Larry Brown could trace his morbid interest in infectious diseases back to a video he’d watched as a boy.
While his younger sister played with plastic stethoscopes, plastic thermometers, and a plastic doll as her patient, Larry watched and re-watched a video about leprosy, Chagas disease, yellow fever, and leptospirosis.
While his sister became a lawyer, Larry became a doctor, but the childhood fascination with infection and tropical disease had never waned. It was one reason why, once he’d qualified and practiced for a short while, he left New York to travel. He worked in Chile and Peru and then Kenya. It was in Nairobi where Larry attended a lecture on HIV that he met and never forgot Philippe Fournier. Philippe’s obsession with his work on HIV was only matched by his obsession to learn about salary levels for microbiologists in the USA.
Nairobi was also where Larry had been asked by someone from the US Embassy if he was interested in looking at the Nigerian health system with a view to, as it eventually explained in his new job description, “assist American companies understand how best to win contracts in the provision of management services and medical equipment.” Larry accepted, was seconded to the American Embassy commercial team in Lagos, Nigeria, and started work by travelling around the country.
His first stop was the northern state capital of Kano. The reason was obvious to Larry. The smaller city of Jos in neighbouring Plateau State was, according to Larry’s calculations, only about 150 miles away, and as the Evangel Hospital in Jos had always held top spot in Larry’s list of places with especially interesting diseases, the chance for a quick visit was too good to miss.
In 1969, before Larry was born, the Evangel Hospital had been the first centre in West Africa to identify the haemorrhagic, Lassa fever virus that still causes around five thousand deaths a year across Africa. Two missionary nurses at the hospital died of the virus, and a third fell ill and was flown to the USA. It was there that the virus was isolated and named. A year later, the medical director at the hospital, a missionary surgeon, also caught Lassa fever after she accidentally cut herself during an autopsy. She was dead within two days.
Some viruses are like that. Surviving Lassa fever without receiving the antiviral drug ribavarin is rare. Measles and chicken pox are pussy cats compared to Lassa.
After his visit and hoping that diplomatic relations between the US
and Nigeria had been enhanced by his short and unannounced intrusion, Larry began to consider what he himself had discovered the day before during his few hours in Kano. The more he thought about it, the more he was convinced that he might have discovered another new fever. This one had none of the characteristics of Lassa fever, but if the estimated death toll in Kano of at least one hundred men was accurate, then someone needed to sit up and take notice. But no one yet had.
Larry’s official visit to Kano had been at the request of his embassy superiors in Abuja, the Nigerian capital. The line was that it would be a useful diplomacy if an American, especially a black one who could trace his roots back to West Africa, was seen to be doing something useful for the ordinary people. All the better if it was handled in a way that could not possibly be interpreted as remotely political or designed to inflame ongoing tensions with the northern Moslem community.
Someone had organised a debate for two schools in Kano. The topic of discussion was to be “Who is more important to society, the teacher or the doctor?” and was designed to encourage students to speak good and correct American English using appropriate American expressions. Who would better run the debate then than a real live doctor fresh out of New York?
But Larry had never been a man who did his job and then went home.
He met the students as required, learned far more from them than they
did from him, returned to his hotel and then, with time on his hands, changed out of his suit, put on a pair of jeans, and headed out to explore Kano.
Perhaps he was naturally drawn to clinics and old mission hospitals, but as he wandered down the Kofar Wambai Road watching, listening, smelling, and generally taking in local Kano life, he took off down one of the side streets. He had hardly walked fifty yards when he found himself looking up at a cardboard sign hanging from a single nail above a doorway. Behind the door was a single-story concrete building with rusting bars fronting dusty, unwashed windows.
Perhaps it was because a red cross is never upside down, but it made him stop, and by twisting his head, he read the rest of the fading writing:
Kofi Clinic Dr A. Mustafa
Interest sparked, he pushed open the unlocked wooden door and found himself in a dark and dusty hallway that might, had the electricity been turned on, have been lit by a single bare light bulb that still hung from the ceiling. At the far end was another door.
“It is closed, sir.” The voice from behind was that of an elderly woman Larry had seen sitting and sewing in the shade outside. She was now standing behind him, holding an old shirt with needle and thread hanging from the corner of her mouth. Dressed in a long colourful dress and an ornate headdress that Larry had recently learned was known at least in Lagos as gele. Despite the dust, the trash, and the rubble around her feet, the woman looked and sounded educated. Larry introduced himself. “Was it a private clinic?” he asked.
“Yes, sir. Dr Mustafa.”
“Did he have many patients?” Larry asked, peering down the hallway at a grey metal filing cabinet lying on its side with empty drawers hanging out.
“No, sir.”
“Where has he gone?”
She shrugged, so Larry tried the door at the end, found it locked, wiped his dusty hand on his jeans, and returned outside. “Do you live nearby?” he asked. She pointed across the road to a concrete block house with a corrugated tin roof and open doorway. “Did you see patients arrive here?”
“Yes, sir.”
“Did Dr Mustafa have many patients?”
“No, sir.”
“When did it close?”
“Maybe two months ago.”
“Why did it close?”
“His patients died?”
“Died? All of them?
“Yes, sir. They were taken away in a truck.”