis equipment, so that parents can have some warning that their child may not be normal. In addition, the Relief has established cri-teria for abortion and mandatory destruction of nonassistable live births, to relieve parents of this difficult responsibility.
We encourage relocation of individuals out of the Yellow Zones south and east of San Antonio, and routinely triage those who refuse to move. The population of these counties has dropped roughly ninety-one percent since the war.
Since the beginning of my tour I have dealt with Cincinnati Flu, cholera, the first Nonspecific Sclerosing Disease panic in Dallas, a massive outbreak of brucellosis in Amarillo, apparently caused by the ingestion of contaminated milk smuggled up from Gonzales County, and numerous other smaller crises. I cannot say that my job is less than exceedingly challenging.
When my four-year tour of duty here is up, I expect to be posted back to England for six months of R-and-R and then down to the Argentine, where we have an extensive operation contending with malnutrition and its associated diseases.
You have asked me to be as personal as possible. What is the life of a Relief officer actually like? Do I meet with any hostility on 40 WARDAY
the job? Of course, a certain amount. And I have emotional difficulties of my own. I must often make decisions that shorten and even take life. When I must isolate populations to prevent the spread of disease, and sometimes even withdraw medical assistance to allocate it to areas where help will still matter, I all but sweat blood.
On the other hand, I have been able to help enormous numbers of people. We have a large number of burn cases in Dallas, many of them scarred to the point of crippling: refugees from the South Texas firestorm, some of them profoundly crippled. I was a part of the committee that decided to allocate sufficient social resources to these people to prevent their dying of starvation or neglect and also to house them in public facilities. We do make decisions in favor of life whenever we can.
I live in an apartment at the Adolphus Hotel, along with the rest of the British here. Our government purchased the hotel because its large number of small suites are ideal for housing single public officials. Only our Commissioner has his family with him.
Until the Southwest Area is reclassified as safe, the rest of us may not bring our families in. So I have two lonely rooms with a long view to the south. The hotel service has been maintained quite well, so I am comfortable. Most of our foodstuffs and all of our li-quor is imported. The food is all tinned, unfortunately, because we cannot risk building lifetime dosage to dangerous levels if we are to remain in our jobs for any length of time. So we cannot eat local food or drink local water. Dallas's water supplies are from lakes, so there is a definite radiation problem, persisting even now. In the summer, long-half-life particles blow up from the south, and in the winter they come down from the north.
There is one saving grace here, though, and that is the people themselves. These are terribly determined people here. In fact, we have encountered few Americans who have not responded to the catastrophe in some positive manner. For example, Dallas normally works a six-day week now, and goes from eight to six. I have met some of the bravest and most wonderful people I have ever known here. I will never forget their calm courage in the face of death, nor their willingn
ess to expose themselves to danger for the sake of others.
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During the flu, for example, our main problem was keeping victims isolated from people who wanted to help them and were willing to endanger themselves to do so. At present we are turning away three-quarters of the applicants for paramedical training, because the teaching staff must concentrate on doctors. People in the paramedic job are exposed to contagious disease and radiation as a matter of routine. Another example of the high morale involves farmers. When we must condemn produce—which happens less and less often now, I'm glad to say—you would expect anger on the part of the farmers. We have come to anticipate complete cooperation. When crops are suspect, the farmers themselves are the first to tell us. "I got in a thunderstorm on the way in, looked like it had blown up from the south," they might say, and assist us in checking the shipment for hot particles. They can be trusted to give the food to the disposal teams for burial if necessary. And these are all people who have known starvation in the most personal terms.
I recall that we sent out an emergency call for cleanup teams after the hot thunderstorm in April of 1989. There were hot spots all over Dallas. And by '89 it was all long-half-life stuff. This radiation was not going to dissipate. We got more volunteers than we had gear for them to wear. People who were already triaged volunteered to work without protective clothing, which was in short supply. I think that the city was probably saved as a viable human community by the men and women who gave what remained of their lives during that cleanup.
Fortunately, most of the local thunderstorms are generated over Oklahoma and North Texas, so a hot storm coming up from the south is rare. There is the problem of radiation being carried down from the Dakotas, but this is not too severe. Most of that flow is southeastward, and affects the Midwest.
[NOTE: At this point Mr. Shandy's breakfast arrived. This is the morning menu of a British Relief officer: one fried egg, one sausage, two kipper fillets, one bowl of oatmeal with cream, one small pot of tea, and one tablet of vitamin C.
Mr. Shandy ate his breakfast and made two telephone calls, one to the Reliefs human resources pool requesting a Spanish-speak-
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ing interpreter to accompany him on a field trip, and another to the Centers for Disease Control to inquire whether or not they were ready to try some newly designed kits intended for testing whole blood for contamination by what he referred to as "exotics." He did not offer to expand on the content of these phone calls. After his breakfast he asked us what we most wanted to know from him.
We requested that he tell us of his experiences in and around San Antonio.]
I was a part of the South Texas Emergency Relief Project in May of '89. There were many people living between Houston and San Antonio who had been out of touch with the outside world for seven months. As it did throughout the country, the electromagnetic pulse destroyed most of the televisions and radios, along with computers, radar stations, medical equipment, and car ignitions.
Add the bombing of San Antonio to the general chaos, and one can see that the conditions would be truly terriying.
