i was a young doctor in africa when aids hit. i saw how it could devastate populations. i also saw how first responders, doctors, nurses and health care workers make the difference. infectious diseases are a global threat. the unseen enemy is a compelling, urgent film that urges the important conversation about what we can all do to protect our families from these diseases.

>> hello, good morning. >> it's 5:00 a.m. in the east. let's start. >> good morning. >> i think -- >> the centers for disease control today issued a health warning following a worldwide outbreak of a mysticous form of few monia. >> people have come down with hars. [ speaking foreign language ] >> the world health organization has declared a swine flu pandemic. >> spread of the h1n1 swine flu. >> it cannot be contained. >> i think we can contain spread -- >> the pan democratics must be taken seriously. >> a big outbreak of a deadly ebola virus has broken out.

>> in the african country of againy has spread. >> people know nothing. there's no cure. >> they don't have the resources -- >> governments rrnd around the world are calling for new measures. >> another case of bird flu. >> it's critical that they control this. >> you have to respond to the challenge. >> three latest victims of the new respiratory virus calls mers has come from middle eastern countries. they believe it originated in bats or camel. >> rapid kidney failure. >> as the zika virus continues to threaten people across the globe -- >> a link to bird flu. >> transmitted by mosquitoes. >> proper mosquitoes could 2r7 the virus.

>> i believe there's such a thing as being too late. >> there's a concern -- [ speaking foreign language ]. >> at home. you can almost hear the biological chatter. >> aids, zika virus. >> contagious -- >> just when technology and science was supposed to make us safer, we suddenly seem more vulnerable to outbreaks. >> whether we like it or not, our world is globalizing ever more. that's not only true for markets and production, but it's also true for behaviors, for

diseases. so we're more vulnerable because of our mobility and we're living in crowded cities. that's fantastic from the per suspective of a virus because in no time, it can infect hundreds of thousands of people. >> there have been about 30 newly emerged diseases that have the potential to become pan democratics. if we do nothing, it's not a matter of if there will be a global pandemic. it's just a matter of when and which virus and how bad. >> the world changes around us at increasing speed. we caused a lot of that change. migrating to cities, stripping the earth of its resources and altaring prime evil jungle. >> we are seeing whole entire

ecologies, that which you can see with your eye and that which you can see only with a microscope. >> one system after another completely reshaped. >> is there a sense -- >> in every case this aforpds opportunities for viruss and bacteria to seek out new homes, cause new havoc, including disease for human beings. >> when contagion happens, life altars in an instant. we don't feel safe. we lose trust. >> it spreads very quickly when you have an infectious disease outbreak. people know what's happening in another part of the world so much more quickly, so much more vividly than ever before, so the contagion of fear moves faster than the con day june of the disease itself and the fabric of society starts to detheater.

>> there's something that destroys the soul of a community that happens when an epidemic is out of control. it's not just the large number of casualties and the deaths, which are itself unthinkable, but it's what it does to the social fabric of a community, our nation. >> the war lasted for 14 years. i was quite little but i still remember vividly everything i saw.

sometimes in a place where it is dark, you can see the bullets flying, like bolts of lightning across the sky. phys pick -- physically see them. a fire will bundle all of us and we hear the opposite direction. huh? you know the bullets are coming this way because you hear the sound coming. huh? and you see the soldiers going that way to go and fight it, so you know you have to go the other way. a look at ebola. how you going to protect yourself? you have an enemy you cannot hide from. you cannot run from ebola. where are you going to go?

who are you going to run to? i got information yesterday that the ebola virus is here. >> ebola is transmitted through bodily fluids, sew liva, blood, u ryan, feces. >> ebola first surfaced in west afternoon ka in a rural community. but this ebola outbreak didn't say in the countryside. the virus quickly found its way to the region's largest cities and health systems that were completely unprepared.

>> i graduated from nurse school two years ago. the reason why i'm here is quite different because i was the only one available. i'm a general practitioner and i got one day training to get prepared for this. we started our mission. the following morning there were ambulances liepd up at our gates and we were not prepared. before we even knew it, we already were overwhelmed with so many patients. >> have a nice visit.

i will take one or two. >> i got that impression i was in haiti, because it was a makeshift structure. the patients are vomiting, bleeding and having diarrhea on the floor and two or three patients have already died, bodies were still there. in three days time, the entire unit was full. meanwhile, there was still patients, and they are begging every time. every time you go to the gate they are begging to come in. we have 35 beds and we have one patients only one. that means patients lie on the floor. you don't have beds but you

facing a group of people who are dying. you know they're dying. you see they're very sick. they are so weak. what if they go home? what if a taxicab these patients are going to go home to die. every one of the taxicabs are infected. and what about the snoem the communities the people go into. maybe we should just open the gate and let them come in and lie on the more in to die. so we just open the gate and just let them in, sometimes 20 persons. and they will we will be to three, four, five hours, trying to give them fluids and other

medicines. and then it never ends. as you are walking out a new patient is walking in. and then when you go home and come back the following morning. there are seven, eight dead for one night. >> i think we all underestimated. absolutely everybody. i know that one case of ebola is an emergency. every new case can give rise to more cases. so it's really act now or pay later. >> right now, the world health organization and other doctors are saying it is out of control in this area of west africa. it's the worst outbreak ever

they've recorded in this part of the world. >> it's unprecedented for several reasons, one, it's the first in west africa. second, it's the first time that -- thirdly, it's first time we have outbreaks in capitol city. >> this could sfloed a megacrisis. >> i think so. >> i really thought how can this epidemic be controlled in the usual way whether there are so many outbreaks different places? the three countries in west africa that are affected by the ebola outbreak have some of the worst health indicators in the world. there are not enough doctors. there are not enough nurses. it is a system that is understaffed, underfunded, and where the infrastructure is very, very old. >> let's go back to 1976 when you were a younger man and you

actually co-discovered this virus. it was in zaire. >> yes. >> now the democratic republic of the kongso. how -- >> and they said it was a mystic out epidemic, it was very lethal, high mohr tality. there were nuns who had died. a small group would go to the mission where the epidemic had started, apparently. they asked for volunteers and i think i was about the first one to raise my hand. although i had absolutely zero experience in doing this. [ speaking foreign language ] >> our mission was to -- one, to put in place some basic measures to contain it and using quarantine. that's what we thought, and, two, to find out how is this transmitted.

