Allah,” was her translation, slightly more blunt than others I’d heard) and how that fateful idea may have dissuaded some victims from seeking hospital care. She helped me understand the sort of little interpersonal intimacies, characteristic of her country, that could be relevant to disease transmission. “In Bangladesh,” she said, “physical contact is very common. We hug, we hold hands all the time.” Even along the road, she said, you see men walking together, holding hands. Such physicality only increased, from a sense of concern, if a person were sick—and more still if the sick person were a venerated figure, like the sect leader in Guholaxmipur. This man was beloved by his followers and seen as close to God. People came as he lay on his deathbed to be favored with a last touch, or to whisper blessings in his ear, or to sponge his body, or to offer him a sip of water or milk or juice. “That is one of the customs here,” Khan explained, “that you give water to the dying person’s mouth.” Many people came to his bedside, bent close, offered him water, she said, “and he was coughing all the time. And the fog was everywhere on people’s—”
I think she was going to say “faces” but like a fool I interrupted her.
“The fog?”
“Yeah, the saliva,” Khan said. “His coughing. So the spit was . . . people told us that he was coughing, and his coughing, the spit, on body, hands . . .” Eliding these thoughts, she left me to fill in the blanks, then mentioned that hand washing, unlike hand holding, is not common practice in Bangladesh. Unlucky followers and family members may have come away from their final audiences lightly glazed with the holy man’s spittle—and then rubbed their eyes, taken food with those hands, or otherwise accepted the virus. You don’t need date-palm sap if you’ve got that.
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Over the course of three days I made several trips to the ICDDR,B, which occupies a complex of buildings behind a high wall in the Mohakhali neighborhood of Dhaka. In addition to the talks with Khan and Gurley, I spoke with some high administrators and some bright young researchers, who gave me a wide range of perspectives and insights on Nipah virus. But the most affecting moment occurred when my taxi through the crazed Dhaka traffic pulled up to the wrong gate of the compound, leaving me just disoriented enough to walk in the wrong door. This wasn’t the sleek building that housed Steve Luby’s infectious diseases program. This was the old Cholera Hospital itself.
A solicitous Bangladeshi man, who noticed me looking lost, asked my destination and pointed me along, suggesting I simply cross through the hospital. A guard opened the next door and saluted me. No one asked for a badge. I found myself intruding through an open ward lined with dozens of beds. A few of those beds were empty, sheetless, showing a mattress of red or green vinyl with a bedpan hole in the middle: cold, practical, ready for the next case. Many other beds were filled with the thin, bony bodies of suffering patients, sorrowful brown-skinned people, alone or consoled quietly by relatives. Here came I, a white man with a briefcase, into this hangar of souls eagerly awaiting attention from a doctor. One woman caught my eyes, then whispered to her child, held beside her on the bed, and pointed at me. Out on the street such a gesture would suggest idle curiosity or maybe a prelude to begging, but here it surely indicated hope—deep hope, hope of deliverance, but misplaced. I averted my eyes and walked on, acutely aware that I had no skills, no knowledge, no training, no medicines that could be helpful to this woman and her child, more’s the worse for me. Through further corridors, other doors, more saluting guards, I found my way to the next interview.
The Cholera Hospital was founded in 1962, as a clinical adjunct to an earlier Cholera Research Laboratory, both of which were eventually bundled into the ICDDR,B. The hospital provides free treatment to more than a hundred thousand patients each year, not only for cholera but also for blood dysentery and other diarrheal diseases. Most of its patients are children under the age of six. Eighty percent of those children arrive at the hospital malnourished. I can’t tell you how many survive. I can’t even tell you how many cholera cases occur annually when the flood season in Bangladesh