The Malthus Pandemic

by Terry Morgan

CHAPTER 4

  Kevin Parker was on the train to London preparing for his talk to what he thought was a small gathering of those interested in Thomas Malthus and human population control. But without being sure of the likely audience or numbers it was proving difficult. His academic's dilemma was whether to pitch it at ideas for direct action to get politicians to do something or whether to stick to the facts and figures.

  Kevin had always advocated positive action but waiting for individual Governments to act was, he now knew, utterly pointless. International co-operation was vital for success but few Governments, except perhaps the Chinese with its one family - one child policy, Singapore, or Iran with its mandatory contraception had faced up to it let alone demanded international co-operation. The political will just wasn't there. It was far too risky to open such a bucket of worms when re-election was always the top priority. Dictatorships were a far better system for imposing the will than democracies. Indeed, it was becoming politically incorrect to even talk about reducing population. It infringed basic human rights, it upset the Catholic Church and was often deemed racist even to mention forcefully ending mass economic migration from destitute and overpopulated war torn countries. The excuses for inaction were endless.

  So political action was completely stalled and reasons to sweep the issue under the carpet for future generations to worry about just went on and on. There were even countries that considered population as a source of political, economic and military strength.

  Kevin Parker had become a very angry and impatient man although he did his best to conceal it from friends and found it hard to support democracy as a system when it came to enforcing birth control. He had written extensively on the subject under his screen name of 'Thalmus' and had once hoped the UK might provide a world lead on it but he was sure now it would never happen.

  The British branch of the Malthus Society rarely, if ever, met together but normally shared their views online. As website moderator and unelected Chairman of the UK branch, Kevin had only ever been able to organise one full meeting of members in the past and that meeting, held in the back room of a public house in Wolverhampton, had not been the success Kevin had hoped. If the group were to move their radical views forward to lobby government then they clearly needed funds from somewhere. Despite Kevin's efforts, no-one had offered either to donate to the group or pay a monthly membership subscription. And Kevin had even had to pick up the bar tab. Undeterred, Kevin had persevered and three years later he was still at it - if anything more motivated than ever and certainly more keen for some direct action.

  He sat back in his train seat and put his notes to one side. Despite being the unelected chairman of the UK branch of the Malthus Society, Kevin was unsure where this strange Mr El Badry who he was due to meet stood in relation to the Society. He could well have been a regular reader or even a contributor but because the website only asked for screen names and not anyone's full contact details, there was no way of telling. In fact, Kevin only knew the details of about twelve UK members by their online names and this was only because of the Wolverhampton meeting.

  But this Mr El Badry could also have been based somewhere outside the UK because there were many other affiliated groups that Kevin monitored - not least the followers of the American Professor, Paul R Ehrlich. Kevin had also lectured on Ehrlich but Thomas Malthus had preceded Ehrlich by two hundred years and was British. Malthus was the one who had set the ball in motion. But knowing that there were thousands of people out there sharing his views was what Kevin found so encouraging.

  Years of lecturing students first thing on a Monday morning had taught him the need to get people's attention right from the start and he wanted to cover as much as possible - conflict over food and water supplies, the misery of war and sickness, economic migration and mass unemployment in the west. He wanted to offer quotes from the great Robert Wallace - the “earth would be overstocked and become unable to support its numerous inhabitants." or, as his even greater hero Thomas Malthus had put it, “the germs of existence contained in this spot of earth, with ample food, and ample room to expand in, would fill millions of worlds, in the course of a few thousand years.”

  Thomas Malthus a British clergyman and economist had published "An Essay on the Principles of Population" in 1798. Population, when unchecked, he proposed, increases in a geometrical ratio. Subsistence increased only in an arithmetical ratio. Malthus outlined the idea of "positive checks" and "preventative checks" on population. Disease, war, disaster and famine were factors that Malthus considered to increase the death rate. "Preventative checks" were factors that Malthus believed to affect the birth rate such as moral restraint, abstinence and birth control. He predicted that only "positive checks" on exponential population growth would ultimately save humanity from itself. Without these checks, human misery was an "absolute necessary consequence."

  Anger and impatience was what had led Kevin to track down the many hundreds of groups with similar opinions on population control dotted across the world. He had found them in North America, South America, right across Europe, Russia, the Middle East and Far East, in Japan and in Australia. Many were closeted individuals operating from bedrooms, others were far better organised. Kevin's list of contacts now ran to thousands.

  There was the German group that operated from somewhere in Cologne with a membership claimed to be in the hundreds. Ausser Kontrolle (Out of Control) still advocated extermination of certain ethnic groups that did not match up to a long list of criteria they had published. Moslems were high on this list due, according to Ausser Kontrole, to "their unwillingness to move their culture forward from where it had stagnated since the hay-day of Islamic influence on science and education."

