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  Then, in September 2011 we inadvertently found ourselves retracing the steps of another order of warrior knights, the Knights of St John of Jerusalem, the Knights Hospitaller. Through the Christian domination of Jerusalem from 1091, the Hospitallers and the Knights Templar were the two predominant military orders in the land we now know as Israel. Our trip was a decade after the 9/11 confrontation in 2001 between jihadist Islamists and what they evidently regard as the Crusader culture of contemporary Western civilisation. It seems odd to those of us who do science for a living that some religious fundamentalists, and we can include extremist elements of all three of the Abrahamic religions (Judaism, Christianity and Islam), still seem to be embedded intellectually in a mediaeval worldview.

  Early in the eleventh century Caliph Ali az-Zahir, who at that time controlled Jerusalem, allowed merchants from Amalfi and Salerno to build a hospital for sick and ailing pilgrims. The Hospitallers coalesced around what became known as the Amalfian Hospital to evolve as a monastic order of Knights, Men at Arms and Chaplains, with their dual medical/military role reflecting that they were given the additional job of providing an armed escort for Christian pilgrims. Following Saladin’s conquest of Jerusalem towards the end of the twelfth century, the Hospitallers relocated to the ancient seaport of Acre (now in Israel), moved on to Cyprus after the fall of the Holy Land, and from there to Rhodes, whence they were expelled a couple of hundred years later by the vastly superior forces of the Ottoman Turks. We’d visited Jerusalem, Acre and Cyprus on earlier trips to that ancient part of the world, and in 2011 we were off to Rhodes.

  Just off the Anatolian (Turkish) coast, Rhodes is the largest of the Dodecanese Islands and the capital of the South Aegean region. After several days in Malta participating in the 4th European Scientific Working Group on Influenza, we flew from Valetta to Athens, then on to Rhodes. A short cab ride took us to the Sheraton Rhodes Resort and we were soon engrossed in the social and intellectual content of the 8th Greek Legal and Medical Conference. Involvement in three (on Crete, Kos and Corfu) of the seven such previous meetings had educated us on the complexities of the science/medical/legal/ethical interfaces, and on intractable societal issues, where many who had come repeatedly to these events are deeply involved. Despite the romantic ambience, the insightful talks are well attended, while evening entertainments and visits to local villages, smaller islands and archaeological sites contribute to a generally relaxed and enjoyable experience.

  This eighth meeting in Rhodes was, however, saddened by the recent death (from cancer) of David Roylance, one of the Melbourne lawyers (the other being Eugenia Metrakis) who organised the meetings. Rhodes is known for the seventh century Rhodian Sea Law that governed commercial trade and navigation in the Byzantine Empire and David was a prominent maritime lawyer. His memory was honoured by the presence of a notable English colleague, Lord Robin Byron. Descended from the Anglo–Scots romantic poet and hero, Robin spoke of the part Lord George Byron played in the Greek struggle against the Ottoman Turks. George (who died of sepsis in Missolonghi) was described by his most famous lover Lady Caroline Lamb as ‘mad, bad and dangerous to know’, though it seems that she was also pretty erratic. Wife of the Honorable William Lamb, Lady Caroline died before William succeeded to the title of Viscount Melbourne and, as Whig Prime Minister, gave his name (in 1837) to the city of Melbourne. Such connections maketh the world.

  Summarising the history of Rhodes over the past three thousand plus years, the island has been variously controlled by the Minoans, Myceneans, Dorians, Athenians, Rhodians (who did deals with the Egyptian Ptolomeys and Rome), Empire of Byzantium and, from 1309–1522, the Knights Hospitaller. Displaced by the Ottomans, the Turks in turn ceded control (from 1912) to Italy. A transient German occupation (1943–45), followed by two years as a British protectorate led to Rhodes becoming in 1947 part of modern Greece. Presumably the Rhodians have been there all along, with today’s citizens reflecting the genetic and cultural contributions of those who went before. Though committed to chastity – interpreted as ‘conjugal fidelity with wives’ – DNA from the Knights Hospitaller would undoubtedly be part of the current gene pool.

  We saw relics of the Ottoman, Hospitaller and earlier eras as we walked around the ancient Port of Rhodes, though there were no remnants of the 33-metre-high bronze and stone Colossus of Rhodes that fell and shattered (226 BCE) in an earthquake. One of the seven wonders of the ancient world, visitors evidently marvelled at the massive pieces left lying on the ground for more than six hundred years. Classically thought to have bestrode the harbour entrance, archaeological evidence suggests, however, that this enormous statue to the sun god Helios probably stood on land, perhaps on the site of the still existing Fortress of St Nicholas.

  Despite the strength of that bastion, the great chain across the harbour mouth and the still-standing, heavily reinforced walls of the Palace of the Grand Master, the 7000 Hospitaller knights and men at arms were unable to withstand the 400 ships and 100,000 soldiers marshalled by Ottoman leader Suleiman the Magnificent. On New Year’s Day 1523, those Hospitallers who survived the six-month siege were provided with fifty ships to carry them, their weapons, their library and a substantial number of accompanying persons to a temporary refuge on Crete. Their longer-term housing problem was then solved in 1530 when King Charles V, the Holy Roman Emperor, gave the Knights of the Hospital of St John of Jerusalem (who had by then added the Knights of Rhodes to their brand name) control of Malta.

