Melaba, Yemen
In his two years with Médecins Sans Frontières, Dr. Jacques Legarde had never driven into a Yemeni village and not been greeted by at least one person.
Except for today.
He looked in the rearview mirror at the two young men asleep in the backseat of the Land Rover. They were twin brothers, Yemeni by birth, trained in France as medical techs, who had volunteered to come back to their native land as translators for Doctors Without Borders. Their given names were Lando and Jalal, but they preferred to go by their French nicknames Frick and Frack, which the brothers thought were hilarious.
“Frick, wake up!” Jacques called. “This is the place?”
The young man elbowed his brother awake and compared the map with a handheld GPS unit. “This is it, boss.”
Jacques opened the door of the white MSF Land Rover and stepped into the noonday sun of interior Yemen. The tiny village, no more than two dozen houses arranged around a haphazard town square, was silent and still in the baking heat.
He’d never been this far east in Yemen before. The village of Melaba was forty miles east of the Haraz Wildlife Sanctuary, which served as a natural buffer between the fighting in the west and the interior of Yemen to the east. The village was deep in Houthi territory, but MSF had received a tip that the town had suffered a serious outbreak of some kind.
The political elephants in Sanaa were talking up another humanitarian cease-fire, which was all the brothers needed to talk their way through the Houthi roadblocks.
Jacques relished his role as the Doctors Without Borders vanguard. Even after two years in the field, the job still held allure for him. He liked to think he’d helped make the world a tiny bit better for his efforts.
But he’d seen some horrific sights as well. While the Saudis and the Iranians fought a proxy war, the Yemeni population suffered. Lack of food, clean water, and routine medical care had devastated small communities like this one.
But still, there was always someone there to greet him when he arrived in a new village.
“Allons-y,” he said to the brothers. “See if you can find someone in charge.”
While the pair split up to search for villagers, Jacques lowered the tailgate of the Land Rover. The interior was packed with the equivalent of a Doctors Without Borders first-aid kit. He could manage the basics from the Rover, but anything more complicated required a field hospital.
Frick returned to the car at a dead run, his eyes wide. “It’s bad in there, boss,” he said in rapid-fire French. “The whole village is sick. Started three days ago. Everyone is sick. It’s—it’s…” Frick sputtered out a few unintelligible words in his native tongue.
Jacques automatically pulled out boxes of masks, latex gloves, and safety glasses. Frick had seen some unspeakable conditions, and if he was shaken, it must be bad.
He handed a mask to the young man. “Show me.”
They jogged to the nearest building, a squat mud-brick hut with a stone door lintel and a dirt floor. Jacques put on his safety gear and stepped inside, letting his eyes adjust to the gloom after the bright sunshine. His nose didn’t need adjustment. The scent of dead bodies in the heat nearly overwhelmed him.
Gradually, the dark interior dissolved into the forms of a young family. A husband and wife with five children ranging from young teens to a toddler. His medical training kicked in as he triaged the situation.
The husband was dead, as were four of the children. The wife, who looked to be midthirties, clasped her youngest child to her chest. The woman was barely conscious, and the child stared at him with dull eyes.
Jacques knelt in the dirt and took the woman’s pulse. Her heart was beating like a rabbit’s and she was burning up with fever. The child let out a deep hacking cough that made Jacques instinctively back away.
“Bring me two IV kits,” he said to Frick. “And I want you and your brother to put on full bio suits, okay?” Frick’s eyes widened at the sudden note of command in Jacques’s voice, and he raced out of the room, calling for his brother.
The woman’s eyes rolled back in her head and she mumbled something in a language he didn’t understand. Her hand pawed at the air like she was reaching for something.
“It’ll be okay,” he whispered. “I’ll do what I can.”
He gently pulled the child away from her mother. He saw now his guess about the child’s age had been wrong, a common mistake in this country where malnutrition was rampant. The young girl was closer to six years old than three, and she had the sunken eyes and pinched features of someone who’d grown up with not enough food.
She was light in his hands as he laid the child on the dirt floor. Jacques had to blink away tears. He didn’t understand politics, he didn’t understand war, but he did understand the suffering of children—and it broke his heart every time.
Frick returned wearing a white bio suit, with a bag of supplies. Working quickly, Jacques slipped an IV needle into both patients and gave them a shot of broad-spectrum antibiotics. It was a guess at best. He had no idea what was causing the fever and pulmonary distress, but it was better than nothing. He felt a rush of frustration at his impotence.
Frack appeared in the doorway, also clad in full bio gear. “It’s like this all over the village, boss. Every house. At least half of them are dead already. What do we do?”
“You do your job,” Jacques said. “Triage the patients, get fluids into the survivors, and give everyone a shot of antibiotics. I’m going to call for reinforcements.”
Outside, Jacques squinted in the sunlight. He carefully took off the gloves, mask, and glasses, then scrubbed down his exposed skin with sanitary wipes. From the glove box of the Rover, he retrieved a satellite phone. The device seemed to take forever to boot up and get a signal.