  Then there was his Indian group, his Indonesian Group and a Singapore Group that advocated a policy of setting IQ tests with those not reaching the required level being left to fend for themselves. There was the Spanish Group, the Italian group and a very low profile South African group with similar views to Ausser Kontrole.

  But Kevin's favourite group was the Nigerian one. Tunje Fayinka, also a college lecturer in Sociology, ran the group from his flat in Barnet, north London. Tunje believed that even the current population of Nigeria of some 166 million - a figure expected to reach 390 million by 2050 - was already totally unsustainable. Increasing ethnic and religious conflict was already proof of the need to reduce the population back to at least the 45.2 million figure it stood at in 1960.

  Kevin and Tunje had a lot in common. They were, in fact, good friends and verbal sparring partners. But Tunje had learned to be far more careful with what he said in public or wrote online.

  "Big Brother is always watching, Kevin. Go careful. The least you should do is keep the laptop hidden some place where MI6 won't go looking. Alternatively, just appear to be an innocent nutcase."

  Until then, Kevin had not thought very much about security.

  With good evidence, Kevin Parker knew that his UK Malthus Society website had become a genuine focal point for similar groups and he was proud of all that he had done to achieve that. Kevin now wanted to see some results for all his efforts, but not at any cost.

  He sat back as the train rolled into Reading Station and picked up his copy of the Guardian. He read the headlines once again and then dropped the newspaper back on the adjacent, empty seat. Buying a Guardian had become a habit although he rarely read it properly these days. The newspaper was another English institution he now disliked because of the furore that had erupted amongst indignant would-be mothers attending fertility clinics and wealthy politicians with four children after his open letter to the Editor was published. Indeed, he had, afterwards, been summoned to meet the University departments' Professor for an explanation.

  But Kevin had personal experience of poor living conditions and overcrowding. As the oldest sibling of eleven brought up on a housing estate in Liverpool he had seen and felt the consequences. His father had left soon after Kevin was born and
his ten brothers and sisters had ten different fathers.

  Castration or mass sterilisation had once been an attractive and popular idea put on the Malthus Society website and Kevin, with Tunje Fayinka's help, had become an expert on access to water supplies in target countries just in case an opportunity arose. But what was really needed was action on an international scale. A world war with nuclear weapons might have helped but was too indiscriminate. An epidemic of biblical proportions had possibilities but science moved so fast these days that treatments almost always became available before they had any real effect. Mass famine brought on by essential crops like rice and wheat being ruined by widespread resistance to pesticide was another idea. Kevin had been running out of new, practical ideas until, that is, he reached the Chelsea apartment of Mr El Badry

  Larry Brown had been working for the American Embassy in Nigeria for less than six weeks and the cultural shock of life outside its confines had more than lived up to his expectations. But he had come for the interest more than career progression so he was more than ready to do whatever was needed. And, if he found he didn't like the job, he'd just move on somewhere else.

  As a New York doctor, who had quickly tired of the daily mix of coughs, colds and backache, Larry had decided to do some overseas volunteering. He went first to Chile and then to Kenya and it was in Nairobi that he was asked if he was interested in looking at the Nigerian health system with a view to - as it eventually explained in his new job description - "assisting American companies to understand how best to win lucrative contracts in the provision of management services. medical supplies and medical equipment."

  Larry had been unsure about taking the job at first but the thought of combining it with some travelling around Nigeria and possibly elsewhere on expenses had swung it. He had spent the first few days in Lagos and, if it not been for the hotel he'd been staying at, wasn't sure he if he would have survived the job for long. But the new apartment he now had was making it bearable and he was also starting to make the most of his status with the American Embassy.

  It was this status that helped him make the appointment at the Kano State Government office to ask about the closed Kofi Clinic. He was met by a State official whose own status wasn't so well defined.

  "Our police don't have time to look for missing Doctors, Doctor Brown," the man said. "More important to our police and security forces is to deal with those murderous Islamist thugs, Boko Haram, who are threatening to disturb our peace."

  The man had then seen an opportunity for a joke. He laughed.

  "You need to watch out Doctor Brown. They don't like Westerners, especially Americans and in particular black Americans who they think have gone native."

  "But I heard there were over one hundred deaths from this disease," said Larry.

  The official shrugged. "We had a hundred die in a bomb blast a month ago."