because that's the key to stop epidemics, to know exactly what the risk is, how is it transmitted. it's really detective work. so we tested whole villages, talked to the population, and then have a very primitive question aaron, how old, where have they been and what we found is that there were very few survivors and that the case fatality rate was over 90%. nearly all new viruss come from animals.

here human pry mates. during the outbreak we started collecting samples from all kinds of animals. i even took bloods in pigs because a number of pigs decide at the beginning of the epidemic, so we said you never know, but we didn't find any trace of ebola. my boss at the time had always told me, watch out for the bats. and it became a bit of a joke, but the old man was right, because the only reservoir that we think were ebola is hiding are some kind of fruit eating bats. >> when i was a child i really liked to read all these science fictions. i reallyize science really fantastic.

you can find something new. this is why i'm working on if emerging or reemerging bacteria and viruss. i think from ebola, when you put all the data together, transmission, rules or cycle, it's clear. so definitely, it's from bats. and then you have intermediate host. it could be some mammals, either -- and then i could also be directed from bats to humans. you can see. ebola, sars and mers are all from bats, so they're a very serious problem. >> if we look around the world, you can see that bat populations are being severely stressed by climate change.

some of them because they live in the upper tiers of rainforests and feed on wild fruit, but the upper tiers of rainforests are getting the biggest impact of the heat increase and increase of heat radiation. add to that that humans are encroaching into the forests. bats are shy reaches. they too not seek them out. we see more and more bat populations starving and coming into human habitation areas to feed on our agricultural production. in the process, they're passing their virus on to other animals and to humans. we are imposing changes in the microbial world willy-nilly, thoughtlessly and we do so at our peril.

>> we have dramaticcally increased our contact with animals in a variety of ways. through deforestation, industrialization of agriculture, and vastly increased consumption of animals. hiv spread out of africa from a few murngies and chimpanzees to affect millions of people on every continent. sars jumped from a bat to a sieve it cat to a person to countries in a matter of a few weeks. animal and human health are completely linked. in the 21st century, 75% of all new infectious diseases have come from animals. sometimes directly. in other cases through intermediaries like mosquitos.

j if anyone had sat down and done a fantasy hit parade of emerging diseases that might come to the americas from africa or from asia, zika would never even have been on the list. zika virus originated in africa and had never been off the african continent until it started making its way across asia and south pacific, ending up in french polynesia and, yap. yap is a small place that most people have never heard of but when zika hit it, 70% of the population got infected. that was really quite startling. if anybody had been paying attention. >> but they weren't. zika jumped from the south pacific to brazil? 2013, two years before it was identified there. the timeline corresponds to an

increase in travel between the south pacific and brazil. including visitors who attended a preworld cup soccer tournament, the confederation cup. >> scoooore! >> someone was carrying the zika virus and some individual got bitten and absorbed the virus. that's the beginning of the saga. and then undoubtedly, the el nino weather event provided the necessary ingredients, rainfall and drought that fundamentally changed the conditions on the ground andallowed for the spread of this virus. >> come, come, come.

[ speaking foreign language ] [ speaking foreign language ] [ speaking foreign language ] [ speaking foreign language ]

[ speaking foreign language ] [ speaking foreign language ]

[ speaking foreign language ] >> in 2015, the zika virus suddenly spread across brazil, primarily through the bite of one type of mosquito. the medical establishment only began to comprehend zika's danger as the number of babies born with the defect micro cephaly started to dramatically increase. [ speaking foreign language ]

[ speaking foreign language ] [ speaking foreign language ] [ speaking foreign language ]

[ speaking foreign language ] since the alarm went sounding around the world from be still, we have seen almost every day another revelation about this virus. what we now know is that this is a slow dangerous virus. we grossly underestimated it. it is malaria in that it is transmitted by mosquitos and can cause enormous outbreaks. it is hiv in that it is sexually transmitted and it is worst than all the above as we come to

understand what this virus actually lives on. where does the virus go in a pregnant woman? it goes into this tiny forming creep, the fightous and it feeds on it and reineffects back into the mother's bloodstream over and over again. and what is it feeding on in that fetus? baby brain cells. and so every single part of the brain of that developing child is damaged. >> the zika virus affects its victims in a completely different way from the ebola virus. what they share in common is how fast they can move. randomly attacking some, while sparing others. some epidemics grab our attention while others, in spite of the larger number of victims, remason more hidden.

>> it's so close. we still get. welcome. >> owatonna, minnesota. it's a beautiful town. to me, it's like mayberry, rfd, opie tailor made's town. the chief brought a sick princess here because of healing waters. >> when we moved here it just felt like home. i think we got lucky. the good lord just gave us two good kids. sarah was always the princess. shannon was opposite.

she was a tomboy. she loved skate boarding. and she loved video games. >> shannon, she was a complete surprise. >> shannon. >> sarah was almost 16 and i was 40. she was a joy right from the get-go, she was a joy for everybody. >> we were a tight family. >> first time out by herself. oh, my gosh! >> when she got her permit, she was so tickled. >> she goes by herself. >> i was so proud of her. >> oh, my gosh, oh, my gosh. somebody's driving. that a girl. oops. oh, hi. >> she was in her senior year of

high school, she came home wednesday night, said i think i got the flu at school. that was wednesday. >> and thursday she didn't seem to be, you know, baseline for being sick. but she wasn't getting better. and that's when terry and i agreed we've got to take her. >> when i took her that sunday to go to the hospital. we waited two hours. it was that packed. that's when i knew there was a big epidemic of flu going on. she's sitting next to me, she's got her head on me. i took a selfie, scent it to her mom, said we're still waiting. >> the doctor said it was the flu, it had to run its course. they gave her some cough medicine just for comfort. terry went and got it. while i got her back into bed. [ texting sounds ]

>> it's about 5:00 in the morning. i was sitting in the living room and i heard her moving around upstairs. i thought, wow, she's getting out of bed. i got 7-and i went to the coffee maker and i saw my peripheral that she got up and went to the bathroom. she tapped on the shower curtain and i said you want to take a shower and she nodded yes. i said ok. i was filling the water and it got so full. she laid back and her knees kept buckling. she kept pushing on the end of the tub to keep herself from sliding under it. then i saw her eyes and --

[ sighs ] i woke terry up. >> said she's not breathing and i come running down and i still remember her on the floor, mom giving her cpr. >> i'd never had to do that before and it's not like they teach you in class. >> all i could do is dial 911. [ telephone ringing ] >> 911. what's going on there no. >> my daughter's 17 years old. >> she's not breathing! >> she's not breathing. >> not breathing? >> stay on the line with me. hold on. >> please! oh, lord. come on in. she's right in there. go ahead.

