The Fatal Strain (6 page)

His neighbors were not happy to see Jones when he returned to his home in the district capital, Kabanjahe. They were terrified of the curse. They had also heard that Jones had become the target of a major manhunt. The provincial health department, alarmed that a contagious patient was on the loose, had asked local officials to track him down and ship him back to the hospital in Medan. The word on the street was that police had also joined the hunt for Jones and his family.

“They’ll arrest us if we don’t go back,” Jones’s aunt warned him.

Jones objected, “If I go back there, I’ll die for sure.”

Jones and his wife debated what to do. The family told Jones they would defer to his wishes. But with his condition deteriorating, he was no longer in any shape to keep running.

After three days on the lam, Jones was readmitted to Adam Malik Hospital, a sprawling urban medical complex of white buildings with
red tile roofs that, like many public hospitals in Indonesia, was in need of a little convalescence of its own. The corridors were clean, but their tile floors were chipped and the air was sour. Many of the fluorescent lights were out. While groundskeepers kept busy raking the lawns, the grass was perpetually overgrown, and many of the bushes were draped with drying laundry. The hospital was named for a former Indonesian vice president. But a letter had fallen off the sign over the main entrance so that it now read ADA MALIK, which is Indonesian for THERE’S MALIK!

 

Though Jones had surrendered to health authorities, he was not done fighting. He refused to take Tamiflu or accept intravenous medication and injections of antibiotics. As hard as it was to breathe, he would rip the oxygen mask off his face. The nurses were terrified of him. When they came close, he would wrestle them away, flexing his tattooed biceps, or lunge at them with a fork.

The doctors treating him in the special “red zone” set up for bird flu patients looked around and found a young resident physician whose family was from Karo district. He could speak to Jones in his local dialect. Soon the resident won a measure of cooperation. But only a measure. Jones began taking his medicine but still resisted giving the blood samples required to monitor his progress. “He thought it would make him weaker. For people like him, one drop of blood is worth a plate of rice,” one doctor told me.

The red zone was demarcated with a red line painted on the hallway floor outside the two rooms where the most infectious patients were segregated. Hospital staff donned masks, helmets, rubber gloves, gowns, and boots before crossing the line. But as Jones slipped in and out of consciousness, now hooked up to a ventilator, more than a dozen unprotected family members pitched camp on the outdoor terrace just beside his room. They filtered in and out of the ward all day long, wearing neither masks nor gloves despite the timid protests of the medical staff. “We weren’t afraid of catching the disease,” his wife explained. “If we have to die, we’ll die. No one else would look after him. Even the nurses were reluctant to look after him.”

Dr. Luhur Soeroso, the silver-haired chief of the pulmonary department, took a deep interest in Jones. “This is a very rare case,” he
told me as he thumbed through the patient’s file. When I met Soeroso, he had an air of composure and comportment that seemed out of place amid the bedlam beyond his office door. He wore a pink shirt with a pair of Mont Blanc pens in his breast pocket and a red tie fastened with a gold clip. On each hand he wore a gold ring, one inlaid with small diamonds, the other with a large black stone. He had just completed writing an article about Jones that he was hoping to publish in the
New England Journal of Medicine
. While all the other family members who caught bird flu had died within twelve days of falling sick, Soeroso noted that Jones was still alive and battling the virus six weeks later.

Jones was also unusual because he had developed brain abscesses after three weeks in the hospital and was suffering from severe headaches, mental distraction, and crippling muscle pain. Soeroso attributed this to a secondary infection caused by parasites that Jones had long ago picked up in his village. The intense battery of antibiotics and other medication had depressed his immunity, allowing the parasites to attack the central nervous system. He had tested positive for a parasitic infection called toxoplasmosis. A CT scan had revealed multiple pockets of pus in his brain.

The family’s stubborn resistance to blood tests had made treatment difficult. But then the medical staff struck a deal with the family. If Jones would agree to give blood specimens, the family could invite a witch doctor to the hospital to see him.

