I stared at the wonderful contraption. “And you wrote the Yeyuka software on this?”
“Absolutely.” She smiled proudly. “First, the software characterises any damaged surface adhesion molecules it finds — there are always a few floating freely in the bloodstream, and their exact shape depends on the strain of Yeyuka, and the particular cells that have been infected. Then drugs are tailor-made to lock on to those damaged adhesion molecules, and kill the infected cells by rupturing their membranes.” As she spoke, she typed on the keyboard, summoning up animations to illustrate each stage of the process. “If we can get this onto a real machine…we’ll be able to cure three people a day.”
Cure. Not just cut them open to delay the inevitable.
“But where did all the raw data come from? The RNA sequencing, the X-ray diffraction studies…?”
The woman’s smile vanished. “An insider at HealthGuard found it in the company archives, and sent it to us over the net.”
“I don’t understand. When did HealthGuard do Yeyuka studies? Why haven’t they published them? Why haven’t they written software themselves?”
She glanced uncertainly at Masika. He said, “HealthGuard’s parent company collected blood from five thousand people in southern Uganda in 2013. Supposedly to follow up on the effectiveness of their HIV vaccine. What they actually wanted, though, was a large sample of metastasising cells so they could perfect the biggest selling point of the HealthGuard: cancer protection. Yeyuka offered them the cheapest, simplest way to get the data they needed.”
I’d been half expecting something like this since Masika’s comments back in the hospital, but I was still shaken. To collect the data dishonestly was bad enough, but to bury information that was halfway to a cure — just to save paying for what they’d taken — was unspeakable.
I said, “Sue the bastards! Get everyone who had samples taken together for a class action: royalties plus punitive damages. You’ll raise hundreds of millions of dollars. Then you can buy as many machines as you want.”
The woman laughed bitterly. “We have no proof. The files were sent anonymously, there’s no way to authenticate their origin. And can you imagine how much HealthGuard would spend on their defence? We can’t afford to waste the next twenty years in a legal battle, just for the satisfaction of shouting the truth from the rooftops. The only way we can be sure of making use of this software is to get a bootleg machine, and do everything in silence.”
I stared at the screen, at the cure being played out in simulation that should have been happening three times a day in Mulago Hospital. She was right, though. However hard it was to stomach, taking on HealthGuard directly would be futile.
Walking back across the campus with Masika, I kept thinking of the girl with the liver infestation, and the possibility of undoing the moment of clumsiness that would otherwise almost certainly kill her. I said, “Maybe I can get hold of a bootleg machine in Shanghai. If I knew where to ask, where to look.” They’d certainly be expensive, but they’d have to be much cheaper than a commissioned model, running without the usual software and support.
My hand moved almost unconsciously to check the metal pulse on my index finger. I held the ring up in the starlight. “I’d give you this, if it was mine to give. But that’s thirty years away.” Masika didn’t reply, too polite to suggest that if I’d owned the ring outright, I wouldn’t even have raised the possibility.
We reached the University Hall; I could find my way back to the guest house now. But I couldn’t leave it at that; I couldn’t face another six weeks of surgery unless I knew that something was going to come of the night’s revelations. I said, “Look, I don’t have connections to any black market, I don’t have a clue how to go about getting a machine. But if you can find out what I have to do, and it’s within my power…I’ll do it.”
Masika smiled, and nodded thanks, but I could tell that he didn’t believe me. I wondered how many other people had made promises like this, then vanished back into the world-without-disease while the Yeyuka wards kept overflowing.
As he turned to go, I put a hand on his shoulder to stop him. “I mean it. Whatever it takes, I’ll do it.”
He met my eyes in the dark, trying to judge something deeper than this easy protestation of sincerity. I felt a sudden flicker of shame; I’d completely forgotten that I was an impostor, that I’d never really meant to come here, that two months ago a few words from Lisa would have seen me throw away my ticket, gratefully.
Masika said quietly, “Then I’m sorry that I doubted you. And I’ll take you at your word.”
Mubende was a district capital, half a day’s drive west of Kampala. Iganga delayed our promised trip to the Yeyuka clinic there until my last fortnight, and once I arrived I could understand why. It was everything I’d feared: starved of funds, under-staffed and over-crowded. Patients’ relatives were required to provide and wash the bedclothes, and half of them also seemed to be bringing in painkillers and other drugs bought at the local markets — some genuine, some ripoffs full of nothing but glucose or magnesium sulphate.
Most of the patients had four or five separate tumours. I treated two people a day, with operations lasting six to eight hours. In ten days, seven people died in front of me; dozens more died in the wards, waiting for surgery.
Or waiting for something better.
I shared a crowded room at the back of the clinic with Masika and Okwera, but even on the rare occasions when I caught Masika alone, he seemed reluctant to discuss the details of getting hold of a bootleg HealthGuard. He said, “Right now, the less you know the better. When the time comes, I’ll fill you in.”
The ordeal of the patients was overwhelming, but I felt more for the clinic’s sole doctor and two nurses; for them, it never ended. The morning we packed our equipment into the truck and headed back for Kampala, I felt like a deserter from some stupid, pointless war: guilty about the colleagues I was leaving behind, but almost euphoric with relief to be out of it myself. I knew I couldn’t have stayed on here — or even in Kampala — month after month, year after year. However much I wished that I could have been that strong, I understood now that I wasn’t.
There was a brief, loud stuttering sound, then the truck squealed to a halt. The four of us were all in the back, guarding the equipment against potholes, with the tarpaulin above us blocking everything but a narrow rear view. I glanced at the others; someone outside shouted in Luganda at Akena Ibingira, the driver, and he started shouting back.
Okwera said, “Bandits.”
I felt my heart racing. “You’re kidding?”
There was another burst of gunfire. I heard Ibingira jump out of the cab, still muttering angrily.
Everyone was looking at Okwera for advice. He said, “Just cooperate, give them what they want.” I tried to read his face; he seemed grim but not desperate — he expected unpleasantness, but not a massacre. Iganga was sitting on the bench beside me; I reached for her hand almost without thinking. We were both trembling. She squeezed my fingers for a moment, then pulled free.
Two tall, smiling men in dirty-brown camouflage appeared at the back of the truck, gesturing with automatic weapons for us to climb out. Okwera went first, but Masika, who’d been sitting beside him, hung back. Iganga was nearer to the exit than me, but I tried to get past her; I had some half-baked idea that this would somehow lessen her risk of being taken off and raped. When one of the bandits blocked my way and waved her forward, I thought this fear had been confirmed.