Portico

A Short Story

PARTIAL TRANSCRIPT FROM THE PORTICO HEARINGS
7.7.21
PRESENT: DR MILTON POOLE (CHAIR),  LISA NGAN (SEN - D), JAMES GERHARDY (SEN - R), OLIVIA SMYTHE (STENOGRAPHER), DR REUBEN FAIRCHILD

CHAIR: [inaudible] But we're broadly fine to start now?

SEN GERHARDY: I don't think --

MS SMYTHE: Senator Ngan is still in the restroom.

CHAIR: Is that -- is that something that is expected to take --

MS SMYTHE: I don't know. 

CHAIR: I'm sorry?

MS SMYTHE: I can't speak to the specifics of, ah, of what --

CHAIR: No, of course. That's fine. Dr Fairchild, we thank you for your patience.

DR FAIRCHILD: [inaudible]

CHAIR: Ah, here she is.

SEN NGAN: My apologies.

CHAIR: Are you -- 

SEN NGAN: Yes?

CHAIR: Is everything -- let's move on. If we’re all —

SEN NGAN: Yes, Chair.

CHAIR: Alright. The time is 10:44am on the 7th of July 2021.

SEN GERHARDY: That's right.

CHAIR: Sorry?

SEN GERHARDY: I was, Chair, confirming --

CHAIR: Right. Good, yes. This is a closed hearing into the actions of the private contractor, Portico Pty Ltd, hereafter referred to just as "Portico", in the -- we're all fine to just call it "Portico", yes?

SEN NGAN: Yes.

SEN GERHARDY: Yes.

DR FAIRCHILD: That’s fine.

CHAIR: That's good. I just don't want to bother with the "proprietary limited" every time the name comes up.

SEN GERHARDY: Of course.

SEN NGAN: Yes.

CHAIR: Good. So. This is a closed hearing into the -- sorry, Senator Ngan was there a problem?

SEN NGAN: Not at all, no, I'm --

CHAIR: I thought I detected --

SEN NGAN: -- I'm just eager that we should get started, Chair.

CHAIR: Yes, well, I think we all are, Senator. 

SEN NGAN: I didn't mean to suggest --

CHAIR: It's quite alright. So, a hearing into the actions of private contractor Portico -- I've said that -- specifically the response to the Ebola outbreak in Burkina Faso, 2020. The panel wishes to thank Dr Reuben Fairchild for his time and cooperation and emphasise that this is testimony given of his own free will and he is free to leave when he wishes. 

DR FAIRCHILD: That is correct.

SEN GERHARDY: I’d also like to add my thanks to the doctor for giving up his time to appear today.

(PAUSE)

CHAIR: Okay.

DR FAIRCHILD: Thank you, Senator.

CHAIR: I should also acknowledge that while this is a closed hearing, a transcript of these proceedings will be made available for archival purposes, based on the stenography of Ms Olivia Smythe, who is present.

MS SMYTHE: I am.

CHAIR: Excuse me?

MS SMYTHE: I was just saying, I am present, yes.

CHAIR: That's what I said.

MS SMYTHE: No I --

CHAIR: You don't need to talk, I think. I should also acknowledge, for the transcript, that Dr Fairchild is appearing before this commission via Proxy. 

DR FAIRCHILD: That's right. 

CHAIR: And where are you actually located, Doctor? Physically, I mean?

DR FAIRCHILD: London, Chair. 

CHAIR: Yes well, good. The Proxy you are appearing in before the panel has been verified to -- ah, you know -- to be -- is it...

SEN NGAN: There has been an independent verification that the man in this room is connected, via a second generation Proxy implant in the base of his spine, to Dr Reuben Fairchild. Yes. 

CHAIR: Yes, good. And this, ah, fellow -- the Proxy -- he can't, you know, hear or respond in --

SEN NGAN: No, Chair. The man acting as Proxy for the doctor is unconscious. 

CHAIR: Good. That's good. Alright. Senator Ngan, given your anxiousness to begin, perhaps you can start.


SEN NGAN: Thank you, Chair. Dr Fairchild, you were Chief Science Officer at Portico from 2011 through to late 2020, correct?

DR FAIRCHILD: I was CSO at Portico during that period.

SEN NGAN: Is that different to the Chief Science Officer?

DR FAIRCHILD: No, I'm agreeing with you. 