  Larry knew he was getting nowhere. But from what the State Government official had gone on to tell him, during their raid of the Kofi Clinic they had found no patient records but a drawer in an otherwise empty desk containing a note book listing the first names of over one hundred patients who seemed to have attended at some time or another.

  There were no family names and no addresses for any of the patients but each of them had been given a number. All they knew was that conditions at the clinic were very poor. They had found it empty except for three stretchers, one wheel chair and the empty desk. Locals said they had seen patients arriving in the back of Doctor Mustafa's Toyota pick-up truck and that all the patients had looked very sick and weak and had been coughing when they were led inside by Doctor Mustafa and another man. One man said he'd seen what he thought were two dead bodies under a green cloth being taken out using the same Toyota truck although no-one could back this up. But it was unanimous - those arriving there looked and sounded very sick and some, if not all, of those who left it were already dead. All the official knew was that when they came to inspect the clinic no-one was there and no-one had seen Doctor Mustafa since.

  Philippe Fournier's idea to take his new Italian friend, Mara, for a Saturday drive in a rented Jeep to the small town of Kijabe fifty kilometres north west of Nairobi, Kenya was supposed to form part of a relaxing and mildly adventurous weekend away from Philippe's work at the Kenyatta National Hospital. Also, as he was becoming desperate to invite Mara back to his room later, he was rapidly running out of ideas to impress.

  He had, in fact, struggled to win the girl over for a week or more as she had seemed far more interested in meeting other foreign students in Nairobi than learning about the valuable and pioneering work he was doing on HIV treatment and prevention.

  "This is not just for the benefit of Kenyans," he had stressed. "Work we do here is for the good of all Africa. This is now a seat of excellence."

  Having left France and England in order to pursue his childhood ambition to return to his grandparent's roots and work in Africa, Philippe's manner had become, perhaps, a little overbearing when it came to constantly mentioning his work and the low pay that came with it. But he felt strongly about what he was doing and was sure that an Italian nurse being paid generous expenses to learn a bit about tropical diseases in order to further her own career back home could have shown just a little more interest. He was also sure she earned far more than he did which was upsetting.

  Philippe had visited Kijabe once before, although on that occasion it had been with a group of about ten others in a mini bus. This time, he was to be both the driver and the tour guide.

  Fifty kilometres was no great distance but it was far enough outside the capital to give a feeling of being on a sort of romantic safari. It would also be quick to get back home if things turned out well.

  During the journey he had explained once again about the work in his department - that it was there, as he put it, "to find more multi-sectoral and multi-disciplinary partners to reduce HIV transmission, to mitigate the impact of HIV/AIDS on vulnerable populations" and that his role was "especially focussed on training and ways to convey information and advice." And all throughout his explanation he had tried to use occasional Italian words mixed with the English. It had been quite an effort but Mara still seemed more interested in looking out of the window of the Jeep.

  Nearing Kijabe, though, he had finally got around to describing where they were actually going. Kijabe, Philippe explained, was Masai for "Place of the Wind" as it stood on the edge of the great rift valley and was over two thousand metres above sea level.

  "And it has a railway station," he explained as he swung the steering wheel of the Jeep to avoid a Masai farmer with a cow.

  "Where does the train go," Mara asked and Philippe beamed at the show of interest.

  "Uganda one way and Mombasa the other," replied Philippe. "And there is a small hospital there. It is called Kijabe Hospital. And there is a guest house for those who get lost or delayed."

  Mara looked out of the passenger window.

  Philippe, though, had not reckoned on there being a problem at Kijabe Station.

  The train driver, fifty six year old Samson Omwenga had taken ill whilst on the footplate. He hadn't felt well for several days but at Kijabe, he had finally given up his efforts to deal with the increasingly nauseous headache, sore throat, dizziness, the tickling cough and the general feeling of weakness. He had struggled to climb down from his engine, collapsed onto the platform and announced, between bouts of coughing that he was unable to continue. A doctor had been called but, when Philippe and Mara arrived to view the historic station and the train that was still known as the Lunatic Express, they were still waiting. Meanwhile, the passengers had disembarked and were either sat waiting for developments or standing in groups discussing the aptness of the train's other name.

  Parking the Jeep next to a large puddle of red, muddy water, Phillipe got out and waited while Mara decided it would be safer and certainly cleaner and drier if she clambered over to get out of the driver's door rat
her than use the passenger door.

  By then, Philippe had been approached by someone clearly in charge of railway administration to ask whether he was the doctor. Being black but with facial features suggesting he was not Kenyan but possibly of West African and Francophone origin, Philippe was, nevertheless honoured to be mistaken for the doctor.

  "Yes," he said. "I am a doctor, but not a medical doctor. I work at the Kenyatta National Hospital. What is the problem?"

