The Sanctuary Of Tomorrow

The Mystery Unfolds

William Dales woke up in a village north of Pamba, Zaire. As a twenty-three-year-old University of Cambridge biology student, he was yet to get used to living in rural Africa, even after being here for three months. The comforts of his daily life in Cambridge were secondary to none in his current residence. William thought back to what had informed his decision to travel to Zaire. He was a great admirer of Sir Henry Morton Stanley and he had read all his journals. He knew all there was to know about this explorer. Henry Stanley was a Welsh journalist and explorer who was famous for his exploration of Central Africa. He is known for his search for the source of the Nile, which led him to Zaire. William Dales planned to reclaim the steps of Henry Stanley. He reluctantly rose out of his sweat-drenched sleeping bag and peered out through the flimsy mesh flap of his canvas mountain tent. The sounds and sight of the morning buzz of the village behold engulfed him. Women were outside their homesteads making fires for a morning meal, children were chattering and chasing barking dogs, men were gathering their farm and hunting tools. The sounds of the lush forest also rented the air. High above his tent he caught glimpses of chirping of birds and screeching of monkeys as they skittered in the trees.
He hesitantly made his way out having had a long and sleepless night. He had tossed and turned all night, breaking out in streams of sweat and constant shivers. As he gathered his thoughts on the day ahead, he could hardly concentrate. He felt weak and nauseous. His first guess was that he had malaria, even though he had been careful to take his chloroquine phosphate as prophylaxis against it. The village had numerous stagnant pools of water and swamps which were habitats to swarms of mosquitoes. It was an almost impossible mission to avoid insects. Surprisingly, the locals carried out their daily activities such as farming in these areas unbothered by the buzzing of these disease carriers. But did they have a choice?With his health concerns, he rushed to a mission hospital nearby. Ambuku was slightly larger than the village he had just left, and the mission hospital appeared to be a mission of despair. It was no more than a meager collection of cinder-block buildings, all in dire need of repair. The roofs were either rusting corrugated metal or thatched like the native huts. There seemed to be no signs of electricity or running water. The hospital was in shortage of all equipment and staff. There seemed to be no order of being attended to. A crowd of patients milled around the entrance, shoving and pushing each other. It was ironic that they had the energy to cause a commotion, presuming they were sick. Once in a while, an angry nurse would appear and shout at the crowd in their local dialect. They would hurriedly scamper to form a single file line. Patients in dire need of medical attention lay on the floors writhing in agony and pain, without as much as glare from the few medical personnel in the facility. This seemed to be the norm. After waiting in line for over an hour, William was ushered into the doctor’s room. Simple wooden furniture, namely two chairs and a table occupied the room. The doctor’s appearance itself was not inspiring. The only indication that he was the doctor was the faded plain white overcoat he wore, which in itself had seen better days. The examination was rapid, and as William had already surmised, he was diagnosed with malaria. The doctor ordered an injection of chloroquine and advised him to return if he didn’t feel better within the next day or so. He left the room, sure he would not attempt to return to the place even if his life depended on it.The examination over, William was sent into the treatment room to wait in line for his injection. It was at that point that he noticed the lack of aseptic technique. There were no disposable needles. The nurse merely rotated one of four syringes. William was certain that their short stay in the sterilizing solution was not nearly long enough to render them germ-free. The long queues and general negligence by the medics would not allow proper procedures to be followed. The nurse’s hygiene and lack of professionalism was also a matter of concern. She had an unkempt appearance and lacked basic protective equipment such as gloves. When it was his turn, he was tempted to say something in protest, but his French was not fluent enough. Furthermore, he knew he needed the medicine. He said a silent prayer as the shot was administered.The next day, William was glad that he’d been silent at the hospital since he was already feeling better. He stayed in the Ambuku area, preoccupied with photographing the diverse wildlife in the forest and collecting artifacts. Every day was a new adventure and he soon realized he would never exhaust the vast forest. By the fourth day, William was preparing to continue with his journey up the Zaire River, following