SEN NGAN: Right. This means that you were Chief Science Officer at the time of the Burkina Faso Ebola crisis?

DR FAIRCHILD: That's right.

SEN NGAN: And you oversaw Portico's operations on the ground there, in Burkina Faso I mean.

DR FAIRCHILD: I think that depends on what you mean by "oversaw"

SEN NGAN: Does it?

DR FAIRCHILD: Well, yes. I think it's reasonably important to establish the bounds of what I was responsible for. Did I sit in on most meetings? Yes. Did I hand pick the team? Again, that's correct. Was I in charge of every little detail? Did I make sure we had paperclips handy? Well, no.

SEN NGAN: Do you think it is likely that this panel is interested in who was in charge of the paperclips at Portico?

DR FAIRCHILD: I do not presume to know the interests of this panel, Senator Ngan.

SEN NGAN: Thank you, Doctor. But, broadly speaking, is it fair to say that you oversaw the response in Burkina Faso?

DR FAIRCHILD: If we are being broad here today, yes.

SEN NGAN: And where did you oversee this from?

DR FAIRCHILD: Here in London.

SEN NGAN: Just in London.

DR FAIRCHILD: Yes.

SEN NGAN: You didn't, as you're doing today, use a Proxy at all? To supervise the operations on the ground in Burkina Faso, I would have thought --

DR FAIRCHILD: I did, yes.

SEN NGAN: That doesn't count as being on the ground in Burkina Faso?

DR FAIRCHILD: Well, perhaps. Do we have the time to argue about what it means to be anywhere while using a Proxy?

SEN NGAN: I'm not interested in that debate, Doctor --

SEN GERHARDY: You raised the --

SEN NGAN: I'm just trying to establish that, as part of Portico's medical relief effort in Burkina Faso, you used a Proxy.

DR FAIRCHILD: That's right.

SEN NGAN: Were you the only member of the Portico staff to do so?

DR FAIRCHILD: The use of Proxies in healthcare has been relatively uncontroversial for half a decade. 

SEN NGAN: I didn't ask if it was controversial, I was asking if you did it.

DR FAIRCHILD: You know we did, I just told you we did. 

SEN NGAN: And was that your decision? To use Proxies?

DR FAIRCHILD: I was privy to that decision, yes.

SEN NGAN: Sorry, did you personally make that decision or was it someone else.

DR FAIRCHILD: I made that decision.

SEN NGAN: You just said you were privy to it.

DR FAIRCHILD: Yes. I was privy to it because I made it. 

SEN GERHARDY: I think this would be a good time to remind Senator Ngan that Dr Fairchild is not on trial.

SEN NGAN: Thank you, Senator. 

SEN GERHARDY: And that the staff at Portico risk their lives --

SEN NGAN: I just want some clarity on --

SEN GERHARDY: -- risking contagion in a foreign--

SEN NGAN: I understand --

DR FAIRCHILD: I'd also say --

SEN GERHARDY: Yes, Dr Fairchild?

DR FAIRCHILD: I'd also say that the approach we took in Burkina Faso was multi-faceted, and that the use of Proxies was just one of those facets. 

SEN GERHARDY: Thank you, doctor. Of those other facets --

SEN NGAN: I'm sorry, Senator, I'm not quite finished on this line of inquiry.

SEN GERHARDY: No?

SEN NGAN: No.

SEN GERHARDY: I did not realise. I thought you had finished.

SEN NGAN: People don't tend to finish their inquiries mid sentence.

SEN GERHARDY: No.

SEN NGAN: No. 

SEN GERHARDY: I apologise.

SEN NGAN: Thank you.

CHAIR: What's this?

SEN NGAN: I'm sorry, Chair?

CHAIR: There was a disagreement?

SEN GERHARDY: It's quite alright. 

CHAIR: Very good.

SEN NGAN: With apologies for the, um, tone of the question before --

DR FAIRCHILD: That is quite alright, Ms Ngan.

SEN NGAN: Senator Ngan.

DR FAIRCHILD: Of course.

SEN NGAN: I'd like to ask about the specifics concerning the use of Proxies in Burkina Faso.

DR FAIRCHILD: I'm not sure I have that information at hand.

SEN NGAN: I haven't -- I haven't asked my question yet.

