Gregory David Roberts - Shantaram

"We'll take these samples and have them analysed," he said, nodding to an assistant who filed blood, sputum, and stool samples in a metal carry case. "But I'm sure you're right, Hamid.

There are twelve other cholera outbreaks, between here and Kandivli. They're small, mostly. But there's a bad one in Thane- more than a hundred new cases every day. All the local hospitals are overcrowded. But this is not bad, really, for the monsoon. We hope we can keep a cap on it at fifteen or twenty infection sites."

I waited for one of the others to speak, but they simply nodded their heads gravely.

"We've got to get these people to hospital," I said at last.

"Look," he replied, glancing around him and drawing a deep breath, "we can take some of the critical cases. I'll arrange it.

But it's just not possible to take everyone. I'm not going to tell you any lies. It's the same in ten other hutments. I've been to them all, and the message is the same. You have to fight it out here, on your own. You have to get through it." "Are you out of your fucking mind?" I snarled at him, feeling the fear prowl in my gut. "We already lost my neighbour Radha this morning. There's thirty thousand people here. It's ridiculous to say we have to fight it out ourselves. You're the health department, for God's sake!"

Sandeep Jyoti watched his assistant close and secure the sample cases. When he turned back to me, I saw that his bloodshot eyes were angry. He resented the indignant tone, especially coming from a foreigner, and was embarrassed that his department couldn't do more for the slum-dwellers. If it hadn't been so obvious to him that I lived and worked in the slum, and that the people liked me as much as they relied on me, he would've told me to go to hell. I watched all those thoughts shift across his tired, handsome face and then I saw the patient, resigned, almost affectionate smile that replaced them as he ran a hand through his untidy hair.

"Look, I really don't need a lecture from a foreigner, from a rich country, about how badly we look after our own people, or the value of a human life. I know you're upset, and Hamid tells me you do a good job here, but I deal with this situation every day, all over the state. There are a hundred million people in Maharashtra, and we value them all. We do our best."

"Sure you do," I sighed in return, reaching out to touch his arm.

"I'm sorry. I didn't mean to take it out on you. I'm just... I'm way out of my depth here and... I guess I'm scared."

"Why do you stay here, when you can leave?"

It was an abrupt question, under the circumstances, and almost rude. I couldn't answer it.

"I don't know. I don't know. I love... I love this city. Why do you stay?"

He studied my eyes for a moment longer, and then his frown softened again in a gentle smile.

"What help can you give us?" Doctor Hamid asked.

"Not much, I'm sorry to say." He looked at the dread in my eyes, and heaved a sigh from the hill of exhaustion in his heart. "I'll arrange for some trained volunteers to come and give you a hand.

I wish I could do more. But I'm sure, you know, I'm sure that you all can handle it here-probably a lot better than you think, just at this moment. You've already made a good start. Where did you get the salts?"

"I brought them," Hamid answered quickly, because the ORT salts had been supplied illegally by Khaderbhai's lepers. "When I told him I thought we had cholera here, he brought the ORTs, and told me how to use them," I added. "But it's not easy.

Some of these people are too sick to hold them down."

ORT, or Oral Rehydration Therapy, had been devised by Jon Rohde, a scientist who worked with local and UNICEF doctors in Bangladesh during the late 1960s and early 1970s. The oral rehydration solution that he developed contained distilled water, sugar, common salt, and other minerals in carefully mixed proportions. Rohde knew that what kills people who are contaminated with the cholera bacterium is dehydration. The ugly fact is that they shit and vomit themselves to death. He discovered that a solution of water, salt, and sugar kept people alive long enough for the bacterium to pass through their systems. Ranjit's lepers, at Doctor Hamid's request, had given me boxes of the solution. I had no idea how much more of the stuff we could expect to receive, or how much we would need.

"We can get you a delivery of salts," Sandeep Jyoti said. "We'll get them to you as soon as possible. The city is stretched to its limits, but I'll make sure you get a team of volunteers here as soon as we can send them. I'll put a priority on it. Good luck."

We watched in grim silence as he followed his assistant out of the slum. We were all afraid.

Qasim Ali Hussein took control. He declared his home to be a command centre. We called a meeting there, and some twenty men and women gathered to devise a plan. Cholera is largely a water borne disease. The vibrio cholerae bacterium spreads from contaminated water and lodges itself in the small intestine, producing the fever, diarrhoea, and vomiting that cause dehydration and death. We determined to purify the slum's water, beginning with the holding tanks and then moving on to the pots and buckets in each of the seven thousand huts. Qasim Ali produced a bundle of rupee notes as thick as a man's knee, and gave it to Johnny Cigar, deputing him to buy the water purification tablets and other medicines we would need.

Because so much rainwater had accumulated in puddles and rivulets throughout the slum, those too had provided breeding grounds for the bacteria. It was decided that a chain of shallow trenches would be established at strategic points in the lanes of the slum. They would be filled with disinfectant, and each person walking the lane would be required to pass through the ankle-deep antiseptic drench. Plastic bins for safe disposal of waste materials were to be placed at designated points, and antiseptic soap would be given to every household.

Soup kitchens would be established in the chai shops and restaurants to provide safe, boiled food and sterilised cups and bowls. A team was also assigned to the task of removing the bodies of the dead and taking them on a trundle-cart to the hospital. My task was to supervise the use of the oral rehydration solution and to prepare batches of a homemade mixture as required.

They were all huge undertakings and onerous responsibilities, but no man or woman at the gathering hesitated in accepting them.

It's a characteristic of human nature that the best qualities, called up quickly in a crisis, are very often the hardest to find in a prosperous calm. The contours of all our virtues are shaped by adversity. But there was another reason, far from virtue, for my own eagerness to accept the tasks-a reason found in shame. My neighbour Radha had been desperately ill for two days before she died, and I'd known nothing of it at the time. I was gripped by a feeling that my pride, my hubris, was responsible for the sickness in some way: that my clinic was founded in an arrogance - my arrogance-that had allowed the disease to breed in the smear of its conceits. I knew that nothing I'd done or neglected to do had caused the epidemic. And I knew that the disease wouldVe attacked the slum, sooner or later, with or without my presence. But I couldn't shake off the feeling that, somehow, my complacency had made me complicit.

Just a week before, I'd celebrated with dancing and drinking because, when I'd opened my little clinic, no-one had come. Not one man, woman, or child in all the thousands had needed my help.

The treatment queue that had begun with hundreds, nine months before, had finally dwindled to none. And I'd danced and drunk with Prabaker that day, as if I'd cured the whole slum of its ailments and illnesses. That celebration seemed vain and stupid as I hurried through the sodden lanes to the scores who were sick. And there was guilt in that shame as well. For the two days while my neighbour Radha lay dying, I'd been ingratiating myself with tourist customers in their five-star hotel. While she'd writhed and thrashed on a damp earth floor, I'd been calling down to room service to order more ice-cream and crepes.