Hepatitis…and a million other things spread by mosquitoes, ticks and other biting insects: Malaria, Dengue Fever, Chikungunya. The list of potential diseases was very long for puddles in a West African country where sewage washed the streets.
It must feel impossible to parent children in such a part of the world. You could try to keep your child inside the bubble of your house. But even that bubble is contaminated as rats scamper from shack to shack, sewage seeps under your walls, and flying insects stick you with their dirty hypodermic-needle stingers.
Finally, we arrived at a one-room turquoise shack, corrugated metal roof torn away from the front wall at both corners. A woven rug that must have been pretty once—it had remnants of orange and gold threads shining through muddy splashes—hung from the top of the doorframe.
One of the soldiers knocked on the wall next to the door. “Hello! Anyone home?”
An old woman pulled the curtain aside. Peeking into the waning daylight, she squinted.
The soldier wasted no time. “Hello, ma’am. We’re looking for the mother of Akachi Anikulapo-Kuti.”
The woman reacted as though seeing a ghost. She tried to close the curtain on the soldier, but she had no door to protect herself, just a flimsy wisp of illusion. From inside, we could hear her shouting, “No! No! No!”
The soldier lobbed a grenade of hope her way. “Akachi isn’t dead, if that’s what you’re concerned about. He’s doing well, actually.”
The curtain opened. A withered old man stepped outside. His face was as wrinkled as prunes, his hair white and wiry, his eyes clouded with cataracts. Looking up at the soldier, he said, “My wife—Akachi’s grandmother—can’t deal with this anymore. Akachi’s mother—our daughter—has Ebola. She developed symptoms a few days ago: fever and muscle pain. Her husband and his brother have taken her to the church. Ebola is a curse, a punishment for our sins. We intend to pray until God hears us.”
The soldier asked the old man for directions to the church.
Agitated, Akachi’s grandfather waved his hand toward the center of the slum, pointing toward the open high-rise that climbed like a jumble of children’s blocks into the air above the shacks.
We hurried to the church. We knew we should be in protective gear. Everyone grabbed paper masks and latex gloves from their pockets and put them on. That’s all we had with us.
We passed the kids splashing around in puddles. We waved to them, but ignored their requests for more candy.
Two doors down from the high-rise, we found a makeshift church. We could only tell it was a church by the wooden Cross nailed into the front wall of it, sticking up above the roof. There was no door. Inside, there was a small altar, a few pews, tables filled with burning candles. My God, such a fire hazard to the entire slum. A procession of people circled round and round the rows of pews, chanting. A priest held a limp woman in his arms, praying over her and pouring water onto her forehead. Water dripped from her Ebola-fevered forehead onto his bare hands and arms.
We had seen enough. It was Dante’s Inferno, The Divine Comedy. “Abandon all hope, ye who enter here.” This slum was cursed. Not by God or by Satan, but by poverty and ignorance and the most damned of luck to be living near bats and monkeys infected with the horror of hemorrhagic disease.
As we walked back to the armored vehicle, the sun dropped slowly from the sky, lighting the horizon with fiery clouds of red and orange and gold, as though God had tossed His plaything upon a funeral pyre. The ball was clearly in our court.
Back at camp, Dr. Steele called it a night. She said she’d speak with the World Health Organization and the CDC about conditions inside the slum, but there was nothing more for us to do tonight. We were the day shift and she’d see us tomorrow. She warned us to use the Disinfecting Station before doing anything else.
The next morning, we found out the slum we had visited was now quarantined by the local government. Residents would no longer be allowed to leave. Liberia’s armed forces had been ordered to shoot on sight anyone attempting to leave the quarantined area.
I needed a moment. We had been told the news at breakfast. I went back to my residence hall, sat down on my bed and wept. Akachi’s family had been condemned. Even if the little boy survived the disease ravaging his body, he would have no one to return home to. The slum world he knew had been given a death sentence in order to save the rest of the world.