DR FAIRCHILD: No, I understand that. It's just --

SEN NGAN: -- so how could you --

DR FAIRCHILD: I meant to say --

SEN GERHARDY: [inaudible]

DR FAIRCHILD: -- only that if you're after the more granular aspects of the project I can't speak to that without the relevant documentation to assist me.

SEN NGAN: My question isn't complicated, so why don't we just try to do this freestyle?

CHAIR: Freestyle?

SEN GERHARDY: Without notes. 

CHAIR: I see.

SEN GERHARDY: It's a term from rap music.

CHAIR: Well, good.

SEN NGAN: For what purpose did you use Proxies in Burkina Faso?

DR FAIRCHILD: Oh, I see. Management and training, primarily. 

SEN NGAN: And what does that amount to?

DR FAIRCHILD: It amounts to having experienced experts, who can't be physically present for reasons of logistics, assisting local authorities and our own staff at Portico in setting up diagnostic and treatment centres in remote parts of West Africa.

SEN NGAN: And these experts are offering this assistance using the bodies of Burkinabe nationals? Via Burkinabe fitted with the Proxy receiver?

DR FAIRCHILD: "Using the bodies" might be a touch vulgar.

SEN NGAN: How else would you describe it?

DR FAIRCHILD: I don't -- your characterisation is technically sound.

SEN NGAN: Were any of these Proxies used in patient treatment?

DR FAIRCHILD: What would be the point of that?

SEN NGAN: I'm asking you.

DR FAIRCHILD: Portico has its own team of highly skilled, highly trained doctors on the ground in West Africa. Using doctors in another part of the world, going through a Proxy is an unnecessary extra step.

SEN NGAN: Thank you.

CHAIR: Senator Gerhardy, you've been very patient, if --

SEN NGAN: Sorry, I just have one more question for now.

CHAIR: Oh, apologies. I didn't realise --

SEN NGAN: Just one more.

CHAIR: Go ahead.

SEN NGAN: Is it -- I'm trying to choose my words carefully here, Dr Fairchild -- is it fair to say that Portico's activities in Burkina Faso were kept secret from the general public?

DR FAIRCHILD: I wouldn't use the word secret, no. Again, I would say you're being a tad dramatic. With the greatest respect.

SEN NGAN: What would you say it was, then?

DR FAIRCHILD: I would say it was something for which we did not seek publicity. 

SEN NGAN: And do you think that it would ever have become public had the death toll in Buaito not become international news? 

SEN GERHARDY: The doctor isn't here to --

DR FAIRCHILD: I can't really speak to hypotheticals. 

SEN NGAN: Okay, let me try something else --

SEN GERHARDY: You said just one more question. If you're going to --

SEN NGAN: This is --

SEN GERHARDY: -- monopolise the floor like this, perhaps I can just go home.

CHAIR: No one needs to go home, let's just keep this civil please.

SEN NGAN: This is a continuation of my previous question, Chair.

CHAIR: Oh alright. 

SEN NGAN: Can you explain why you decided not to advertise the fact that Portico had a relief effort underway in Burkina Faso?

DR FAIRCHILD: Again, I don't understand the question.

SEN NGAN: Did you think --

SEN GERHARDY: Oh come on.

SEN NGAN: Did you think that the public would react negatively to Portico using Proxies in a plague zone?

DR FAIRCHILD: No. I don't even recall if the use of Proxies was discussed in terms of public reaction, Senator. It was, as I've endeavoured to communicate, a relatively small part of the entire operation.

SEN NGAN: But you were still concerned with public backlash.

DR FAIRCHILD: There is, and I'm not sure you have the experience to properly appreciate this, a certain amount of hysteria -- especially where developing countries are concerned -- around how treatment is administered by western organisations in these circumstances. Our priority was not engaging in a PR battle with the public on this. 

SEN NGAN: What was your priority?

DR FAIRCHILD: I would have thought that would be obvious.

SEN NGAN: Regardless, please indulge me.

DR FAIRCHILD: First and foremost to contain the spread of the disease and then to treat those afflicted in the quickest and most effective way possible. 

SEN NGAN: How did that work out in Buaito, Doctor?

CHAIR: Dr Fairchild, you can ignore that. Senator Ngan, you can take this as a -- what is it in football -- a yellow card? 

SEN GERHARDY: I believe so. 

CHAIR: Which is the one where you don't get sent off right away? I want that one. The one that's a warning.