Initial reaction in rural communities was to go toward the cities. We must recall that in less than a second a silent and invisible EMP burst had plunged people from the twentieth century to the Middle Ages. So they knew absolutely nothing of what was happening beyond the borders of their own towns. People who could have direct-dialed Tokyo one second could not telephone the county sheriff the next. The disorientation was extreme. So they went toward the source of communications, which was the cities. But in South Texas this was a terrible error, because San Antonio was in flames. In fact, the city survivors were streaming into the countryside—not many from San Antonio, but hordes from Austin because of the fire and Houston because of fallout. Many Houstonians, in their confusion, went toward San Antonio, not away from it. Apparently the traffic jams to the east and north of the city were so bad that escape westward was the only alternative. The sheer massiveness of the attack on San Antonio created damage and injuries previously unexpected. There were large numbers of people with sight loss due to flash effect even miles from Ground Zero. Others suffered not only burns but toxic reactions to synthetic-fiber clothing that had melted into their skin. Like the other cities, San Antonio was struck with airbursts and groundbursts, creating a THE WEST 43
massive dust cloud. The large number of huge weapons detonating simultaneously at first blew immense quantities of dust into the air, then created updrafts that drew it upward where it mingled with particles created in the fission phase of the explosions.
Conditions in such places as Lavaca, Gonzales, and DeWitt counties were appalling. The populations had quadrupled in the first days after the war. Gasoline and food ran out very quickly.
Radiation sickness was virtually epidemic and was followed shortly by all the diseases we have come to associate with large groups of undernourished, debilitated people.
Although we arrived in Dallas three months after Warday, it was not until three more months had passed that we were organized enough to arrange an overflight of San Antonio and South Texas. We were in an SC-7 Skyvan loaded with extra fuel tanks in the rear of the passenger compartment so that we could accomplish a round trip to and from Dallas if ground conditions were too unstable to permit us to land. You must recall that we had been broadcasting into this area on all available bands for some months, and getting no response. Military recon flights indicated an extensive population. So we did not know what to expect. The Commissioner wished to determine whether or not to extend British Military Rule to the area. This has not been done in many parts of the United States, but it is generally considered for areas where the population is in a state of confusion or upheaval, and the local authorities are not able to cope.
We flew as far south as Seguin, which is thirty miles from San Antonio. To avoid ground radiation we did not go below three thousand feet, but rather observed through binoculars. Seguin proved to be largely burnt.
At that time I got a look at the condition of San Antonio. I remember being astonished that this little city had been so terribly devastated on Warday. People had hardly even heard of it in Britain. One would have expected Los Angeles or even Houston before San Antonio. Of course, it has since come out that a good part of the planned Soviet attack didn't go off, so in a sense San Antonio was simply unlucky. The Soviets had given it first-strike priority because of the extensive U.S. Air Force repair and refitting facilities there, and the huge complex of military hospitals, the atomic 44 WARDAY
supplies dump at Medina Base, and the presence of a mechanized army that could have been used to preserve order across the whole of the Southwest as well as seal the Mexican border.
Perhaps, also, they knew that American intelligence did not expect this particular attack, and considered that there was value in surprise.
It is no wonder that the American military prohibits photogra-phy in such places. The effect on national and indeed worldwide morale would be very negative. From a distance there is nothing to see but the black landscape and the gleaming fused earth around the Ground Zero points. The land is mostly flat, with some rolling hills to the north. Although I never went to San Antonio before the war and had never met anyone from there, my first experience of that blasted corpse was, quite frankly, shattering. I sat at the window of that plane unable to move, unable to speak.
The cabin was silent. After a time we simply flew away.
We soon found ourselves over the town of Yoakum, Texas, which showed on our charts as a population area of approximately eight thousand people.
There were two tent communities to the south of the town. The fields roundabout were planted in corn and various vegetables, but looked to be in poor condition due to post-blast weather effects.
There were numerous horses about, many of them hitched to cars and pickup trucks from which the engines had been removed to lighten them.
Our appearance caused a great deal of e
xcitement in the town.
People rushed out of houses and buildings waving sheets or articles of clothing or just their arms. We were able to land on State Highway 77 on the outskirts of town. There was a local airfield, but the runway was too cracked to justify the risk of using it, and the road seemed solid.
The first to meet us were a man and a woman on horseback.
They had rifles in holsters on their saddles, and as they came to a stop they drew them. I'll never forget the first question, from that lean, bewhiskered man with the hollow eyes: "Y'all from Russia?"
They thought they had lost the war. This was, we were to find, generally the assumption in isolated populations. I explained that THE WEST 45
we were British. We were at once escorted into town. We had various emergency medicines, and our orderlies soon set up an aid station with the equipment we had brought. Our station was placed in the showroom of a local Ford dealership, the Wendell Motor Company. This offered us a large floor space and limited access via two doors. At the same time, the people waiting outside could see for themselves that we were working as quickly as we could. Ampicillin, keflex, and tetracycline were our main supplies, along with morphia and heroin for pain sufferers. We also carried cyanide and copies of the euthanasia rules. Cultural resistance to this program is very strong, especially in rural America. But people usually come to understand that truly unspeakable suffering ought to be relieved by death if the victim has no scruples of conscience, or is indeed begging for it.
On that first day in Yoakum, our three doctors and six medical orderlies treated 211 of the thousands who presented themselves.
The actual local population was approximately fifteen thousand at that time. In my estimation, there were no able-bodied individuals.
It was fortunate that we brought the four soldiers, because violent disagreements kept breaking out among the patients, especially as to whose dying children were to have the first chance at the antibiotics.
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