Paige held up the finished origami for Asim and smiled. “Elephant.”
“Elephant.” Asim repeated the word in broken English, but his grin transcended all languages.
So far, no infection had set into the wounds. She prayed that the extra boost in calories she’d ordered for him would help quicken the healing process, because while his malnutrition wasn’t severe, the high-energy peanut paste provided protein along with an antibiotic treatment and vitamins.
Scarce rains had translated into thin crops and less food for those living outside the cities. On top of everything else, they needed a therapeutic feeding center for the entire camp, but until supplies were trucked in, there was little she could do to fight the need.
Instead of worrying about what she couldn’t do, she tried focusing her attention on Asim. She tousled his kinky black hair. “A few more days, and you’ll be able to leave this tent.” And go where?
The question haunted her. Little boys didn’t belong in refugee camps where there was nothing but long hot days and nights. But while most humanitarian agencies advocated maintaining education services in order to preserve a sense of normalcy, the resources simply weren’t here. Which reminded her of the reality of her question. Until things were resolved with the rebels, no resources were coming in, none of them were leaving . . . and she wasn’t going home.
A wave of homesickness torpedoed across her heart. But she wasn’t the only one longing to go home. Or the only one wondering if she was going to survive this nightmare.
Brandon called to her, pulling her from her thoughts. “Do you have a minute?”
Paige patted Asim on the head and nodded. “Of course.”
She followed him across the room, out of earshot of Jodi’s bed. “I’ve been sitting with Jodi. She’s in a lot of pain.”
“I’ve given her everything I can. Any more and her respiratory status could be compromised.”
“I don’t understand what’s wrong. You said the gunshot wound is healing, but she seems to be getting weaker by the hour.”
“Her body is fighting something, and we’re still trying to pinpoint what it is.” Paige ran over Jodi’s symptoms in her head for the dozenth time. So many of the diagnoses Paige was now being forced to make were nothing more than gut instinct. Even the lab technician who’d come with them on the plane was severely limited beyond anything but the basics. Which brought her back to Jodi. And the fact that she had no idea what was wrong with her.
While the gunshot wound seemed to be healing as expected, Jodi had developed other complications that seemed unrelated. The hives had spread from her ankles and wrists and her lungs were filling with fluids. Paige had already run through the list of possibilities with her nurses, covering every exotic disease she could think of, but nothing they’d discussed completely fit the symptoms.
Paige picked up Jodi’s chart from her desk and tapped her finger against the top. There had to be something she was missing. “I don’t know where else to look. She’s not been sick until now?” They’d been over it all before, but it wouldn’t hurt to go through it again.
“No.”
“Anything that had symptoms of an amoeba or parasite-like diarrhea or flu?”
“No. The only thing she complained about was a couple headaches, and of course her leg bothers her some. She has a pin in her ankle, but it was something she never let slow her down.”
“Where else did you visit before the RD?”
“Morocco for a couple days, then a cruise down the Atlantic Ocean along West Africa. When we were on land, we tended to skip the local tourist magnets and head for the bush, but we also tried to be smart as to where we went and what we ate. We arrived in the RD last Wednesday, spent a couple days at the game park outside of
Ngamoli, then headed for the base camp.” Which meant it could be anything.
She pointed to Dayo, her local lab assistant, wishing he had the resources that would in turn make her job easier. But he was limited to testing for basic issues like pregnancy, malaria, TB, and HIV.
“As primitive as our lab might be, we’re still able to diagnose a few things. Unfortunately, every test he’s been able to run on Jodi has come back negative.”
Brandon blew out a sharp sigh. “I understand your position, but I need answers. I can’t handle watching her suffer, especially when there is nothing I can do.”
“For now, all I can do is treat the symptoms and try to make her comfortable, hoping her immune system and the antibiotics can fight off whatever this is.”
“Could the lab in the hospital in the capital diagnose her?”
“I can’t make any guarantees, but I would think so. Even in this part of the world, they’d have much greater access to supplies than I do.”
Brandon’s gaze shot to the door. “Then I’ve got to get her there.”