SEN GERHARDY: Yes, a yellow card is a warning. The red card is sent off, I believe.

CHAIR: Very good. Is that something you do?

SEN GERHARDY: Excuse me?

CHAIR: Do you play? Football?

SEN GERHARDY: No, Chair. 

CHAIR: Fine. Senator Ngan, consider yourself warned. Yellow card and all that. Senator Gerhardy?


SEN GERHARDY: Thank you. Dr Fairchild, can you expand on those stated aims you mentioned earlier in Burkina Faso. What, in short, was Portico doing there?

DR FAIRCHILD: This probably requires some context.

SEN GERHARDY: Please.

DR FAIRCHILD: The first reports of an Ebola outbreak appeared in early June of 2020, initially in a small rural village named Buaito. 

SEN GERHARDY: Buaito has no more than a thousand people in it, with one road in and out, why was this of concern? 

SEN NGAN: We know why -- 

CHAIR: Senator --

SEN NGAN: We're just wasting --

CHAIR: Senator. Dr Fairchild.

DR FAIRCHILD: Thank you. Buaito sits on the Volta, which is -- perhaps for the edification of some here -- West Africa's largest river system. 

SEN NGAN: I don't question the seriousness of --

DR FAIRCHILD: It flows not just into many of the major population centres of Burkina Faso, but also into Ghana, Côte d'Ivoire --

SEN NGAN: I understand --

DR FAIRCHILD: And so stopping this threat before it travelled with traders down the Volta was of a very high urgency. You can set up containment zones, but restricting the movement of people up and down a major river is nearly impossible. The best approach is, and remains, to contain and quash the virus wherever it surfaces.

SEN GERHARDY: And so that was your priority.

DR FAIRCHILD: I think that's been established, yes.

SEN GERHARDY: Thank you.

SEN NGAN: May I just --

SEN GERHARDY: No. Doctor, much has been made by the media of the death toll in Buaito.

DR FAIRCHILD: Yes.

SEN GERHARDY: This was due, mainly, to the uncharacteristic, and -- and I don't pretend to be a medical professional here -- but the unprecedented nature of this Ebola strain. Is that correct?

DR FAIRCHILD: That is correct. Typically, where Ebola is concerned, the death toll does not amount to much. Sorry, that's perhaps not sensitive. I mean to say that it's a very nasty disease but not nearly as fatal as others. The strain we encountered in Buaito was both remarkably aggressive and, as our colleagues at Médecins Sans Frontières working nearby discovered, airborne. 

SEN NGAN: I'd like to ask about that. 

CHAIR: Go ahead, Senator.


SEN NGAN: Dr Fairchild, at what point did Portico discover that the virus had become airborne?

DR FAIRCHILD: At the same time as you did, I'd imagine, when Médecins Sans Frontières held their press conference. Actually, no, sorry. A few hours beforehand I was telephoned by Lily Cendra of MSF to let me know. 

SEN NGAN: You didn't work it out for yourselves? You'd been in Buaito for almost a month by then.

DR FAIRCHILD: Treatment and containment is our focus, not diagnostics. 

SEN NGAN: But in order to properly contain the virus you have to understand how it's transmitted, don't you?

DR FAIRCHILD: You do, but you also have to take certain things as read if you're going to have a hope of working quickly. The assumption that the strain we were dealing with was not airborne, was one of those.

SEN NGAN: Why? 

DR FAIRCHILD: Did we make the assumption that the virus was not airborne?

SEN NGAN: Yes.

DR FAIRCHILD: Well, Senator, primarily because conventional wisdom says that it's impossible. We took it as read.

SEN NGAN: Is this why you didn't have sufficient PPE? To protect your doctors?

DR FAIRCHILD: We had personal protective equipment suited to deal with every single Ebola outbreak in the last six decades, Senator.

SEN NGAN: Just not an airborne one.

DR FAIRCHILD: If you would like me to explain again --

SEN NGAN: So, what did you do when you discovered the virus was airborne?

DR FAIRCHILD: When we discovered it was airborne, Senator, we worked to save the people of Buaito and contain the spread, at great personal risk to our doctors. Now if --

SEN NGAN: But none of them died.

DR FAIRCHILD: Excuse me?

SEN NGAN: None of the Portico-employed doctors listed as part of this relief team died. I mean, none of them will talk to me, but they're not dead. 