Henry Stanley’s footsteps, when his health took a rapid turn for the worse. The first symptoms he displayed were migraine, concurrent chills, high fever, nausea, and diarrhea. The fact that he was also sweating like a pig while there was a heavy downpour in the ice-cold weather did not help the situation. He hoped it would pass as quickly as it had come. He retired to his tent and shivered through the night. All he could dream of was his heater, clean sheets, and the bathroom outside his bedroom back home in Cambridge. He wondered if what he was going through was worth it and if he would endure to the end. When the first sun rays appeared at dawn, he was wide awake. He had vomited throughout the night and this left him weak and dehydrated. With great difficulty and in excruciating pain, he gathered his few valuables and made his way slowly to the mission hospital. He remembered the first time at the neglected mission hospital and how he had sworn it to be the last time. But beggars are not choosers. When he arrived in the facility, he momentarily leaned against a tree, trying to regain strength for a few more steps to the entrance. When he finally made his way in, he suddenly vomited crimson red blood and collapsed on the hard floor. He woke two hours later in a room occupied by two other patients, both suffering from drug-resistant malaria.The doctor, the same man who had examined William on his first visit, was alarmed by the severity of William’s condition and noted some strange additional symptoms: a strange rash over his chest and small surface hemorrhages in his eyes. It was not a normal case. He had never witnessed such a condition in his twelve-year career. He imagined it was a strange sickness that the foreigner had transmitted from their land. He had run out of ideas on what to do since he had no-one to consult. He went ahead to diagnose it again as malaria, but he was disturbed. As an added precaution, he decided to include a course of chloramphenicol in case the young man had typhoid fever. Little did they know that William Dales was patient zero of a virus that was yet to spread insanely?The LetterThe Regional Health Commissioner for the Pamba region, Dr. Omberi was an ever-busy man. His pristine nature of a perfectionist made him earn both respect and fear in equal measure from his juniors and peers alike. He had climbed up the ladder from to his position not by chance, but by merit. Not much puzzled or bothered him, but today was different. He glanced out the open window of his office at the expanse of the Zaire River as it shimmered in the morning sunlight. The dancing rays on the water surface had a calming effect he did not wish to let go. Then, forcing his mind back to reality, he stared again at the letter he had just received from the Ambuku Mission Hospital concerning the deaths of a British male William Dales, and a blacksmith from a village near the Machar River. The mission doctor claimed that their deaths had been caused by an unknown infection that spread rapidly. Some of the victims were; two patients housed with the British and five members of the blacksmith’s household. Eight of the hospital’s outpatients and a nurse had come down with severe cases of the same illness.A decision had to be made. As much as there were only two choices, it was a tough call. The first choice was taking no action. He could just ignore the letter and assume to have never received it. This was an easy and logical choice. They could just come up with reasonable causes for the deaths that arise. Maybe blame it on the rampant and ever recurrent malaria in the region. No tongues would wag if so, unless…The greatest fear was that this unknown ailment could spread like wild bush fire infecting and killing dozens more. A spark of deaths would raise questions, which he would have no answers. There was also the issue of the dead British national. The British government would be expected to investigate circumstances under which a citizen died in a foreign country. You wouldn’t count on them to be less than thorough. Diplomatic friction with a superpower is the last thing Zaire needed. The other option would be to fill out official forms reporting the incidences and forward the letter to Kinshasa. He would then have to make a trip to Ambuku to analyze the situation firsthand and report back to Kinshasa. The second option was too tedious. Besides, he was campaigning for an elective post in the region, which required all his attention. The strange disease in Ambuku would have to wait. He tore the letter into pieces and tossed it into the wastebasket as he walked out to his next meeting.Action