>> i just remember a pair of blue pants that kneeled down on the other side of her and he told me they'd take over and i stepped away. >> even when they said we're flying her to rochester, i waved at the helicopter, thinking everything's fine. i had no clue. [ machines beeping ] [ steady tone ] >> when they said she didn't make it and i said i want to see her. they said you'd never recognize her. the flu killed her organs long before she actually died.

i still think she ought to be coming home. >> the biggest pain in the world as a parent is losing their child. this is the most unnatural thing to happen to a human being, and you stand next to it and you think my goodness, i am there to prevent this from happening and sometimes i cannot. and sometimes i don't know why i cannot. >> the question of how and why one particular person may die from influenza is the million dollar question that we need to tackle. >> it is surprising how much we

need to learn about flu, a disease that causes worldwide epidemics every year. >> she had a little raspiness in her chest. >> it came back positive. i remember saying ok. it's no big deal. it's just the flu. >> it hospitalized three to five million. >> within 24 hours she was sbe baited. >> killing at least 200,000 every year. >> we went in as they were coding her. >> my baby girl scarlett pronounced dead. >> the majority of the adult influenza have something called a risk factor. they have a weak immune system or diabetes or a pregnant woman having a risk for both themselves as well as the child. we know these factors. but this is a virus that can

mess up your body to degree that even the most healthy young unhappy playful person is taken away from this planet in a couple of days. >> every year, we struggle to fight seasonal flu. but what experts are really afraid of is a new strain of flu. one that the human population hasn't been exposed to before. one that almost no one will have any immunity against.

when you're so fascinated by the virus or by a problem, only then you just forget about everything and you just continue. >> the goal is we want to make a vaccine to prevent hiv, to prevent hiv infection, to prevent aids. we have people in u.s. and people in africa and asia also cooperating with us. hundreds and hundreds. hundreds of people.

sometimes i am afraid. things can go faster. infectious diseases, they take the plane, they are everywhere. you really want to surprise, yeah, create surprise so that it cannot be transmitted anymore. we need to be more smart than nature to beat it. >> i definitely would like a better world. and i want try to do something useful for it. so that's -- i think it's also impacted by having kids, so more and more that's something you want to give them something better at the end of the day.

>> when we think about the threat of a disease spreading around the world as a pandemic threat, obviously airborne infections are at the very top. things like sars and flu are something that we know is difficult to control because of the way it spreads through aerosols. most people become infectious with the flu before they even have symptoms. anybody can travel clearly across the world with an infectious disease incubating in them without them even knowing that they're sick yet. >> in 2009, a new flu emerged, h1n1. also known as swine flu. we now know it first appeared in the u.s. in the pig industry, initially infecting people at state and county fairs. in a little over a year, swine flu infected around 1.3 billion

people. it was the most common shared experience on earth. flu poses a great pandemic threat because it has the kpasz to be very deadly. >> what we're most worried about right now is this bird flu that we know is highly pathogenic. >> kills between 50 and 60% of the people it ineffects. >> currently, this deadly new bird flu doesn't spread easily between people. but it is spreading rapidly among wild birds and poultry.

experts are afraid this could be a pandemic threat. >> it's a live poultry market, so the birds are alive. they're sold alive because people value the fact that it's very fresh meat. so you buy your chicken or your duck alive and then it is killed and cleaned, emptied, of course. eviscerated. the viscera go into some of these buckets here and then the birds are put in hot water and then put in these drums where these plastic tubings help get rid of the feathers. and then when the birds have been defeathered, eviscerated and cleaned, they're cut up and given back to the person who bought it.

the issue here is that the water is the same to clean all the ducks and chickens. the other issue is that these people are wading in viscera, feathers and the water that seshs to clean them. so there's really a lot -- a lot of virus here. >> in 2011 when the pasteur institute started monitoring the wash water, 18% of the water samples were positive for h 5 n 1. four years later, 66% of samples were positive. >> we know that bird flu is very, very deadly. and we know swine flu spreads very quickly. what we worry about is that if those two reabsorb and we could have a new strain that could spread as quickly as the swine flu did but have the mohr tality

rate of the bird flu. that's the big fear. that we've now literally created the petri dish that we were worried about and both viruss are sitting in there at the same time. >> pan democratics are one of the biggest risks we face. >> this is an yirk of human lives. it should be thought of in the same way that we think of terrorism, protection against national disasters against national defense. this is a human security issue and it is also an economic security issue. >> the ute break of sars could trigger a global downturn. >> fear of the sars virus has caused serious financial damage to businesses, cities, even entire countries. >> at the height of sars, nobody was going to restaurants. people didn't want to go shopping.

at one point, retail sales were down by 50% and travel to asia was down. estimates of the impact of sars have been an economic impact of 40 billion or so. if a global pandemic took place, you're looking at an economic impact measured in the trillions of dollars, not 10s or hundreds of billions. it has such a big impact on business and life. >> you hope the world has the capacity to see an outbreak, mobilize forces, and contain it. right? unfortunately, we rarely do that. especially if the outbreak occurs in a poor country. >> well, here we are in liberia. that's sierra leone and there's the border crossing.

do you see security, do you see military? do you see anyone who would stop someone coming across this border? not only does it spread across the borders of the original country as occurred with ebola in west africa, but it crosses seas. it crosses continents and that constitutes a pandemic. endemic is your worst-case scenario. so you fail to control the outbreak, you fail to control the epidemic and you fail to control the pandemic, and now that microbe is a permanent feature in the biological landscape that humans are living in. the worst example of that is hiv. we started off with tiny outbreaks in a handful of places and the world responded completely incorrectly.

it became pandemic and now endemic, so we have 37 million people living infected with hiv and there is no country on the planet without this virus. >> before the devastation of aids, there was smallpox. smallpox killed 500 million people in the 20th century alone. more than all the wars in that century combined. whenever an infectious disease truly catches hold, it forces health workers to make impossible choices about the public's freedom and rights. >> i was the youngest person in the smallpox team and i was certainly the only person in the history of the united nations recruited from the ali backa ashram.