DR FAIRCHILD: Would this tragedy have been more palatable to you if Portico employees had died, Senator?

SEN NGAN: Well, it would make a hell of a lot more sense. 

DR FAIRCHILD: I'm not sure what you're implying but if this tone of question is going to continue --

SEN NGAN: Were the people of Buaito medically trained, Dr Fairchild?

SEN GERHARDY: What does this --

DR FAIRCHILD: You'd have to ask them.

SEN NGAN: Well, most of them are dead, so I can't.

SEN GERHARDY: Can we get a modicum of civility --

SEN NGAN: Did you know that three days after the announcement by MSF, a trader came down the Volta and into Buaito?

SEN GERHARDY: What?

(PAUSE)

DR FAIRCHILD: I find that very unlikely; the area around Buaito was completely quarantined.

SEN NGAN: I'm telling you that he got through. He didn't even mean to, but he did. He had no idea what was going on. You said it yourself that a river like the Volta is notoriously difficult to quarantine.

(PAUSE)

DR FAIRCHILD: That's true.

SEN NGAN: I've spoken to him, through a translator.

DR FAIRCHILD: Alright.

SEN NGAN: Would you like to guess what he told me he saw?

DR FAIRCHILD: No.

SEN NGAN: I have a written statement from this man, Doctor. Should I --

SEN GERHARDY: I'd like it to be noted on the record that none of this was discussed with the panel, and had it been, I would have objected in the strongest possible terms and, in fact, I do object right now in the strongest possible terms. As I've repeatedly said, Dr Fairchild is not on --

SEN NGAN: It’s a long statement but I can give you highlights --

SEN GERHARDY: None of this has been cleared --

SEN NGAN: He said there were no doctors. In Buaito. Do you know why he would have said that, Dr Fairchild?

(PAUSE)

SEN NGAN: No? How about this. Did you pull your team out of Buaito when you learned the disease was airborne?

DR FAIRCHILD: [inaudible]

SEN NGAN: Excuse me?

DR FAIRCHILD: We tended to the infected until the last --

SEN NGAN: Well, he said that he saw locals, people he recognised from previous trips to Buaito; they were tending to the infected. 

DR FAIRCHILD: Yes, but --

SEN NGAN: Treating them, actually. He said they were administering medicines.

DR FAIRCHILD: Alright. 

SEN NGAN: Did the locals in Buaito know how to do that? 

DR FAIRCHILD: No.

SEN NGAN: He said that he saw several corpses waiting to be buried. And that many of the locals treating the infected were unwell themselves -- that he could see that they were already bleeding from their noses and mouths.

DR FAIRCHILD: That is...probable.

SEN NGAN: But do you know what confused him the most? Would you like to guess? 

(PAUSE)

SEN NGAN: No?

DR FAIRCHILD: They were speaking English.

SEN NGAN: Fluent English. With American accents. 

(PAUSE)

SEN NGAN: How many locals had Proxy receiver implants?

DR FAIRCHILD: Fifty. Or so.

SEN NGAN: That's a lot. When did your team have the time to install the implants?

DR FAIRCHILD: A day before the MSF announcement.

SEN NGAN: Because you knew what was going to happen.

DR FAIRCHILD: We suspected -- this was a contingency --

SEN NGAN: So, when the MSF made the announcement, you evacuated your people to Ouargaye and kept up the work through the Burkinabe Proxies. 

(PAUSE)

SEN NGAN: You wore these people like hazmat suits.

(PAUSE)

DR FAIRCHILD: I don't know if I'd characterise it as [inaudible]

SEN NGAN: What was that?

DR FAIRCHILD: Nothing. 

SEN NGAN: Did you use up all fifty?

CHAIR: "Use up"? What's --

SEN NGAN: How many days did you get out of each Proxy? Before they died and you moved onto the next one.

DR FAIRCHILD: There was no --

SEN NGAN: Roughly.

DR FAIRCHILD: Three days.

(PAUSE)

DR FAIRCHILD: [inaudible]

SEN NGAN: Speak up.

DR FAIRCHILD: Under the circumstances, we felt -- we needed to provide some level of -- there's a balance, with these things. We were probably able to save many more -- and if -- of course there's a regrettable --

(PAUSE)

DR FAIRCHILD: [inaudible]

CHAIR: No. Yes, we can, of course -- a short -- or perhaps it’s now a good time for lunch.

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