“Brandon, wait. I realize your urgency to find answers, but leaving the camp carries with it its own risks. You saw what happened this morning to those three men who tried to leave. They’ll do the same thing to you if they have the chance. And Jodi needs you alive.”
“There’s a jeep. If I could get past them, then outrun them — ”
“Brandon, look at me.” Somehow she had to convince him that running at this point wasn’t the answer. “I know you’re worried about Jodi, but right now she’s in stable condition and isn’t running the risk of dying. If you try and mess with the rebels, her odds of not making it out of here alive will rise substantially.”
“I’ve got to at least consider the possibility.”
“You’ve also got to consider the reality.”
“My wife has run the Boston Marathon eight times. She’s climbed the Canadian Rockies, Mount Whitney, and Mount Kilimanjaro. Coming here was a chance for her to prove that she hadn’t lost everything important to her in the accident.”
Her concern for Jodi ran deep, but her patient wasn’t the only one she was worried about. “When’s the last time you ate?”
Brandon shrugged. “I don’t know.”
“I want you to go to the food tent. They have beans and rice fixed for the staff. Get something to eat. Then go talk to Nick if you still think planning an escape is what you need to do.”
Brandon hesitated, then nodded. “Okay.”
Dayo set another stack of charts on her desk as Brandon left the clinic. “What did you tell him?”
“What could I tell him besides the truth? That I have no idea why his wife is sick. I’ve thought of every scenario I can, but whatever it is, it simply doesn’t fit into any normal pattern. I’ve looked at Rocky Mountain tick fever, meningococcal infection, even the measles.”
Dayo tapped Jodi’s chart. “Maybe you’re on to something.”
Paige shook her head. “What do you mean?”
“Measles. We know the typical symptoms of measles — fever, cough, red eyes, and eventually spots in the mouth. But what if this isn’t a typical case of the measles.”
He had her attention. “Explain. Except for a handful of cases I’ve had to treat in the past couple of months, measles isn’t exactly a disease I’m used to facing on a day-to-day basis.”
“I worked with a Canadian volunteer three years ago who talked about a patient he’d treated with atypical measles. It occurs in people who are incompletely immunized against measles with a killed measles vaccine, then are exposed to a wild-type measles virus. That specific vaccine was only used from 1963 to 1969, and it sensitized the patient to the measles virus and didn’t offer any real protection.”
“What are the symptoms?”
“Exactly what we’re looking at. Fever, the build-up of fluids, pneumonia, swelling of the extremities, with a rash that is atypical in measles.”
“It’s more like hives.”
“Exactly. And it appeared first on her ankles and wrists.”
Paige considered the diagnosis. Measles presented a new problem. In a perfect scenario, most people who contracted measles would recover with few, if any, complications. But with the cholera crisis, conditions in the camp were far from perfect. Which meant the disease could be a death sentence for dozens if allowed to spread.
“If you’re right, we’re going to need to set up a separate isolation tent. We can’t handle an epidemic of measles going through the camp.”
“Do you think it has spread?”
“We have no way of knowing at this point. But we better be prepared. Because if it does spread, we’re going to have another disaster on our hands.”
A commotion in the waiting room interrupted their conversation. Taz rushed through the crowded area, carrying a small child in his arms.
Paige grabbed her stethoscope and jumped into action.
“Put her there.” She pointed to the only empty bed, then felt the child’s forehead. She was burning up with fever. “Where did you find her?”
“Out among the tents while we were checking the water.”
“Do you have any idea where her parents are?”
This young girl wouldn’t be the first child to have been separated from her family during the chaos of one of the raids, or to have lost parents due to the cholera. In the past twenty-four hours, she’d already treated a number of children who would carry emotional scars from their experiences. And no pink origami animal could bring a lasting smile to their lips after the horrors they’d witnessed.
Samson stepped forward. “Her name is Raina. She . . . she’s my daughter. Which means my wife and other children are here.”
A gnawing sense of worry stopped Paige from celebrating with Samson. The telltale marks were clear. Fever . . . red eyes . . . tiny spots on the inside of the mouth.
“Jodi can’t be the source, but it’s definitely measles.” Paige glanced up at Dayo, who stood at the end of the bed. “And it’s already started to spread.”