The DC-3 aircraft landed at 9.00 am, promptly on time. Pamba airport had been partly cleared to await this flight, for it ferried a very important person. Dr. Omberi watched the flight nervously. He was filled with anxiety and was visibly fidgeting. When the aircraft’s door was lowered, he broke into a cold sweat. Dr. Richard walked briskly, making direct eye contact with Dr. Omberi as he approached him. Dr. Richard was a heavy-set man, physically intimidating, but that was not the reason Dr.Omberi was nervous. Dr. Richard was Dr. Omberi’s superior from Kinshasa. The previous day, Dr. Richard had received a disturbing telephone call from Dr.Omberi. Dr.Omberi informed him that he had just received word that there was an outbreak of an unknown disease in Ambuku. The disease had affected the locals and the mission hospital’s staff. It was therefore of paramount importance and urgency that he travels to assess the situation on the ground. Dr.Omberi was careful not to mention the letter he had received one week earlier since this would implicate him.Dr. Omberi’s vehicle was parked adjacent to the hangars. The two men briefly exchanged pleasantries and immediately got down to business. Once the car started, Dr. Richard inquired of any additional news from Ambuku. Dr. Omberi momentarily stared blankly into oblivion. He heard Dr. Richard repeat the question. He quickly cleared his throat. “We have lost nineteen medical staff and one hundred and sixteen villagers, Sir. The mission hospital has since been closed”.  Dr. Richard listened in utter shock, his face aghast. He had not imagined an epidemic of this proportion or magnitude. Tough decisions had to be made, and fast. Dr. Richard decided that the entire Pamba region had to be quarantined. He quickly made the necessary calls to Kinshasa and then ordered the reluctant Dr. Omberi to arrange transportation for the next morning so they could visit Ambuku and assess the situation firsthand.Grave Yard
An eerie silence filled the air in the empty courtyard of the Ambuku mission hospital. It reeked of death. Wearing face masks, they hesitantly walked into the hospital. They were greeted by a stinking stench. Six plastic garbage bags were piled on each other, containing corpses. Dr. Omberi leaned against the wall, lifted his face mask, and vomited on the stained black floor. He felt weak and dizzy as he struggled to walk out. In the next room, a child lay on its back, breathing laboriously. It was only covered in a loose sheet. Sores oozing of pus and blood were visible through the thin sheet. The child was in immense pain but could make no sound. It was as though it knew it was dying and made peace with it. All around were sights of pain, despair, and death. Dr. Richard made a telephone call to Kinshasa. He requested the air force to airlift the remaining patients from the mission hospital to Kinshasa for specialized treatment in a bid to save their lives. But it was an almost impossible task since they did not know what they were dealing with. In typical government procedures handling style, it took over four hours for different agencies and authority figures to coordinate and give approvals for the request. It was too late. The mission hospital was now a graveyard, every patient had breathed their last. The few remaining medics hurdled in a bunch, trying to find solace in each other. At this point, all Dr. Richard and Dr. Ombire were sure of, is that they were dealing with a highly contagious and very deadly disease.The DiscoveryOne of the medics airlifted from Ambuku mission hospital started displaying symptoms of the strange disease. She died in thirty-six hours, despite having undergone massive supportive therapy. No diagnosis was made. After the autopsy was performed, samples of her blood, liver, spleen, and brain were taken. These samples were sent to the Institut de Médicine Tropical in Antwerp, Belgium; to the Centers for Disease Control in Atlanta, U.S.A.; and to the Microbiological Research Establishment in Porton Down, England. In Ambuku region where the strange disease was first detected, there were now three hundred sixty-two known cases of the disease. The fatality rate was estimated to be at ninety-three percent.The Ambuku virus was isolated almost simultaneously at the three international laboratories. It was noted to be structurally similar to the Burg virus, first seen in 1964 in a fatal outbreak in veterinary workers handling black mambas from Ghana. The new virus, considerably more deadly than Marburg, was named Machar after the Machar River north of Pamba. It was thought to be the most deadly microorganism seen since the bionic plague.Return to Normalcy
Three months after the first case was reported, the unknown disease in Ambuku was considered successfully contained since no new cases had been reported in the area for several weeks.The quarantine of the Pamba region was lifted and air service reinstated. The Machar virus had returned to its source. The location of that source remained a complete mystery. An international team of professionals, including Dr. Ford Armstrong of the Centers for Disease Control who had played a big role in localizing the Dassa Fever virus, had scoured the area, searching for a reservoir for the Machar virus within mammals, birds, and insects. The virologists had no success whatsoever. Not even a clue.