Later in the day as I cared for Akachi, I felt a sadness welling up in me unlike any I had ever known. I and the other medical staff were trying to make him better, with the odds of his survival unlikely. But if he did make it, then what? Where would he be sent? Would he end up with anyone who would love him and offer him the remnants of a childhood or would he be sent as a servant or slave to work an adult job, as so many poor kids around the world were forced to do?
When Dr. Steele walked over to Akachi’s bedside, he woke up and cried again about wanting his Mama. This time, he wailed about the monsters in yellow duck suits. The minds of children are marvelous. We had become large humanoid ducks to him, some kind of nightmarish cartoon characters. I told him that behind our suits, we were just doctors and nurses. “Akachi, you know how sick you feel? We’re just keeping the germs from reaching us, so that we can make you better.”
Akachi wailed even louder. I did not seem to have a way with kids, and I regretted that.
Determined to help Akachi feel less afraid of me, I came back onto my next shift with a dozen stickers of kids’ cartoon animals stuck onto my protective suit with temporary glue approved by Dr. Steele. That actually made Akachi laugh! But then he became so exhausted by the excitement, he collapsed onto his pillow and fell into a deep sleep.
I sat by Akachi’s bedside, holding his tiny hand in my large turquoise glove. I could see his small bones outlined against his thin, taut skin.
As I sat there, the machines attached to the little boy began to beep and chirp. All the bells and whistles signifying rapid decline went off. Akachi’s breathing became shallow and rapid. Blood leaked from his nose.
I hopped up to make room for Dr. Steele to maneuver next to the bedside.
Akachi’s heart monitor flatlined. I saw the straight line and heard the shrill announcement that his heart had stopped beating.
Dr. Steele asked me to get something-or-other. I forget what, an extra blanket or something. As I walked away to get it, I heard her pronounce: “Time of Death…”
Then she turned around and told me I was dismissed for the day.
Covered in sweat and dizzy, I followed her suggestion. I left the treatment center and went directly to the Disinfecting Station.
Two hours later, I couldn’t take it. I returned to the section of the treatment center where Akachi’s bed had been. I’m not sure what drove me there. I guess I wanted to see the empty bed for myself or find out if another patient had been assigned to it, to help my psyche let this innocent child go. I blamed myself. What if I hadn’t made him laugh? What if he had needed the extra energy to fight off the virus? I know that was silly, but I had leapt into the bargaining stage of grief. Maybe if I made enough bargains inside my mind, God would bring Akachi back. I don’t know. It wasn’t rational.
When I walked back to Akachi’s curtained area, I almost screamed behind my face shield. He was still there, lying flat on his stomach on the mattress, which seemed odd. Normally, an Ebola patient would be removed from a hospital bed and cremated as soon after death as possible. I mean, at least in this camp and every reputable medical facility designed specifically to deal with serious, contagious diseases such as Ebola.
In the slum that Akachi came from, bodies of dead Ebola victims were often left wherever they had succumbed to the disease, or were dragged into the street and deposited there out of a realistic fear that the family would be quarantined by the government if they found out they had been exposed to Ebola or in the mistaken belief that moving bodies out of homes into the stree
t somehow helped prevent transmission of the disease. In reality, Ebola-infected bodies are most contagious immediately after death and placing them in a public area is disastrous.
Post-apocalyptic science-fiction-sounding events were happening in Liberia on a regular basis. At one point, the government took matters into their own hands and buried the bodies. However, they made the graves too shallow. Dogs dug up the bodies and were seen eating them. Now, dogs don’t develop Ebola symptoms, so no one even knows if they’re carrying the disease; but they can pass it on to humans by licking or biting us. That sounds like the stuff of nightmares, horror, and science fiction; but in much of Liberia, it’s reality.
In our camp and in all the other modern medical facilities where Ebola patients are treated, however, the deceased are immediately removed from the beds where they passed away. They are quickly cremated or sprayed down with disinfectant and buried. So it was an anomaly that Akachi was still in his hospital bed hours after he had died.
I swallowed my scream down into my heart and studied the little boy. His bowels had let loose, with their telltale sign: the tarry black-jelly stool of Ebola. Blood had saturated the middle of Akachi’s pillow, surrounding his head like a macabre halo, most likely having leaked from several orifices in his head, including his