>> we had eradicated smallpox. utsds this big stayed in the middle of india. we were about to do our victory dance and suddenly across the border, we started getting new outbreaks. they all came from one place, a place called tatanagar. the first place we went was to the rail station. it was the scene from the worst nightmare you'd had in your life. there were dozens of people stretched out on the tracks, on the cement dead from smallpox. it smelled of death. the tatanagar was the home of the tatar iron and steel company. so i went to the company's house. it was almost midnight when i got there. i said i need jeeps, i need managers, i need doctors, i need vaccine.

the next day i had a hundred jeeps. we set up training programs and used maps to develop strategy and took the hundred jeeps and built our little army. we were doing great. we found 2,000 cases of smallpox. we were stopping the disease in tatanagar but still as we're vaccinating everybody, the trains were carrying people away. we were still exporting the virus. we quarantined the city of 600,000 people. nobody could leave the city unless they were vaccinated. we eliminated smallpox in that entire area around tatanagar in less than six months, but it kept coming back. we traced it to a tribal group

called the ho tribe. so i went and visited the members of that tribe and i said, well, you've got to take smallpox vaccine. you've got to stop this transmission. he said i won't take it. i do whatever god's will is if i'm to get smallpox, i'll get it. after a while, more cases kept coming out from the ho community and we all agreed that we were going to have so forcibly vaccinate these ho tribesmen. the middle of the night, we went out into the villages into the jungle and we surrounded them and pulled them out of their houses and revaccinated them. and after we had broken into their house, pulled them out of bed, forcibly vaccinated them, this dignified tribal elder

looked at me and reached over to the vine and there was one fruit, a cucumber, a kind of gourd. he pulled it off and he cut it he said i don't like what you did. i think you're wrong. but that's over now. now i see that you are a guest in my house. the only thing i have to offer is this cucumber. and so you ask yourself. were we right? we did a lot of things that in their individual isolation, if i put the harshest light of truth on it right now i would be begging to find an altern tv way to do it. and i ask myself did i

exaggerate the importance of what i did? did i place myself above some kind of moral compass? did i quit too early trying to find a way to accomplish the same thing? but that's sort of between right now me and god and me and my conscience. small pocks has been eradicated and i'm thrilled about that. ♪ >> the idea of night raids or forcible vaccination today is

just unthinkable. there's a few big things that are very different. internal politics, global politics, extremism, the whole issue of human rights. you have to be transparent because the wrong information can actually contribute to the spread of a disease. i'm particularly interested in looking at rumors. the way that rumors replicate and spread are very similar to how viruses spread. they need a host. they need to be supported to stay alive and thrive. >> there we are. okay. hi. >> rumors have been around since man existed. but i think right now what's changed in particular social media is the global spread and the speed. look at twitter. you needed 140 characters or something. and that's all you need to spread the rumors and

perceptions that we're tracking. and one of the things we found is that rumors thrive in times of uncertainty. they thrive in times when people need an answer. are eagerer for an answer. >> the it old model of how you respond to an infectious disease outbreak is you issue a firm warning to the public and say what you should and shouldn't do. that doesn't work anymore because people are responding to rumors on twitter and facebook and they want to engage and challenge and have their own opinions about what's going on. >> agenda. >> when an epidemic occurs, there is a clinical management

and the reactions of society and managing that can be as important as actually dealing with the epidemic itself. good afternoon ever abody. this is the third meeting of our task force on ebola. i'm very worried to be honest. >> i can be outbreak to a war. >> riots are breaking out. >> as ebola continue said to spread, distrust. >> barbed wire. >> an isolation ward. hundred hads clashed with the police who fired live rounds and tear gas. >> we have used our own resources but obviously we have

limitations and we hope that the international communities see this as an international catastrop catastrophe. >> two americans who have been infected will be sent home for care in atlanta. >> he came infected while working as a nurse in eastern sierra leone. >> just diagnosed with beebola. >> he will be flown back to the united states for treatment. >> oh, my god. he from west africa, right? >> no, he's from the states. he's an american. >> oh, my god. >> and a repeating pattern. the world only really started to pay attention to the ebola epidemic when foreign workers began to fall sick. >> the international response

has continued to ramp up. >> they're going to create an air bridge to get health workers and medical supplies into west africa faster. >> it will be galvanized. >> china is sending health care professionals. >> there are 84 flights a week leaving the infected countries. >> for the first time the ebola virus is in the united states. >> contracted in liberia before flying to dallas, texas. >> he lied so he could leave liberia. >> a travel ban may make sense. >> we should not be allowing these folks in, period. >> as of today one case came from liberia. one. and there will we more but right now, one. and in response to that they say

let's close the borders. nobody from africa will be allowed in. they don't even know west or east or south africa is. and close our airports. i mean, that's a combination of ignorance and arrogance that could create rue nation for our economic system. >> today testing confirmed that a patient here in n yorty had tested positive for ebola. >> spencer tweeted ebola patients in guinea. >> 12 hours before he detected his fever, he was on the l train, the a train? one train, two bowling alleys, he needed a restaurant. >> no quarantine was required. >> the governors of new york and new jersey decided to change

that. >> casey hick ocwas forcibly quarantined, even though she testeds negative twice. >> we have the legal authority to do it, we're doing it. >> it was pretty clear the epidemic in the united states was an epidemic of fear. we got a practice run on how americans will respond and boy, we got an "f." >> in addition, it had renewed our determination. >> we're spending a lot of time with our community. community leaders with our

colleagues on how to better handle this ebola epidemic. >> is this a wake-up call for you or the international community to start looking at all the potential viruses that may come to harm us so that we start putting things in place to prevent -- >> well, to be honest in the 38 years we have collectively failed and every time when there's a big epidemic we say never again and we're going to put in place mechanisms to do this and that and it doesn't happen. so we have to now really fight that this will happen this time and there are better systems in place. >> in the falloff 2014 significant aid and man power finally started arriving in the

region. in liberia there are contentions from china, sweden, and the united states. it was chaotic and coordination was often difficult. but make-shift etus were finally replaced with purpose-built hospitals. >> i communicate with the ministry. jfk closed down. so we just transferred a team from jfk to mod. >> ali, check this and boots in

my office. >> coordination team. >> good morning. yesterday i started getting complaints. there were two patients brought to the triage and lying there for more than an hour. nurses were informed. i mean every patient that come here, think about your relative being in that position. you can't have them waiting in the triage for one hour before they get care. we need to be vigilant about it. >> i've seen so many people die. sometimes i'm afraid being a medical doctor. one laboratory technician working for us at jfk got infected. then my hygienist got into a physical fight before the

patient became infected. then two got infected at home. then dr. scotland got infected. after i joined jfk three intern doctors came including scotland. dr. scotland always wanted to walk side by side in the unit with me and when everyone else was tired and walking for four and five hours, dr. scotland would stay. the perfect friend, the perfect colleague. one day he took the day off and then i call him to see how he is doing and he said doc, you know what? i have sudden chills. i said shh. i said okay.

