GWOT VI - In The Time Of Cholera
Apr. 5th, 2020 08:17 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
drewkittyForeground: a woman and two men, wearing uniforms he had never even heard of. A matte red, in BDUs, with reflective stripes sewn on pockets that appeared inside-out. The woman, a captain's bars. The men, wearing chevrons he'd learned the hard way to associate with sergeants. The unit tape: RED LION. The patches on both shoulders - a lion flipping off the world, with a paw that looked like a ... penis?
The seating - pews ripped out of a church and flung to the side, then hastily propped up.
Background: a church, from which the pews had come. He could smell the reek of feces from where he stood. It came from the people piled inside, where the pews had been.
Behind the woman, a man wearing white gloves streaked with brown and red, carrying a baseball bat painted red, also streaked with brown and red. His clothes were dirty but his armbands, a black letter "G" on a white field, were surprisingly clean. Notably so.
The man stepped forward.
"I am Sergeant Jones of the Refuge Emergency Militia. You have all volunteered to help. If you do anything else, fuck off - now or then, I don't care - or I will beat you to death with this stick. Even _think_ about messing with Red Lion and we'll find a tire to set you on fire with. Not kidding.
"Introducing Healer-Captain Wilson."
He faded into the background but his eyes did not stop moving.
"Thank you for the introduction, Sergeant. I am Healer-Captain Ernestina Wilson of the Red Lion Society. If you don't know what Red Lion is... well, that's possible, we are in Iowa. We're what happens when you torture Red Cross workers. On Firecracker Day, I was a medical student at Stanford. Three weeks later I was running a radiation sickness camp in Concord. Eight weeks later I was interned, along with my patients, by Homeland. Eighteen months later the Resistance liberated the camp infirmary I was running - my seventh.
"You will call me Healer-Captain Wilson. You will call them Healer-Three Anetsky and Healer-Two Nguyen. We are here in Iowa today for the same reason we go anywhere - to save innocent lives.
"This entire region, not just this camp, is facing a cholera epidemic. Two Nguyen, cholera."
The sergeant thus described, a thin Vietnamese-Californian with etched lines where most people keep their faces, stepped forward..
"Cholera. Bacterial infection. Originated in Ganges Delta in India in the 19th century. Now endemic worldwide, partly due to carelessness by world relief organizations including the United Nations. Reached Africa in the 1970s, reached South America in the 1990s, and from there to North America today. Caused by eating food or drinking water contaminated with bacterium Vibrio cholerae 1.
"Cholera epidemics do not exist in peacetime conditions because clean drinking water and sanitary toilets for feces prevents its spread. This is a severe poverty, disaster and war disease.
"Time of onset: 12 hours to five days. Symptoms: profuse vomiting, acute watery diarrhea. Mechanism of death: severe dehydration, can kill within hours. Death rate with antibiotics and IV fluid support: well less than 1%. Death rate with no IVs and no antibiotics, but oral rehydration salts and field nursing, 20%. Death rate without any treatment, 50%.
"Most infected persons are asymptomatic but their feces contain cholera for one to ten days, infecting others. Most people who develop symptoms have watery stools but recover quickly. Those who do not, are either given medical care, or supportive care, or die swiftly.
"Oral rehydration salts are packets dissolved in quarts of water. One adult moderate case may require six quarts and therefore packets per day. Field expedients for ORS are possible but require access to salt and sugar. Zinc is indicated for children under five. Breastfeeding must be strongly encouraged.
"Vaccines provide one to three years of protection. This is an unprotected population; only California soldiers and Red Lion Helpers are recently immunized.
"Handwashing with soap and water for twenty seconds, properly boiling or sanitizing water, storing food away from insects and controlling toilet habits of the sick and small children are critical control points. Proper disposal of infected human remains is vital but impossible in wartime conditions.
"Due to disruption caused by the Firecracker War, 2nd American Civil War, and continuing instability, World Health Organization classifies the former American states as cholera endemic.
Logistics reports that neither IVs nor antibiotics nor ORS are available in zone. Intelligence confirms that no public health medical surveillance is available in Western Iowa. We have sent samples for testing but have no laboratory. Ma'am."
She turned from him back to the crowd.
"Thank you, Helper."
"This is where you people come in. Red Lion offers to hire you as auxiliary field workers. The pay is two meals a day, a safe place to sleep, a vest to wear that you must wear, and the knowledge that you are saving lives. Also, when you become ill which you probably will, medical care equal to that given to others in the safe zone.
"What you will do is whatever needs doing. You may teach handwashing. You may teach how to build latrines; you may build latrines. You will wash the sick and give clean water to the sick. You will dispose of their infected feces. You will become initiates of the mysteries of death. You will carry corpses and you will dispose of them properly.
"Each of you may select one other person, who is not able bodied, to be fed one meal a day and kept in a secure camp. Such camps have been overrun in the past; there are no guarantees in war. But we will do what we can to keep your dependent safe. All able bodied people will work.
"There is no personal protective equipment. We have no vaccine with us. You just heard that we have no antibiotics and no ORS and no IV fluid support.
"If you take this job, about 20% of you will die.
