“That is a guess even I could make. Tell me what you think the chances are.”
Dr. Kassis looked at the porch and used the toe of his rubber boot to grind something into the concrete while he thought. “Tomorrow’s reality—if this is an airborne strain of Ebola—is so horrific that it begs me to hope the evidence I seem to see here is wrong. But if these were our people, and this outbreak was in our homeland, I would say the same. I would beg for help from the WHO, even the Americans. I would beg you not to take Rashid out of here until I knew the disease was not airborne.”
“And how can I find out for sure?” Najid asked.
“That would be a long process with many tests and many specialized doctors, and he could die before we find out. Otherwise, we may not know for months.”
“But if it is airborne, that knowledge will come too late for these people, am I right?”
“You are correct.” Dr. Kassis nodded obsequiously. It was a habit of Kassis’s that irritated Najid endlessly.
The doctor went on to say, “On this continent, it will be obvious to every doctor that this strain of Ebola is airborne a long time before the tests confirm it. It will be obvious in the mountains of bodies—bodies of the millions who die because they have no access to healthcare that could potentially save some of their lives.” He was looking out at the dark sky when he absently repeated, “Some.”
“What will happen then?”
“As soon as that Italian doctor notifies his superiors and convinces them to come, the world will start to change. Slowly at first, but as the evidence builds over the coming days and weeks, the Western countries will close down every airport in the world. Commerce will stop. They will do whatever they can to save their own people. They will have their telethons, make ads showing sick children, cry for the suffering, but this part of the world will still be ravaged by the disease.”
“And the mortality rate?” asked Najid.
“Of this strain—if it is a new strain—mortality can’t be known until the bodies are counted. Marburg, the only other Filovirus we know of, kills a quarter of those infected. Ebola Zaire is a vicious strain and kills ninety percent. Other strains kill as few as sixty.”
“With medical treatment will the mortality rate drop significantly?” Najid asked.
“Anecdotally, I must say yes, but Ebola, as frightening as it is, is rare. It hasn’t been studied enough for us to know the effects of treatment for certain.”
Najid eyed the doctor. “So only one in ten might be alive at the end.”
Dr. Kassis gestured to the hospital doors behind them. “You see how it is here. A disease that infects so many so fast does not have to do all the work of killing on its own. There are people in there who with good medical care might survive, but the medical staff and the facilities are overwhelmed. They have run out of everything they could use to treat these people. Many of these will die of secondary infections and causes. The death toll may surpass ninety percent wherever the disease attacks third-world populations.”
Analytical as always, Najid couldn’t help but ask more questions. “That makes sense to me, but is there medical data to back this up?”
Dr. Kassis looked at Najid. “How much do you know of Marburg virus?”
“I read much about these viruses on our trip here. However, I am certain that my knowledge is shallow. Please, tell me what you know.”
“Marburg virus was originally discovered in Germany—in Marburg, of course. So even though the virus was completely new to the doctors and the patients involved, of the thirty-one people infected, only seven died, nearly twenty-three percent.” Dr. Kassis concluded with half a shrug. “Modern country. Modern facilities.”
Najid leaned against the porch railing. “So it is not as lethal as Ebola.”
“No.” Dr. Kassis leaned on the railing beside Najid. “In Durba, in the late nineties, an outbreak of the familiar strain of Marburg and a new strain killed eighty-three percent.” The doctor pointed southeast. “That was in Congo, during a period of upheaval. People had little or no access to medical treatment. Again, in Angola in 2005, during one of the incessant civil wars, Marburg killed ninety percent. The people had no access to medical care. In my opinion, medical care makes all the difference in the survivability of these diseases.”
Najid smiled behind his mask, both for the fact that Dr. Kassis took the risk to volunteer an opinion, and for confirmation that he’d done the right thing in bringing the doctor to treat Rashid.
The doctor continued, “Imagine what will happen with Ebola, with its sixty to ninety percent mortality rate, when the number of cases overwhelms the fragile medical systems of the Third World.” He gestured at the closed doors. “As is happening here. It frightens me.”
“What of this experimental drug, ZMapp?” Najid asked. “I read they are treating infected American doctors with it.”
Dr. Kassis nodded. “And they seem to be responding well.”
Najid snorted disdainfully. “But there is only enough for a few Westerners, while Africans die by the hundreds. By the thousands tomorrow. Perhaps by the millions soon.”
Najid continued to speculate. “And all while the West hides on the other side of the oceans, hoarding their supplies and doctors, frantically working to mass produce their vaccines and treatments. It appears they may even succeed. All while they wring their hands and shed their crocodile tears over dying Africans and dying Arabs.”
The doctor nodded.
“At the end of it, months from now, the disease will reach their shores—that is inevitable—but by then they will be prepared. Over here, most of us will already be dead.”
“That may be true,” Dr. Kassis agreed.
“They will get what they’ve always wanted.”
The doctor took a moment to adjust his mask that felt like it was slipping down his face. “What’s that?”
“Africa, the Middle East, probably even China, and more. Everywhere Islam or communism is strong, the people will suffer and die, leaving the world to the West. That is what the West has always wanted—unchallenged power to exploit the resources of the world. Those of us who remain will be too weak and too few to do anything about it.”
Dr. Kassis adjusted his goggles to cover the top edge of his surgical mask. “Sadly, I can’t disagree with your analysis.”
“What would you do if you were me, I wonder?” asked Najid.
“I can’t—”
“Answer me honestly, Kassis. If only this one time in your life. Tell me what you would do.”
Kassis scraped the toe of his rubber boot on the concrete again, grinding into nothingness whatever was there. “I love your brother like my own son. But to bring him back may bring death to everyone you know. If I were you, I would leave Rashid in my hands to treat. I won’t tell you that I can save him. I can only tell you what I told you before we came, that I can give him a better chance to live. But you should leave this place. Go home and pray.”
When Najid spoke again, Kassis flinched, as though he were expecting harsh treatment for his bad choice to speak the truth. But Najid replied, “We are different men, with different stations in the life, different burdens. Thank you for your honesty, Dr. Kassis. I will ask that from this day forward, you speak your mind openly and honestly whenever I ask. I will not like what you tell me—I assure you I won’t. But I will need your honest counsel.”
“You shall have it then,” replied the doctor.
“Your trepidation will go away in time.” Najid put a hand on Dr. Kassis’s shoulder. “We came here to save my brother, nothing else. But I see now that Allah has led me here for another purpose.”
Najid called to one of his men, commanding him to retrieve the weapons from the SUVs. To the doctor, he said, “If this Ebola is airborne, it will kill many—if not most—men. That is a horror I cannot do anything about. I find it equally horrifying that the West may come through this unscathed. I will not allow that. I will not cede the world to them through my own inaction. Allah put me here for a reason. And that reason is to make this decision. When this disease ravages mankind, it will not be only brown bodies on the funeral pyres and in the mass graves.”