keep your calm. come to the unit and we'll take a sample. that night the first thing scotland did was call me. he said dr. moses my result came back positive. i started to cry. i started to shed tears. then i told him i'll do everything in my power to make sure you're okay. i will get an ambulance. and then the ambulance came to receive him. they put him in. i did everything i could do for him and manage him that night. i didn't get him. he didn't talk to me. the following morning he just dropped and died. just dropped and died. just dropped and died. yeah.

many patients have survived our unit. well up till now i feel like i've done nothing. i didn't save scotland. ♪

>> i voluntarily decided to give care to these children. >> hello everybody. we're going to have our lunch. these children are here because they lost their relative said from ebola and the community are afraid of them. they are risking their life. since we are survivalists, we cannot infect them, we cannot get infected by them. so these children are brought here to be on a quarantine. and we can be really, really be afraid, not wanting to share their problem. they don't know who to trust. what i found while talking to

them one on one hearing their stories, they start talking back to us. >> when ebola ends, everything's going to change. families are apart for good. my daughter is 4 years old. i call her my best friend on earth. and my son is a also very brilliant. because i'm so afraid of them becoming infected i had to stay away for so long. the consequences are far more than death. in africa we eat together, we share from one spoon, eat from the same plate. how many people want to do that

now? ebola is not only killing us, it's destroying all of our cultures and traditions and reducing our hope for the future. >> we are talking about the prevention of the emerging virus. it's three factors are important. immediate action. >> we're trying to find some small molecules or antibodies to inhab thet virus to enter the cells. >> the 21st century can be

characterized by a race between the modernation and the advances. our only chance of winning the race is to use 21st century tools to fight epidemics. ideally even to prevent them with vaccines. >> in terms of research they provide incredible tools. they have been with us for millions and millions of years of evolution. we can ask the right questions, then we may be able to find some useful information. >> yes, he is. come right on in. >> we have surveillance projects. we're trying to isolate from swien to birds to humans. taking samples to find out what are the mechanisms. >> what you are talking about

vaccine development, we know even less for flu than we know for ebola. >> so we need to have our universal flu vaccine soon. so everybody's working on that. >> can you show me the slides you have prepared. >> currently we create a new flu vaccine every year. adjusting it to the match the circulating strains of flu. it takes months to make that. what scientists are trying to develop is a universal flu vaccine, one that can work against all strains of flu. seasonal and pandemic. >> right now it takes nine months to develop a vaccine. that's too much time. if there's a pandemic, a lot of people will die before a vaccine's ready. >> like this? okay.

>> all right. sg >> see you soon. >> the it problem's not just vaccines, we need better diagnost diagnostics. >> better diagnostics are critical. we frequently misdiagnose influenza and in the field m misdiagnomi misdiagnose ebola and zika, confusing them with other diseases. we lost valuable time to contain them. >> thank you. you have been identified. >> this is the area where we have a lot of the diainggnostic machinery we're working on. it will run across the chip. you close it up and the carterage can sit right here. right now the run time is

somewhere in the order of half an hour. so what you can see on the screen here, this is the intact virus. maybe it's ebola, maybe it's influenza, maybe it's zika. you can imagine it being useful in an airport or somebody wanting to bring it to a triage site if there is some disaster of some outbreak. >> today the president of brazil gave public health officials the right to enter any home or business to eradicate mosquito breeding grounds. >> already puerto rico is in the cross hairs of the virus.

>> scientists are still trying to understand the full range of neurological effects the zika virus causes in both babies and adults. >> they have finally found the zika virus in mosquitos in the miami area. >> people are scared. cases rose from 4,000 to by some estimates 16,000. can you imagine, colleagues, the fear and anxiety in this chamber if these mosquitos were outside this jar, not inside this jar? >> zika is a serious threat to americans. >> zika is spreading rapidly around the world. at least 29 countries have local zika transmission. >> we're already seeing mosquitos transmitting zika in

the united states. it's really just a question of how many states, how widespread and how many people will acquire infection as a result. we are not prepared for zika. every outbreak we go to the capitol hill folks and beg and every outbreak it becomes very political. in the united states there are a patchwork of laws that guide help. there's no consistency in the level of funding or urgency or training or expertise. am i allowed to go on your front lawn, your prievate property an spray insect side? in some cities, yes, in some cities no. am i allowed to force you, to compelyou to drien a swampy like

condition in your backyard because it's breeding mosquitos? there's no consistent law. public health is a two-way trust. i have to trust government's go doing the job. but government can't do the job of public health unless the public is engaged. if government says mosquitos are here and they're carrying a really dangerous disease. we need come on your property, we need have access to ways to eradicate those mosquitos and you say i believe in the second amendment. nobody's coming on my property, then there's no trust and no public health. similarly, if there's an epidemic that has a vaccine, you line your children up. and if you're not willing to do so, then you're not part of the trust that is the basis of

public health. if there's one hallmark of my lifetime on this planet it is the erosion of trust in government. and public health is paying a price at every level for that erosion of trust. >> each year terry gets the vaccine i don't get it. and we gave shannon the choice and she chose not to. i'm trying to understand the flu vaccine because i want to know if we got shannon vaccinated if it might have saved her life. there's so much information on the internet. i can go to 30 different websites and get 30 different

answers. you don't know who to trust. >> there's something about the flu vaccine that conjures confusion. while not currently a perfect tool and varying in effectiveness from year to year over the last decade the flu vaccine reduces the risk of getting the flu by at least 50% and reduces hospitalizations and deaths. >> a little over a year ago a mom that lost a little girl put together a facebook page and she titled it "flu moms." and when she hears of another mom or somebody finds us, they join. here is a mom. she had a booth at a fair and all of us -- all of our children were pictured. there's shannon. and when children came to the

booth to get their faces painted, then the parents standing there waiting would get the information. they'd be told about these children who have died and the importance of vaccination, that kind of thing. >> we have a new mom. julia. not wonderful to be part of a flu mom group but it's a great that we all are here for one another. we'll learn her story pretty soon. >> there's a huge amount of parents that are utterly confused. and that's a big communication challenge when it comes to the vaccine. >> so the question is does she have anything?