Spread to America
Dr. Thomas Heinstein, a tall, honorable ophthalmologist originally from Canada and cofounder of the Heinstein Clinic in Spring Valley, adjusted his glasses and looked over the advertising proofs laid out on the circular table in the clinic’s conference room. To his right was his brother and partner, Michael, a business-school graduate, who was examining the proofs with equal attention. The material was for the next quarter’s drive for new prepaid subscribers to the clinic’s health-care plan. It was aimed at young people, who as a group were relatively healthy. That was where the real money was in the prepaid health-care business; Michael had been fast to point out.Thomas liked the proofs. It was the first good thing that had happened to him that day. It was a day that had begun badly with a fender-bender on the entrance to a freeway, resulting in a nasty dent in his new BMW. Then there was the emergency surgery that had backed up the clinic. Then there was the heart-rending AIDS patient with some weird complication who’d coughed in his face while he tried to examine the man’s retinas. And on top of everything else, he had been bitten by one of the monkeys used in his ophthalmic herpes project. What a day!Thomas picked up an ad scheduled for the Nevada Sunday Magazine. It was perfect. He nodded at Michael, who motioned for the adman to continue. The next part of the presentation was a slick thirty-second TV spot slotted for the evening news. It portrayed carefree bikini-clad girls on a Malibu beach, playing volleyball with some handsome young men. It reminded Thomas of an expensive Pepsi ad, though it exalted the concept of prepaid health maintenance as delivered by an organization like the Heinstein Clinic in contrast to conventional fee-for-service medicine.Along with Thomas and Michael were a handful of other staff doctors, including Dr. Natalia, Chief of Medicine. They were all directors of the clinic and held small amounts of stock.Michael cleared his throat and asked if there were any questions from the staff. There were none. After the advertising people had departed, the group voiced unanimous approval of what had been presented. Then, after a brief discussion about the construction of a new satellite clinic to deal with the increase in subscribers from the Beach area, the meeting was adjourned.Dr. Heinstein returned to his office and cheerfully tossed the advertising proofs into his briefcase. It was a sumptuous room, considering the relatively low professional salary he drew as a physician in the group. But his salary was just incidental remuneration compared to the profits from his percentage of the outstanding stock. Both the Heinstein Clinic and Dr. Thomas Heinstein were in sound financial shape.After catching up on his calls, Dr. Heinstein made rounds on his postoperative inpatients: two retinal detachments with difficult medical histories. Both were doing well. On his way back to his office, he thought about how little surgery he was doing as the sole ophthalmologist of the clinic. It was disturbing, but with all the ophthalmologists in town, he was lucky to have what he did. He was thankful that his brother had talked him into the clinic idea eight years ago.Changing his white coat for a blue blazer and picking up his briefcase, Dr. Heinstein left the clinic. It was after 9:00 P.M., and the two-tiered parking garage was almost empty. During the day it was always full, and Michael was already talking about the need to expand it, not only for the spaces but for the depreciation; issues like that Thomas didn’t truly understand, nor did he want to.Musing about the economics of the clinic, Dr. Heinstein was unaware of two men who had been waiting in the shadows of the garage. He remained unaware even after they fell in step behind him. The men were dressed in dark business suits. The taller of the two had an arm that seemed permanently frozen into a flexed position. In his hand was a fat briefcase that he held high due to the immobility of the elbow joint.Nearing his car, Dr. Heinstein sensed the footsteps behind him as they quickened in pace. An uncomfortable sensation gripped his throat. He swallowed hard and cast a nervous glance over his shoulder. He caught sight of the two men, who seemed to be coming directly toward him. As they passed beneath an overhead light, Dr. Heinstein could appreciate that they were carefully dressed, with fresh shirts and silk ties. That made him feel a little better. Even so, he moved more quickly, rounding the back end of his car. Fumbling for the keys, he unlocked the drivers’ side door, tossed in his briefcase, and slid into the welcome smell of coach leather. He started to close the door when a hand stopped him. Dr. Heinstein reluctantly raised his eyes to what turned out to be the calm, blank face of one of the men who had followed him. The suggestion of a smile crossed the man’s countenance as Dr. Heinstein looked at him inquiringly.Dr. Heinstein tried again to pull his door shut, but the man held it firmly from the outside.