 

 

 

Agenda Purba was laboring in his rice paddy when the Mitsubishi van drove up. He looked over to see who it was. Several passengers were strangers, but he recognized at least one man from his village. The visitors said they had a sick relative in Medan and needed Purba’s help urgently.

“Can’t you bring the patient to me? I have no way to get there,” Purba demurred.

“He can’t leave the hospital,” one visitor responded. “We’ll take you to him.”

Purba was in no mood to make the long trek to the coast. It was already late in the afternoon. “I’ll give you the right ingredients so you can do it yourself,” he said.

“No, please, can’t you do it the first time?” the visitor pressed.

Purba thought it over and agreed. “But on one condition,” he added. “Bring me all the way home again.”

Along with Suherman Bangun, Purba was one of the most prominent witch doctors in the village of Jandi Meriah. He was a skinny fifty-six-year-old with disheveled, graying hair and an oddly elongated face, carved with deep creases. A few wispy white beard hairs sprouted from his chin. His manner was agitated, almost manic, and when he spoke, he would look into space and squint, his heavy lids settling over melancholy, light brown eyes.

Even as a boy, Purba had realized he was special. He could always climb the tallest coconut trees in the village. But it was only when he turned twenty-one that he became a mystical healer. “I got the inheritance from my grandfather. He had this power. Before he died, he gave me the power by touching my left arm,” Purba told me, rolling up his sleeve, extending his arm and tapping it with his right knuckles to illustrate the bequest. “I can still communicate with him through dreams.”

Within years he became famous for his specialty: curing hernias. “If someone’s colon is sticking out their anus, I chew up some betel nut and spit on his stomach,” Purba explained with the cool detachment of a doctor describing an upcoming outpatient procedure. “I don’t have to touch him. I just light a cigarette and hold it. When it burns down to my fingertips, that’s the moment the colon goes back inside the body. But I can make it happen whenever I want. If I say you’ll heal tomorrow, you’ll heal tomorrow. If I say ‘heal now,’ you’ll heal now.” Over the years, Purba claimed his reputation had attracted patients from as far as Medan and even Java island. “I can do hernias, snakebites, and scorpion bites,” he boasted. “But I don’t do broken bones.”

Before Purba had driven off to Medan, he’d rushed home to slip on his one clean shirt and say good-bye to his wife. She’d insisted he
promise to stop along the way and eat something, reminding him he’d been under the weather and needed to keep up his strength. He promised. “I didn’t want her to get angry at me,” he recalled.

The van pulled out of Jandi Meriah about an hour before sunset and reached Adam Malik Hospital six hours later. It was midnight by the time Jones’s relatives had hoisted the ailing young man from his bed and carried him out to the terrace for the ceremony, setting him down in a chair. Purba began to prepare the ingredients. He laid out twenty-one betel pepper leaves, each about the size of his calloused palm, arranging them in rows. Then, into each, he deposited palm blossoms called
mayang
, some pasty white lime called
kapur sirih
, reddish brown chunks of an astringent called
gambir
produced from local vegetation, and bits of the orange-colored betel nut from an areca palm called
buah pinang
.

Purba asked Jones his name. Jones told him, and the witch doctor began to chant over the leaves, praying for the young man’s recovery. Then Purba lifted the first of the stuffed leaves to his lips. He chewed it up, puckered, and softly spit it onto Jones’s forehead. Bending over the patient, he gently blew the slime over the flesh. The witch doctor lifted the second leaf, chewed it up, and spit it onto Jones’s chest, repeating the same procedure. He continued until he had finished all the leaves, slathering the torso, arms, legs, hands, and feet, alternating between left side and right, making particularly sure to cover all the joints.

“Afterward, he looked better,” Purba recounted. “I asked him how he felt. He said he felt better. He felt relieved.” Purba told him to go back inside the ward and go to sleep. Then he passed a bag of ingredients to the family, instructing them to repeat the same spitting procedure four times a day: in the morning, noontime, afternoon, and night. Finally Purba asked to be taken home to his village. It was dawn when he got back.

Just three days later, the Mitsubishi van reappeared beside Purba’s paddy. The family had used up all the ingredients. They wanted Purba to return to the hospital and personally repeat the ritual. He again acceded to the request.

