THERE CAME A TIME a couple of months in when you couldn’t walk down the street or open a newspaper without arousing a creeping dread in the deep blood, as though someone was watching you from the shadows, but when you turned around there was no one—just the deserted sidewalk flanked by the boarded shops, and, before they blew away, little piles of brick dust like anthills every fifty yards or so under the places they had carelessly drilled the emergency broadcast speakers into the building facades. The speakers buzzed incessantly with the official warnings repeated on a loop, reminding us to wear our masks, to dispose of clothing after it had been worn outside, to avoid leaving our homes unless strictly necessary. And the rumors grew, whispered from neighbor to neighbor and mixing with the roll of sirens in the distance and the sulfurous stink of garbage piled weeks high on the curbs and the feral sense of decay and, no matter how much you had steeled yourself to it, always the clammy fear rising in your chest like walking out into deep water.
But it started small, as these things always do—the mustard seed that holds the almighty kingdom of heaven, the merry flap of the wing that roils the hurricane. Or, here, the rustling in the stillness an hour before sunrise in a clearing half a world away.
As best we could reckon later, the patient had struggled out of the thick overgrowth, a shadow perceptible in the fragile predawn gray only for its movement and the faint swish of its legs against the underbrush—the nyenje, which usually filled the night air with a dizzying rasp, had given it up hours ago. He had walked all night through the dry October heat that had long since baked everything, even the woodlands, to the same tired, dun color, and now he staggered across the clearing towards the whitewashed concrete box that was the clinic. The triage tent had been unmanned at that hour, and the patient had made it up the rough-hewn steps and into the main ward before collapsing onto his knees and crumpling to his side between two rows of cots, some empty, some full. A sleepy nurse moved towards him reflexively and felt for his pulse. The box of latex gloves on the examination table was empty, and she used her bare hands, leaning her face towards his to listen for breath sounds and watch for the rising and falling of his chest. He was alive.
He was utterly spent, though, the determination behind his eyes fading under the glassy shimmer of fever. Perhaps thinking that the withering heat and the cracked lips suggested dehydration, three orderlies set up IV fluids and helped him to a bed, where he would lie, inhaling and exhaling, for thirteen hours until the doctor’s usual Tuesday visit from Solwezi, a hundred-fifty miles northeast.
The doctor was late. There was no easy route from the town to the clinic, deep in the Mufumbwe district of the North Western province, and today the transport lane had been impassable for his battered truck, so he’d taken the long way around. He was in a hurry as he checked on his old cases first, moving from bed to bed adjusting instructions on charts and confirming discharge orders with the nurses, occasionally pushing his glasses back up the sweaty bridge of his nose with the back of his wrist. He knew most of the discharge instructions he gave would never—could never—be followed by these patients. The prescriptions were too expensive to fill; the conditions of the surrounding villages and ubiquitous copper mining camps too harsh for extended convalescence. But he wrote the instructions anyway.
He saw eight patients over two hours before turning to the new arrival. And as he looked down at him, touching the glistening forehead and listening to the shallow breathing, in and out, twenty times per minute at a tidal volume of half a liter, his face grew stony and his jaw clenched. He stared, transfixed, as a single drop of blood crawled from the patient’s nose slowly down the side of his cheek, accelerating with the angle until it fell with a soft ‘pft’ onto the pillow below.
‘Have the discharges already left?’ he demanded suddenly of no one in particular, shaking off the reverie he had fallen into.
‘Five of them,’ a broad-faced nurse answered.
‘Call after them—they must return right away,’ he ordered quietly, not wishing to alarm the others. He glanced down the row of beds to a woman who had been laboring for nearly a day. Her baby was breach, and he still held out hope it would turn on its own.
‘The phone is out,’ the nurse protested, ‘the last blackout…’ she started to explain but trailed off at the look of panic on his face.
‘Where did they go?’ he asked, his voice rising, ‘we’ll send someone after them, do we know where they would go from here?’
The nurse shook her head, bewildered both by the question and by the sharp note in his voice. This wasn’t a neighborhood with street addresses neatly screwed to tidy mailboxes, and most of those who sought treatment at the clinic arrived on foot from days away, sudden apparitions against the tangle of skeletal miombo trunks, and left the same way. During rainy season, the footprints sunk in the mud-bound clearing between the clinic and the tree line would have given tacit direction, but now the dry, cracked earth kept its own counsel.
‘Get them back,’ he ordered feebly, ‘and not another soul is to leave this clinic—patient or staff—am I clear?’ His eyes moved despairingly over the ashen body before him, the dark bruises where the blood had pooled under the skin pulled taut from the swelling, the stains on the sheets beneath the patient’s waist, the eyes fixed and glassy. ‘We’re under quarantine,’ he finished. His hands moved instinctively towards the chart hanging on the end of the cot, but it was only out of habit—he knew it was already too late.