>> it's something we see on the rise, which is quite alarming. inflew ezau uenza is possibly t preventible with a vaccine but nobody uses it and that's not great. one of the most common misperceptions is people say i've never been sick. but there's another aspect to vaccines and it's not just me, it's the people around me. because of the potential of me giving something to somebody that may be serious to them, even if it may not be serious to me and i may sit next to somebody in the subway with a very weak immune system and they may not know it and i may not know it but i may very well give somebody the flu. so there's the question of the common good verses the individual good. if we want any effectiveness of

a vaccine, we need to get vaccinated. >> the great influenza of 1917/'18. that's to have said to have gone around the world four times without an airplane. that's 100 years ago now. at the end of the great influenza, 50 million or 100 million have died. that's against a global population at the time. less than 2/7th of what it is today. multiply 50 or 100 million by three. you're talking about a number of deaths that is totally catastrophic. a hit to our economy that's unimaginable. in 2006 i brought the top

epidemiologist from all over the world and the vast majority felt that in the next 20 years/30 years, there will be a pandemic and will have the potential to bring humanity to its knees. >> new strains of influenza are already infecting birds in over 75 countries. and the way we are interacting with the animal world is putting us at risk. we encroach on wetlands. so wild birds mix more frequently with domestic poultry. our food trade is globalized. and factory farms are growing in scope and size. >> with all influenzas, there is a critical moment when a virus circulating in one species of say, birds, manages to mutate in

a form that allows it to get into say pigs. and then from there to spread easily between people. we've seen this over and over. it's going on all the time. right at this moment. here's what a truly horrible worst case scenario pandemic would look like. first there would be a jump from some animal species to humans. the first humans would be the people close to those animals. and then their families and the kids in the schools. and it would not be regionally confined for long at all. days, that's it. and let's assume it kills 5% of the people. 5% would be hundreds of millions of human beings. >> pandemic flu will soon reach

this country. >> so once the epidemic has really begun to spread, you can't begin to imagine the scale of this. >> you want to be as far away from the city as possible. >> you have huge numbers of people thought are not coming to work and that includes jobs we consider essential to public safety. like the guys who turn water systems on and off, the police, the fire department. then people start plasting their conspiracy theories out on who caused it, why is it here. you would see a whole wave of shortages, goods and services all over the world. the stockouts of every single kind of drug. the over crowding of the hospitals. the over crowding of the mortuaries. the sheer numbers of both sick and dying.

what a really severe influenza pandemic would look like is something close to social collapse. >> when not effectively prepared as a world for a pandemic, we doentd have effective response but the biggest thing is that on the ground preparation and preparedness is full of holes. there's a pattern of respondinging to an outbreak rather than investing in preparedness. it's so much cheaper, so much more cost effective than responding after the event has happened. >> major nations around the world currently spend 10 to 20 times less on bio security than

despite of an epidemic causish a greater laws of life. on average influenza pandemics happen every 20 to 40 years. a lesser influenza pandemic, equivalent to 1968, would likely now kill up to 2 million people. an influenza pandemic like 1918 could kill 200 million people. more than the entire population of germany, great britain and spain combined. to prevent pandemics we need to do a much better job of controlling outbreaks.

the world has learned is that they have to be better prepared.

i think you need the right players from the start. i think you need have the public sector working very closely together with the private sector. we need join forces really. from the start to make things happen very quick. i care. and i think -- yeah. i mean many people care. we saw many people there that -- many women that were going to sierra leone to help and to fight. that was amazing to see that response from the world towards sierra leone. s there oar huge sense of accomplishment when you do the right thing, when you see that what you do can potentially make

a difference for those people. trrs morning. >> we see a few patients now. with a staff of better prepared to work. they are more trained. i think disrepair in august or september are doing better. ♪ hear the people cry >> in december we had a 16/17

patients admitted in the confirmed ward and about 14 of the 17 will go home soon. how you doing today? so with time it got better. no fever, no sick. everything all right now? you ready to go home today? any fever? any runny stomach? nothing? >> it's like a miracle. you see a patient. they're dying, sick. and then two, three days they start to regain strength. and then the most exciting thing is that you put the patient out of the ward and then you remove

the tyvok and then the paschabout sees you. they know dr. moses but doesn't know the person. and then some of them start to cry. i said wow. it gives me joy. yeah. it gives me joy. >> morning. every time we are able to tell one person to stay alive and leave this danger zone, go home and give god the glory, right? now staying alive is a continuous challenge.

so these certificates are go home and people are afraid to come around you, you can show this to them. this is evidence from the minister of health. you were treatd and now you are cured. okay. so on behalf of the ministry of health, you have successfully undergone care and treatment and after post treatment assessment, you are now declared free of ebola through medical examination in a confirmed laboratory test december 2014 and it's signed by you on behalf of the ministry of health. >> i want to present this

certificate. hey, mom. please talk to me. this is for you. take it from me now, baby. it's for you, yeah. >> when i see patients i remember them. especially those that there sick that were really sick. i remember them. there's something in each individual body that makes a person survive and another person won't survive. because you see one patient is so sick and that patient lives and you see another patient not so sick and they die and you say why? wraur what's the difference? they're getting the same treatment, the same care.

why?

>> when an outbreak catches hold, it effects every part of our lives. business and government, trust

and freedom. equity and security. the fight against epidemics can only be won if each of us does our part. it turns out we are all the frontline. >> i think it goes on your left side. >> what if i don't want to wear it? >> oh, no. >> oh, my god. you created a procedure so that when people look at themselves in the iphone -- >> it was in this hall 52 years ago that my life was forever changed. i felt i had been drafted into a different kind affarmy. small pox was declared eradicated from the world and so far the only human disease ever eliminated by a public health campaign. we thought what about hiv, aids, h 5 n 1 at their source and

never become a pandemic? i don't dispute it's hard and complicated but we have the tools. we know what to do. it's merely the application of public will. go out and change the world. >> how are you? >> i love internal medicine. what this outbreak has taught me to help people to really make an impact you need to be more than one kind of doctor. i would like to learn health system management. i believe the health system here can be better than what it is. >> going to a different country, right? for one whole year but i'll call you every day, huh?