  The stationmaster quickly explained everything and began to usher Philippe towards the station waiting room while Mara was still shutting the driver's door of the Jeep.

  In the waiting room, a wooden bench had been acquisitioned to use as a temporary bed for the sick engine driver, Samson Omwenga.

  With Philippe still trying to confirm his non medical qualifications to an uninterested stationmaster the circle of onlookers surrounding the sick driver parted to allow him to approach.

  "This is senior engine driver Samson Omwenga," said the stationmaster.

  Philippe got as far as repeating, "Yes, but I'm not......." when the patient suddenly struggled to sit up and then coughed violently. He clearly did not look well. He was sweating profusely, his eyes were red and puffy, his mouth was open and he was clearly having difficulty in breathing. Sitting up was probably making it easier for him to cough or breathe but he looked weak and on the verge of collapse.

  "This is the doctor," said the stationmaster.

  "But I'm not,,,,,,,,,,,,,"

  The patient coughed again, harder and even longer this time, and his eyes widened. Philippe looked at him and felt sorry he was not a real doctor but only had a PhD in microbiology and biochemistry. But he saw patients with AIDS on a regular basis and recognised the look of fear in the eyes. And the sweating suggested that driver Samson Omwenga was running a very high temperature.

  "He needs to go to hospital, sir," said Philippe to the stationmaster.

  "Do you not have some medicine for him? The train is late."

  "Sir," said Philippe. "This man is very sick. He can hardly breath. He has a very high temperature. His lips and eyes are very red. Just look at him. He has no strength.- not even enough to drive the train to Nairobi let alone onwards to Mombasa. He needs a proper doctor. But I am only a......"

  "Can you take him sir? We have too many passengers here and they all think he will be OK to start driving the train again soon and we do not have a qualified replacement. If you take him away they will see that the train is going to be delayed."

  Mara finally arrived and came to stand alongside Philippe.

  "This is Mara," said Philippe." "She is a nurse from Italy. I will ask her what she thinks."

  Within fifteen minutes, Philippe was driving back to Nairobi with Mara in the passenger seat still staring silently out of the window. On the back seat lay a sweating, coughing Samson Omwenga, Philippe took him straight to the Kenyatta National Hospital.

  Late that night, depressed and very much alone in his room, Philippe decided to phone his American doctor friend, Larry Brown in Nigeria for someone to talk to.

  He had once met Larry at a conference on Infectious Diseases in Nairobi and they had struck up a good rapport that had ended in a very memorable evening at a nightclub. As a result, an update on women was always the first subject to discuss and as Mara was still on his mind, he thought he would mention his drive up to Kinjabe and the sick train driver he'd driven back to Nairobi.

  It was two days after Larry Brown's trip up north and he had only just arrived back at his apartment when his mobile phone rang.

  It was Philippe Fournier a Frenchman he had once befriended at a conference in Nairobi. Philippe was clearly in need of a friend to talk to and whatever the cost of the long distance call from Nairobi seemed to think that he, Larry Brown, would be a good listener.

  Larry was trying to get the hang of his new gas cooker and his head was inside the oven. At the same time he tried listening to Philippe.

  "How do you find the local women, then, Larry? Any good? Anything must be better than white women back home, eh? They are far too emancipated, man. That's what I think."

  "No time, yet, Philippe," said Larry. "Still settling in."

  "That being said, Larry, I've got myself an Italian. She's a bit quiet but nice tits - nice lady, Larry - nice legs as well - but didn't get to see much more."

  "Why not, Philippe - something you said?"

  "No, nothing like that, Larry. I took her to Kijabe."

  "That must have been romantic, Philippe."

  "Yes, but I still didn't get a chance. I ended up with an extra passenger in the Jeep."

  Larry soon learned about the train driver and Philippe's return to Nairobi that had been far quicker than his trip out..He stopped his work on the oven and sat on his new sofa.

  "I dropped him off at the Kenyatta National Hospital in Nairobi, Larry. Mon dieu, he was coughing just like a child with the whooping cough. Just like my cat when she had a hair ball stuck. Very high temperature. I called the hospital this evening to check and he died about an hour after Mara and I left him."

  Larry logged it, was still thinking about it and would have liked to know more but Philippe was still talking.

  ".....and women like to be entertained. It's so expensive." Philippe continued.

  "Tell me something I don't know already." Larry commiserated.

  "Do you have any job vacancies that might pay more?" asked Philippe clearly now on a different tack and, perhaps, Larry realised, the real reason for his call. "I'm beginning to think I should have stayed in France."