“Could you tell me the time, doctor?” asked the man politely.“Certainly,” said Heinstein, glad to have a safe explanation for the man’s presence. He glanced at his watch, but before he had a chance to speak, he felt rudely pulled from the car. He made a half-hearted effort to struggle, but he was quickly overwhelmed and stunned by an open-handed blow to the side of his face that knocked him to the ground. Hands roughly searched for his wallet, and he heard fabric tear. One of the men said “businessman,” in what sounded like a disparaging tone, while the other said, “Get the briefcase.” Dr. Heinstein felt his watch snatched from his wrist.It was over as quickly as it had begun. Dr. Heinstein heard footsteps recede and a car door slam, then the screech of tires on the smooth concrete. For a few moments, he lay without moving, glad to be alive. He found his glasses and put them on, noting that the left lens was cracked. As a surgeon, his primary concern was for his hands; they were the first thing he checked, even before he picked himself up off the ground. Getting to his feet, he began to examine the rest of himself. His white shirt and his tie were smeared with grease. A button was missing from the front of his blazer, and in its place was a small horseshoe-shaped tear. His pants were torn from the right front pocket down to his knee.“God, what a day!” he voiced to himself, thinking that being attacked made the morning’s fender-bender seem trivial by comparison. After a moment’s hesitation, he recovered his keys and returned to the clinic, going back to his office. He called security, then debated whether to call the L.A. police. The idea of bad publicity for the clinic made him hesitate, and really, what would the police have done? While he argued with himself, he called his wife to explain that he’d be a little later than expected. Then he went into the lavatory to look at his face in the mirror. There was an abrasion over the right cheekbone that was sprinkled with bits of parking-garage grit. As he gingerly blotted it with antiseptic, he tried to estimate how much he had contributed to the muggers’ welfare. He guessed he’d had about a hundred dollars in his wallet as well as all his credit cards and identification, including his California medical license. But it was the watch that he most hated to lose; it had been a gift from his wife. Well, he could replace it, he thought, as he heard a knock on his outer door.The security man was sycophantically apologetic, saying that such a problem had never happened before and that he wished he’d been in the area. He told Dr. Heinstein that he’d been through the garage only a half-hour before, on his normal rounds. Dr. Heinstein assured the man that he was not to blame and that his, Heinstein’s, the only concern was that steps be taken to make certain that such an incident did not reoccur. The doctor then explained his reasons for not calling the police.The following day, Dr. Heinstein did not feel well but he attributed the symptoms to shock and the fact that he’d slept poorly. By five-thirty, though, he felt ill enough to consider canceling a meeting he had with his mistress, a secretary in the medical records department. In the end, he went to her apartment but left early to get some rest, only to spend the night tossing restlessly in his bed.The next day, Dr. Heinstein was ill. When he stood up from the slit lamp, he was light-headed and dizzy. He tried not to think about the monkey bite or being coughed on by the AIDS patient. He was well aware that AIDS was not transmitted by such casual contact: it was the undiagnosed superinfection that worried him. By three-thirty, he had a chill and the beginnings of a headache of migraine intensity. Thinking he had developed a fever, he canceled the rest of the afternoon’s appointments and left the clinic. By then he was quite certain he had the flu. When he arrived home, his wife took one look at his pale face and red-rimmed eyes and sent him to bed. By eight o’clock, his headache was so bad that he took a Percodan. By nine, he had violent stomach cramps and diarrhea. His wife wanted to call Dr. Natalia, but Dr. Heinstein told her that she was being an alarmist and that he’d be fine. He took some Dalmane and fell asleep. At four o’clock he woke up and dragged himself into the bathroom, where he vomited blood. His terrified wife left him long enough to call an ambulance to take him to the clinic. He did not complain. He didn’t have the strength to complain. He knew that he was sicker than he’d ever been in his life and at this point, he realized every second was a gift, every second was a curse. On the verge of death, life seems incredibly precious. This situation got worse and seemed like a short notice memo of death.