Leon’s firm professional voice gave Jacques a shot of much-needed confidence. Back in the real world, Leon was a cosmetic surgeon from Chicago, but as the MSF country coordinator, Leon had seen it all.
“It’s bad here, Leon. I mean really bad.” Jacques’s voice broke. “We have a small village, possibly up to one hundred fifty people in the midst of a full-scale epidemic.” He consulted the map and read off the GPS coordinates for Melaba. “The patients I’ve seen so far show symptoms of severe bleeding and respiratory distress. The mortality rate is fifty percent and rising. We need a full field hospital on the ground ASAP.”
Leon sounded tired, but that was par for the course. They were all tired. Tired of seeing people dying for no reason, tired of seeing children starving for no reason, tired of patching fighters up only to see them blown up the next day.
“Cease-fire just went through this afternoon,” Leon said. “I’ll get choppers in the air before these idiots change their minds again and start shooting at each other. We’ll be there before nightfall. Hold down the fort, buddy. Reinforcements are on the way.”
“What about WHO?” Jacques asked. “If this is an epidemic, they need to be on it right away.”
“I’ll get one of them on the chopper, if I can,” Leon replied. “You just worry about the immediate situation.”
“Just hurry, man,” Jacques said.
Between Jacques and the brothers, they separated the dying from the dead and did their best to make them comfortable. They were out of saline after the first hour. He dispensed all of the antibiotics he had in the Rover, as well as the morphine. By late afternoon, they were reduced to applying cold gel-pack compresses to the foreheads of the feverish.
Jacques chafed at his impotence. He was treating symptoms, but he had no idea what had struck down an entire village.
Shadows stretched long across the village square when he heard the sound of a helicopter in the distance. Jacques raced out of the makeshift sick ward and quickly stripped off his bio suit. Underneath he was dripping with sweat, and he felt a little light-headed.
Jacques directed the incoming choppers to a field adjacent to the village.
Through the billows of dust kicked up by the rotor blades, he could see that Leon had been as good as his word. The helo was one of the heavy cargo units. The ramp started to lower before the dust even settled, and MSF staff streamed out of the open doorway. The sight made Jacques want to cry with relief.
By the time the moon rose, a white MSF field-hospital tent had been erected in the village square and bright floodlights lit the entire area. The survivors had been moved inside and were being treated.
Jacques felt his knees soften with exhaustion. He staggered back to the Rover to find the brothers asleep in the backseat. He smiled to himself as he climbed into the passenger seat and closed his eyes.
In his dreams, Jacques saw the panicked look of the young child he had taken from her mother. She tried to say something, but he couldn’t understand her. She coughed on him and the skin on his arms turned an angry red. He scratched at his own arms, tearing at his skin. Someone tried to hold back his hands.
“No!” he shouted. “Get away from me.”
“Jacques? Jacques Legarde?” The voice spoke in English.
Jacques pried his eyes open to find a man dressed in a biohazard suit standing outside the Rover. Jacques wiped his forehead. He was sweating and it was hard to catch his breath.
“Who are you?” he demanded. Jacques opened the car door and staggered out. His legs felt weak, barely able to hold his weight.
Dawn was starting to light the eastern horizon, and the high desert air was still and cool in the early morning. Glaring floodlights from the field hospital silhouetted the man, making him look like a ghost.
“Are you Jacques Legarde?” the man asked again.
Jacques nodded. His mouth tasted like sand and he had a pounding headache.
“My name is Sven Gunderson. I’m from the World Health Organization, Cairo office.”
Jacques sank to the dirt. “I need to sit down. Sorry.”
Gunderson handed him a water bottle with a gloved hand. “You are Jacques Legarde and you were first on scene, correct?”
Jacques nodded again. He took a long swallow of water before he answered. “Yes, to both questions. My techs and I were first on scene.”
“I know what caused this outbreak,” Gunderson said.
Jacques rubbed his eyes. He would give anything for a hot shower right now.
“And?”
The man squatted down next to Jacques, then looked around as if to make sure they were alone. “It’s Ebola.”
Jacques wasn’t sure he heard the man correctly. Ebola in Yemen? “I don’t understand.”
“I don’t understand either,” the man said. “That’s why I’m here. There’s more.”
Sleep melted away from Jacques as his brain processed what Gunderson was telling him. “How did the Ebola virus get to a remote Yemeni village?”
Through his goggles, the man’s eyes squinted. “That’s the problem. This virus is a genetic match for a sample that was in WHO custody only a few months ago, but it’s been modified.”
“I’m sorry,” Jacques said. “You’re not making sense. How did it get here?”
Gunderson swallowed hard. “There’s only two possibilities. One is we’ve had a miraculous outbreak of an exactly matched strain of Ebola in the middle of nowhere.”
“What’s the other option?”
“Someone is testing a biological weapon.” Gunderson’s shoulders slumped. “And you’ve been exposed.”