None of the staff at Adam Malik hospital ever objected to either
of the late-night rituals or cautioned Purba that he might be exposing himself to a killer disease. No one suggested he take Tamiflu. No one sampled his blood or monitored his health. But had they tried, Purba would have considered it silly. He knew for a fact the source of the illness striking Jones and his family, and it certainly was not bird flu.

“I know the truth because I speak to the spirits,” the witch doctor told me as we chatted on a wood bench in a thatched shelter on the village outskirts. “I know that Jones’s father made a deal with another, black-magic witch doctor. Both of them have died. But I can communicate with the spirits, so I know what happened.” According to Purba’s detailed account, Jones’s father, Ponten, had petitioned a witch doctor in the Alas River valley to help him become rich and powerful by conjuring the spirit of Begu Ganjang. The witch doctor had obliged. But Ponten never rewarded the witch doctor as promised. “The father broke his vow,” he continued. “Now the family has to pay. Now the whole family has to die.”

But Purba added that he had been able to shift the course of fate. He alone had been able to stay the execution of the remaining family members. “I’m the one to save Jones,” he said. He grinned, baring a mouthful of teeth stained black by decades of betel nut. “There will be no more casualties. Seven is enough. I drew a border around them at the hospital.” Purba stood up to demonstrate and etched a line in the dirt with the tip of his flip-flop. “It stops here,” he assured me, “because I protected the family with my magic line.”

 

 

Jones was discharged from Adam Malik Hospital ten weeks after he had been admitted. It had been a long, torturous stay. Besides losing weight and developing brain abscesses, he suffered what doctors reported was permanent lung damage. He had also become exceedingly bored during his convalescence. As his strength returned, he had begun to wander, repeatedly slipping out of the infectious disease ward for a coffee in the hospital’s small cafeteria, potentially putting other patients and staff at risk.

“I never expected to come home,” Jones recalled when I met him
less than a week after he was discharged. “It was too long in the hospital. I lost hope.” He was still taking medicine, and the doctors had instructed him to come to the hospital for a checkup every week for the next six months. So he, his wife, and their two sons had returned to the crowded, working-class neighborhood near the airport and temporarily moved in with an aunt. Jones would spend much of his time sleeping on a thin woven mat on the floor, which was where I found him when I first came to visit. He gradually roused himself and sat up on the mat. But his gaze remained vacant. Only when I asked about his plans did he smile. “I want to go back to farming, back to my orchards and grow oranges,” he said softly.

Jones was now the head of the Ginting family, the sole surviving son. But he did not know that. No one had yet had the heart to tell him that during his own long recovery, his older brother Dowes had died.

Throughout the Ginting family’s ordeal, senior Indonesian officials dismissed any possibility that the virus had been passed from one person to another. They were afraid the world might conclude this was the start of an epidemic and isolate Indonesia, crippling tourism, staggering the economy, and inciting panic. Health Minister Siti Fadilah Supari later boasted about how she’d convinced her president, Susilo Bambang Yudhoyono, that CNN reports about human transmission of the virus in Sumatra were lies. “From the lessening of the tension in his face, I knew that he trusted me,” she later wrote. Supari would continue to maintain over the coming years there had been no human spread, at times accusing those who disagreed of trying to sabotage Indonesia.

But WHO’s flu specialists were quickly convinced that nearly all the stricken family members had actually caught the disease from one another. Most had fallen sick so long after the eldest sister, Puji, that it was highly improbable they had caught it from the same source as she. More likely, Puji had infected them.

Dowes, however, could not have caught the bug from Puji. He had taken ill too long after the others. If Dowes had the virus, he had caught it while caring for his son, who had caught it from Puji. That would be an ominous precedent, marking the first time the virus had
been found to hop from one person to another and onto a third. But until samples from Dowes tested positive for the strain, this would only be speculation. There were no hospital specimens for him, unlike for most of his relatives. There were just the samples that Tim Uyeki and his colleagues collected when they located Dowes on the hilltop in Jandi Meriah.