  "I don't run an employment agency, Philippe. If I did, the American Embassy would sure find out. You desperate?"

  "Even bloody nurses earn more than me." Philippe said, using a word he'd often heard British nurses use.

  "Sorry I can't help, Philippe," Larry laughed with as much sympathy as he could muster. "Try the bloody French Embassy."

  Next morning, Larry phoned the World Health Organisation - the WHO - in Geneva to ask if they were aware of the Nigerian deaths. They weren't. So Harry then explained what he'd found and suggested someone needed to look into it. As a doctor, he said, one hundred unexplained deaths in one small area, even though it hadn't seemed to bother the Nigerian Health authorities, could hardly be ignored.

  And while he was on the phone, he decided to mention the Kenyan case and then pointed out that a friend of his currently on a back packing holiday in northern Thailand had seen a report on Thai TV news about some sudden deaths near Bangkok rumoured to be from a kind of 'flu'.

  Yes, the WHO knew something about the Thai cases but thanked him nevertheless. Larry Brown was starting to make himself known to the WHO.

  Behind her desk, strolling a few steps in one direction and then back again, the diminutive Director General of the World Health Organisation in Geneva read the report she had just been given with growing concern.

  Her adviser, Richard Lacey, an Englishman, sat patiently across the DG's desk. He knew she wouldn't take long to get to the core of the problem. The two of them had worked together for several years now and the rapport had always been good. Despite their closeness, he always treated her with the utmost respect for the responsibility she shouldered. Doctor Mary Chu had preceded Richard Lacey by two years and she was already way past her first official term in office. To Richard Lacey the DG was not Doctor Chu, or Mary but ma'am.

  "CoV?" Mary Chu said at last. "Coronavirus?" It was a question posed as if she already knew the answer.

  "No one yet knows, ma'am."

  "If it's not Coronavirus, then what is it?" she then asked.

  "Can't be sure, ma'am."

  "Because we aren't getting any reliable virology?" This time it was a statement rather than a question.

  "Yes, exactly."

  "Because the cases are scattered and in rural areas and where doctors are in short supply and where there is no proper health service and no decent laboratory."

&
nbsp; "Yes."

  "Except Thailand, of course, where we have the highest number of cases or at least, the highest number of cases reported by the authorities."

  "That's right. The point about reported cases need underlining," replied Richard Lacey stressing the word reported.

  "The clinical symptoms from all the cases in Nigeria and the single case in Kenya are similar?"

  "Although we can't be exactly sure, the signs are that they are very similar to the Thai ones. The symptoms are different to the Middle East version - MERS-CoV. It's the type of cough that characterises this one. It was only because the American doctor working in Kano, Northern Nigeria and a Frenchman working in Kenya knew each other that the African cases came to light. It seems the American doctor also had links with Thailand so he had also heard about the few cases there. He thought it was worth mentioning. He reckoned there might have been over one hundred cases in northern Nigeria."

  "More than one hundred? How many more?" interrupted the DG, looking at her adviser with visible consternation.

  "Well, we're in touch with the American doctor, Larry Brown. We've not got any data from Kenya - just the one case with similar symptoms. But in all cases we have apparently healthy individuals with no evidence of previous health problems. They catch a cold - dismiss it as we might all do as a two day inconvenience but then the symptoms worsen - serious cough - difficulty in breathing - blood in sputum - fever - then loss of consciousness during an unstoppable coughing fit. All dying within approximately three days of taking to their beds. It's the cough that has triggered the attention. But there might be many more cases we don't know about."

  "And no laboratory has got a proper fix yet?"

  "The Thai lab is working on it but cremations have taken place before sampling. And we have no idea at all what happened in Nigeria."

  "So why haven't the Thai authorities reported earlier? Their Health Ministry is usually so efficient and when I was in Bangkok just last February nothing was said. It was still all about HIV, pigs and chickens."

  Richard Lacey shrugged."Politics, ma'am? Keen to stamp on rumours of any health risks that might affect the tourism industry?" he suggested.

  "Mmm." said the DG. She then sat down and toyed with the watch on her wrist.

  "What exactly does the Thai lab say?" she said eventually.

  "That it looked like a Coronavirus. They thought it was MERS-CoV - Middle East Respiratory Syndrome Coronavirus - at first but the symptoms seemed different. The current virology suggests something similar, perhaps a variant."

  "But they still failed to report it immediately.............?"

  It was Richard Lacey's turn to say, "Mmm."

  The Director General stood up once more and glanced out of her office window. Then she turned back.

  "Can you ask the Regional Director for South East Asia to phone me, please? He has just left to attend the Conference on Virology and Infectious Diseases in Bangkok."