"We estimate over one million refugees in western Iowa today, more with the war between the Churches and Refuge and the California Expeditionary Force.
"If nothing is done, half of them will die. Five hundred thousand, disproportionately children.
"Take one step forward or get out of here now."
The seating - pews ripped out of a church and flung to the side, then hastily propped up.
Background: a church, from which the pews had come. He could smell the reek of feces from where he stood. It came from the people piled inside, where the pews had been.
Behind the woman, a man wearing white gloves streaked with brown and red, carrying a baseball bat painted red, also streaked with brown and red. His clothes were dirty but his armbands, a black letter "G" on a white field, were surprisingly clean. Notably so.
The man stepped forward.
"I am Sergeant Jones of the Refuge Emergency Militia. You have all volunteered to help. If you do anything else, fuck off - now or then, I don't care - or I will beat you to death with this stick. Even _think_ about messing with Red Lion and we'll find a tire to set you on fire with. Not kidding.
"Introducing Healer-Captain Wilson."
He faded into the background but his eyes did not stop moving.
"Thank you for the introduction, Sergeant. I am Healer-Captain Ernestina Wilson of the Red Lion Society. If you don't know what Red Lion is... well, that's possible, we are in Iowa. We're what happens when you torture Red Cross workers. On Firecracker Day, I was a medical student at Stanford. Three weeks later I was running a radiation sickness camp in Concord. Eight weeks later I was interned, along with my patients, by Homeland. Eighteen months later the Resistance liberated the camp infirmary I was running - my seventh.
"You will call me Healer-Captain Wilson. You will call them Healer-Three Anetsky and Healer-Two Nguyen. We are here in Iowa today for the same reason we go anywhere - to save innocent lives.
"This entire region, not just this camp, is facing a cholera epidemic. Two Nguyen, cholera."
The sergeant thus described, a thin Vietnamese-Californian with etched lines where most people keep their faces, stepped forward..
"Cholera. Bacterial infection. Originated in Ganges Delta in India in the 19th century. Now endemic worldwide, partly due to carelessness by world relief organizations including the United Nations. Reached Africa in the 1970s, reached South America in the 1990s, and from there to North America today. Caused by eating food or drinking water contaminated with bacterium Vibrio cholerae 1.
"Cholera epidemics do not exist in peacetime conditions because clean drinking water and sanitary toilets for feces prevents its spread. This is a severe poverty, disaster and war disease.
"Time of onset: 12 hours to five days. Symptoms: profuse vomiting, acute watery diarrhea. Mechanism of death: severe dehydration, can kill within hours. Death rate with antibiotics and IV fluid support: well less than 1%. Death rate with no IVs and no antibiotics, but oral rehydration salts and field nursing, 20%. Death rate without any treatment, 50%.
"Most infected persons are asymptomatic but their feces contain cholera for one to ten days, infecting others. Most people who develop symptoms have watery stools but recover quickly. Those who do not, are either given medical care, or supportive care, or die swiftly.
"Oral rehydration salts are packets dissolved in quarts of water. One adult moderate case may require six quarts and therefore packets per day. Field expedients for ORS are possible but require access to salt and sugar. Zinc is indicated for children under five. Breastfeeding must be strongly encouraged.
"Vaccines provide one to three years of protection. This is an unprotected population; only California soldiers and Red Lion Helpers are recently immunized.
"Handwashing with soap and water for twenty seconds, properly boiling or sanitizing water, storing food away from insects and controlling toilet habits of the sick and small children are critical control points. Proper disposal of infected human remains is vital but impossible in wartime conditions.
"Due to disruption caused by the Firecracker War, 2nd American Civil War, and continuing instability, World Health Organization classifies the former American states as cholera endemic.
Logistics reports that neither IVs nor antibiotics nor ORS are available in zone. Intelligence confirms that no public health medical surveillance is available in Western Iowa. We have sent samples for testing but have no laboratory. Ma'am."
She turned from him back to the crowd.
"Thank you, Helper."
"This is where you people come in. Red Lion offers to hire you as auxiliary field workers. The pay is two meals a day, a safe place to sleep, a vest to wear that you must wear, and the knowledge that you are saving lives. Also, when you become ill which you probably will, medical care equal to that given to others in the safe zone.
"What you will do is whatever needs doing. You may teach handwashing. You may teach how to build latrines; you may build latrines. You will wash the sick and give clean water to the sick. You will dispose of their infected feces. You will become initiates of the mysteries of death. You will carry corpses and you will dispose of them properly.
"Each of you may select one other person, who is not able bodied, to be fed one meal a day and kept in a secure camp. Such camps have been overrun in the past; there are no guarantees in war. But we will do what we can to keep your dependent safe. All able bodied people will work.
"There is no personal protective equipment. We have no vaccine with us. You just heard that we have no antibiotics and no ORS and no IV fluid support.
"If you take this job, about 20% of you will die.
"We estimate over one million refugees in western Iowa today, more with the war between the Churches and Refuge and the California Expeditionary Force.
"If nothing is done, half of them will die. Five hundred thousand, disproportionately children.
"Take one step forward or get out of here now."