you know i love you, right? >> also everybody need to learn when it comes to health emergencies, until the entire world is safe, nowhere is safe. >> good morning. >> what keeps me awake at night now is that we will deliver on our promises to the people of west africa. that we will support these countries to build a systems to make sure that when there's another case of ebola, which will happen, that it doesn't give rise to a big epidemic. >> the time has come that we lived on islands or that we were protected. and there's no way to stop that. because fighting aids or fighting the flu and sars in

asia benefits people in europe and north america. so we need to act beyond the boundaries of our own countries. >> the networks that connect us accelerate everything. the spread of ideas, conflict, people, and microbes. there is no running away. there is no wall high enough. >> what's absolutely missing, just not there is trust. and so coming up with preparedness that looks like it could stand up to the microbes when the attack comes is really about each country carrying their own weight. yes, we always need to be watching. vigilance is permanent. >> the hallmark of the 21st century is that our world is

simultaneously more connected and more fraught. epidemics are a test of who we are. we can use our connections for good. to make the world safer and healthier or those connections will turn on us in an instant. >> we cannot just continue to be responding to every outbreak as it occurs. >> if we do not invest in better preparedness, we are setting ourselves up for future epidemics and pandemics that will cast enormous amounts in terms of both lives and money. >> i constantly run into people who are fatalests and they say pandemics are invetitable so don't work on them. they're not inevitable. outbreaks are inevitable.

pandemics are optional. it's our option if we will be lazy. it's our option whether we will deny the risk. it's our option whether we will refuse to face the consequences. >> we have a chance to stop something that otherwise could be horrific. but it's going to take all of us.

♪

hello, welcome to the special post edition of the film "unseen enemy." it questions if the world is equipped to deal with it if and when it happens. janet tobias wrote and directed the film we just watched. and dr. anthony fauci is the dr. infectious diseases and the author of the book americans at

risk. why we're not prepared for disasters and what we can do. dr. sanjay. >> outbreak is usually when you see some sort of eruption of an infection you wouldn't otherwise expect to see. epidemic is when something starts to spread rapidly among the population. pandemic is when it's spreading around the world. endemic is when it becomes intrenched in a particular place. so certain malaria would be an example. something that started in these first stages but now endemic within certain parts of africa. >> in terms of risk, you say you can't prevent outbreaks, you can't prevent the emergence of a new infectious agent but you can prevent how it spreads. >> exactly.

and that's the whole point. microbes emerge and reemerge. the critical issue is to prevent an outbreak from becometic an epidemic and then a pandemic. with vaccine development, you can blunt that spread. so people think prevent an outbreak. you're just not going to do that. there will be emergence of -- for example when we had ebola in africa, it start would a single case that spread to a few and because of missed opportunities it exploded. if the right proper public health measures had been taken early on, we would not have had an a pandemic. >> there have been isolated outbreaks of ebola in you gaundau. >> 24.

>> there are about two dozen. >> usually in isolated areas. this was very different and infected a greater number of people. >> it was a perfect storm and the perfect storm was you had three countries with poor countries with porous borders. they were situations where they had essentially no health care infrasfr inf infrafrustructure. and some of the cultural things, how you bearury the dead, all o that sinn energized to make thi worse. so the preparation of a body for a funeral did that. you put all those things together and it's the perfect storm. >> you started working on the film before ebola. >> we thought we were doing a film about the past and we were

going to look at the future and the present intervened. so we said we got to go to west africa. and we were there for a couple of months and we came out and began working again on influenza and zika happened. and we thought we're a little bit more topical than we ever imagined. >> you were in west africaau during the ebola crisis. >> it only takes a small amount of the virus anywhere on your skin to cause an infeksz. and as i learned no precaution is too small for the doctors. this is one of the doctors without borders. he's from canada. he comes into these settings for weeks at time. he's not mairied, no children. that would be a job liability, he tells me. >> cover it like that? >> multiple pairs of gloves and

masks. the head is completely covered. a multi layer gown. it's positively suffocating in the 100 degree weather. >> it just shows the preparations. are we prepared? that shows one of the difficulties we're preparing. >> ebola wasn't particularly contagious but it's highly infectious. if you have an small cut or some kind of opening, we all have them, you could potentially get the ebola virus into your blood stream. >> you say your greatest nightmare is being unprepared. >> right. and the issue of being prepared is complicated. part of it is dressing properly and is there a health care cyst toom deliver the goods? and to make diagnoses early? and in countries or regions where there's limited medical

resources, it's one of those factors that allows for a rapid spread of disease in an environment in a time when we don't jet the vaccine s or do anything other than prevent the spread. >> can you predict where the next hot spot is going to be? >> you can keep your eye on things that are suspicious. right now as we speak there's a virus that's a bird flu hsn 9 that jumps from chicken to a human about 40% lethality for humans. thankfully it doesn't spread easily from humen to human but there's the possibility it would evolve to do that. so we're focusing very intensively on areas in china where we're having the bird flu infections. that's something you have to pay attention to. >> is it an area where there's a

lot of air travel to? and there's a lot of variables to determine whether something spreads. >> if it's a respiratory the possibility of a pandemic influenza. influenza, the way it spreads, unlike ebola, where you have to come into direct contact of the body bly fluids, with influenza, somebody gets on the plane, they should be shedding virus for 24 hours before they know they're sick. that's the reason why that's the most dangerous. >> i think the hot spot thing is really interesting, because we've traveled to places where you see animals and humans coming in close contact and that's a real concern. but you could also have a circulating virus, something that we already have seen in the world, that just undergoes a massive mutation, a reassortment, and it becomes a novel virus, becomes a new virus that we have not been exposed to and can cause this sort of pandemic flu. >> and there's fewer and fewer

places that are isolated anymore. with every passing year, there's more and more international travel. an outbreak that occurs in what was a remote village, you have people that will migrate to the capital, especially in a crisis. you go to a capital now, with people who are infected and the capability of the virus now being transmitted to lots and lots of people. those people leaving the capital, going to other countries -- >> animals that normally we might not come in contact with, because the bush meat trade, the growth of populations that want exotic meats, it's -- the world is obviously much smaller. >> which makes containment really difficult at this point. >> you talk about unflun sa, that's one of the most startling things in the film. i don't think people think about the danger of influenza. it seems like something, you know, it's -- everybody knows about the flu, people get shots for it, but -- >> 36,000 people a year more or less die from it. big deal. >> in the united states. it's fair to distinguish between