Hope At Last
This was now a national security matter and the other countries had been warned to stay vigilant. Flight scheduled from Zaire to other parts of the world had already been canceled. Still trying to wrap heads around this new virus, the news anchors, journalists and reporters aired this news as national breaking news. This virus was spreading insanely fast and the world had been hit hard with new cases being reported in other cities. The only thing being aired on radios and televisions was the latest virus that was bringing humanity down to its knees. The last resort was God because doctors neither understood how this virus was spreading nor its origin. Gazing at the sky didn’t provide any answers. Despite the vast challenges, doctors started working together globally without giving up. Laboratories were filled with people in white lab coats, gloves, and masks mingling. Glancing at the microscopes every minute and spending sleepless nights, there were signs of a better tomorrow. This was the anticipated sanctuary of tomorrow as citizens waited for the notification beep on their phones. The anticipated notification was the end of a nightmare, a mystery solved, and a cure. Tirelessly conducting various studies in medical research institutes, the transmission and the effects of the virus on humans were eventually discovered.The ray of light was finally here, the only hope in the darkened days came from the medical research institute news. The laboratory reports showed that the virus was a mutation of a lab-created variety that was designed to fight viruses and bacteria. Haunted by the question that had plagued people for the longest time “what kind of man can do this” the national police department took action.  The blackened and charred nights which had taken William Dales” life among other lives was finally coming to an end. Medics used various technologies to come up with a cure. Keeping in mind that not all cures are black and white; not all cures save us and sometimes saving isn’t what is needed. The vaccine was finally ready for administration and the volunteers for inoculation were many. Large groups started lining up for of the volunteers was Dr. Heinstein.  The results of the patients after administering the vaccine were successful. The healed Dr. Heinstein said he was noticing positive changes after the vaccine. His eyesight was now excellent, better than ever. He wasn’t tiring as easily and sleep was becoming more elusive. Reaching an acceptance of the mortality of all of the victims, the detectives had a lead on how the virus was irresponsibly released. The action taken by national police towards the criminal investigation of this virus showed that they were well trained. They were sharper than most claimed investigators. Sounds of squeaking police car wheels and sirens started getting louder as they approached the house of the suspect. Dr. Vom was the suspect who had worked together with some government agents. Neighbors sat still and smiled as the suspects’ house was raided. Screams could be heard from the house and a voice asking “do you have a search warrant”. By the time the doctor tried to dispute, some officers had already gathered enough evidence that he was behind this nightmare. His family looked up in shock as the man behind a national massacre was living with them. Everyone else was in silence as his children cried out their dads’ name. The police cuffed him and led him to the car. Dr. Vom shuffled his feet in embarrassment looking like he was wishing that the world would swallow him. He enjoyed his silent humiliation knowing that he was heading to a life sentence. They filed a sabotage conviction and the citizens massively started protesting until action was taken. This virus had taught people odd things about life and time. This abrupt nightmare finally came to an end and the survivors enjoyed the sanctuary of tomorrow.