seasonal flu and what we're talking about with highly lethal pandemic flu. seasonal flu, you know, it mutates a little bit every year. for the most part, your body has seen some variant of it, so, you have some protection against it. pandemic flu, what we're talking about with high lly lethal pandemic flu. it's a different virus. it mutated so much, we don't have immunity to it. pandemic flu, nobody has immunity to it. that's part of the concern. >> shannon, her case was just shocking, within, what, within a week -- >> within a week, yeah, she was dead and her mother was doing mouth to mouth on her, trying to keep her alive, which is every parent's worst nightmare. and i think there should be more awareness that flu does kill. doesn't always kill the extremely immune compromised or the elderly. and that we should do better in terms of diagnose nostics and te

absolutely need to support the research to get to a universal flu vaccine. >> shannon hadn't gotten a flu vaccine. would that have made a difference? >> i think this is the issue. we're in an environment where there's lots of reck luck answer to take vaccines in general. this is the pack drop and now we're insisting from a public health messaging point of view that everybody needs to get the vaccine, which i think all of us would agree needs to happen. >> you can't get the flu from a flu shot. i know everyone here knows that, but it just bears repeating. i hear that all the time. the flu shot gave me the flu. and it's inactivated. you can't get it. it causes an immune response. your body may feel miserable for a little bit. that's the immune response doing what it's supposed to do. that's not the flu. because that's one of those myths that i think really makes a lot of people not get the shot. >> are we overdue for an influenza pandemic? can one say that? >> no, you can't, because it's entirely unpredictable.

people say it occurs every 20 years, that's not the case. pandemics are completely -- the only thing that's predictable about a pandemic is that it's unpredictable. we had the horrible one in 1918 that killed 115 million people. we had another one in 1957, another one in 1968 and then we had one in 2009, the h1n1. we really have to have a different kind of preparedness, why we are working on developing what we call a universal unflea influenza vaccine. it would help when it's a seasonal flu or a major change. little changes are called drift and a big change is called a shift. i think that's one of the most important goals in vaccine research that we can have is to develop a universal flu vac

seine. >> we are facing cutbacks in research dollars at the worst possible moment. the pandemics that tony is referring to happening repeatedly, there are always called wakeup calls. we did the thing, h 1 n 1, now we'll invest enough muff to do what needs to be done from a science point of view. they turn out to be not so much wakeup calls but snooze alarms. we get alarmed in the middle of the crisis and we hit that snooze button and drift back off. and we do this not just with n pandem pandemics, but every kind of disaster. it's the same pattern. we're standing in our hip boots in the flood waters and then, you know, it's onto something else. i think that's a problem. but, you know, we really do need to focus on doing the things that tony thinks we need to do, which is starting with the universal vaccine, which would be a tremendous innovation for human kind, really. >> what would that do? >> well, what it would do is, it would induce an immune response that would be protective

against, essentially, every formal of influenza. i don't think we'll get a perfect universal flu vaccine, but you can start off getting to the ultimate goal, so that you can maybe get a vaccination every five to ten years that would give you enough background protection that even when you encounter a brand new pandemic virus, there would be enough of the cross reactivity with that particular vaccine that you'd be able to protect people. that's the ult mall goal. >> it is extraordinary, when you look, you know, for hopeful things, when you look at hiv and how, for many people, it at least in the developed world where they have access to drugs, it is a condition that is now something people can live with, as opposed to a death sentence. >> absolutely. well, the hiv development of drugs and treatment is an extraordinary success story of the relationship between fundamental basis biomedical research, developing an intervention that's highly

effective. i've been taking care of hiv patients for 35 years. the first several years, virtually all of my patients died. i mean, they would come in with advanced disease. we didn't know what the virus was, much less have a therapy. if someone comes in and is recently infected, and you put them on a combination of three drugs, which you can do sometimes with one pill, you can essentially look that person in the eye and say, if they take their medications regularly, they could live, if they're in their mid 20s, an additional 50 years. >> and if they take it regularly, they cannot pass it on. >> it's called treatment as prevention. if someone comes in and they have a viral load, you treat them, you bring down the load, it makes imimpossible to transmit it. >> i don't think people understand that. they've done studies on couples, where one person is positive, one person is negative and there's no cases of people transmitting the virus -- >> if -- >> as long as they take their medicine. >> it is almost impossible. you don't want to say biologically impossible, but it is essentially impossible.

>> and hiv is an example, i think through the phases you described, it was an outbreak and then an epidemic, then a pandemic and now endemic. >> right? >> fair, right? >> it is endemic now. so, it did go through all the stages. >> janet, what do you hope people come away from the film with? >> i think every dau now that i get on the subway and shannon could be sitting next to me and i could have the flu and i could give it to her. and i could kill her and i wouldn't even know. and i never thought that before this, right? and i think that we all -- >> it's that simple. >> it's that simple. we all can really make a difference. is that we need the nih, we need really good doctors, we need good governments and companies, but it also is about what i do. >> this is a powerful point from the film, too, that is not just about the technology and the sips and the development of the vaccines, though that is critical, but the rest of the system has to be intact. we have to have the trust. we have to have a really good public health system, globally. this is not just an american problem or any particular

country. this is clearly now a global challenge that we're all facing. but if we don't have the public health, if we don't have the right medical systems, if we don't have the right ability and knowledge of how to communicate to people to have them comply with what needs to be done, then these are kinks in the armor here. if we have the rack seevaccine,t have a health system to deliver it, we're not going to be not as much progress as we thought we might have. so, it all fits together and i think that came for us very powerfully in janet's filfilm. >> thank you for being with us. if you want to learn more about outbreaks and pandemics, you can go to cnn.com/unseenenemy. there, you will find photo galleries and videos designed to answer your questions and help you explore other topics. that's it for us. thanks for watching.

>> anthony: after nine days of threats of imprisonment, confiscation of footage, and what was the most chaotic, difficult, yet amazing trip of my life, the last thing that stands between us and our flight home is the reason we came, the congo river itself. >> crew member 1: a un truck just said he's been here since this morning. >> crew member 2: i'm going to tell him straight, i've been held up for days. >> crew member 3: what's up, freddy? >> crew member 3: they're starting the engine. awesome. it just broke down again. yeah. >> crew member 4: we now have one hour of daylight left. >> crew member 3: okay, great. here he comes, yeah. >> anthony: you learn quickly. in congo, things change in a moment's notice.