  We were entertained to a welcoming reception at the Grand Master’s Palace, now a museum emphasising the Byzantine era. Apart from the imposing scale of the structure itself, we saw elegant mosaics and some relics of the Knights Hospitaller, including a portrait of Grand Master Philibert de Naillac. Not everything that existed during the time of the knights remains intact. Continuing its military role under the Ottomans, much of the first floor was severely damaged in the nineteenth century by an accidental military explosion, then restored (1937–40) as a holiday villa for fascist dictator Benito Mussolini. Though he never visited his Rhodes retreat, we found it more than a little odd to see a large plaque honouring the dubious Il Duce near the Palace entrance!

  Earlier in Malta, the big influenza meeting was well attended by the science press and, very atypically, it became a global media event. Most will remember the bird flu scare of the early 2000s. First recognised (1977) in Hong Kong, the H5N1 avian flu spread rapidly to kill (or necessitate the slaughter of) millions of domestic chickens. As the infection moved south and west, more than eight hundred people died following direct transmission from birds. The big concern was that the H5N1 virus might mutate to allow human-to-human spread. (As previously noted, I wrote about this at length in earlier books, Sentinel Chickens and Pandemics.)

  Trying to understand what changes might be important, several top groups engineered variant H5N1 viruses that could transmit between ferrets. Big deal, you say, but influenza virologists regard ferrets as human surrogates. In a lively presentation, Rotterdam researcher Ron Fouchier emphasised the potential risk if comparable mutations should occur in nature. Unfortunately, that woke the journalists up. If Fouchier had given his talk in a dull monotone (not unknown at scientific conferences), the media guys might have slept through it!

  As a consequence, the furore about possible ‘dual-use research’ has slowed this (and other important work with viruses) for years. What’s dual use? The appropriate ‘use’ is for serious scientists working under ultra-high security conditions to identify novel mutations before the natural emergence of a pandemic flu virus, like the 1918–19 strain that killed some fifty million people. The concern is, though, that characterising the mutations that allow an H5N1 virus to transmit from person to person could lead to malevolent use where, working from published information, sophisticated terrorists might make and release a lethal pathogen. This led to a moratorium on such work, though how exactly strengthening regulations in well-monitored European and North American laboratories would
deter a molecular virology-trained jihadist or eco-terrorist intent on decreasing the size of the human population is far from clear. These experiments are not that hard to do, and you might think we would be better prepared if studies done by legitimate scientists working in safe facilities were telling us what to look out for!

  Unaware of the gathering dual-use storm, we had time out from the flu meeting to look around Malta’s capital, Valletta. Heavily fortified, Valletta is named for the Hospitallers’ Grand Master Jean de Vallette who, in 1566, laid the first stone of the city. The Knights of St John remained on Malta till 1798, when, expelled by Napoleon and greatly weakened, they dispersed across Europe. The French were in turn evicted two years later by the British, who ruled until 1964, when Malta gained independence as a parliamentary democracy within the British Commonwealth.

  As a strategically placed military, naval and air base in the Second World War, Malta was a constant thorn in the side of the Axis powers during the North Africa campaign. Heavily bombed by the Italians, then the Germans, the massive fortifications built by the knights almost four hundred years earlier (and strengthened since) were barely dented. Over the centuries, those steep stone walls had also seen off the Hospitallers’ old enemies, the Ottoman Turks, on several occasions.

  The British influence was immediately obvious from the line-up of brightly painted, 1940s vintage single-decker Bedford and Leyland buses. Evidently these were replaced soon after our 2011 visit with the formation of a new national bus company. As for the knights, they left most of their gear behind. Suits of armour were useless by 1798 and Valletta under the French remained the safest haven for their magnificent volumes of illuminated manuscripts. These painstakingly created religious relics were by no means the first we’d seen, though the Malta collection is extraordinary. But, just as the invention of gunpowder made the armoured knight irrelevant in warfare, the printing press changed the illuminated manuscript from a means of record and communication to an artwork.

  Then, in the Hospitallers’ St John’s co-cathedral, we saw the eight, ornate side chapels of the Langues, the region-based groups of knights (Anglo–Bavarian, Auvergne, Aragon, Castile, Provence, France, Italy and Germany) that defined their organisation after the end of the Crusades. The Order’s 600-bed Sacra Infermeria was initially (and remained) state-of-the art for a sixteenth century hospital, but it failed to adapt when nursing was transformed by the work of Florence Nightingale in the Crimean War (1853–56), coincidentally with the very beginnings of modern medicine and surgery that have so improved human wellbeing. Remodelled, the substantial Sacra Infermeria survives as a Conference Centre, though that’s not where our influenza meeting was held. Most people educated in the Western tradition find it hard, I believe, to get into a mediaeval religious mindset, but there’s no doubt that the Hospitallers were dedicated to both their caring and military missions and were major power players in their day.

  The Knights of St John tradition continues in five Catholic Chivalric Orders, reflecting that, through their long history, the Hospitallers stayed on reasonably good terms with successive popes. Several years back, visiting the apartment where John Keats died (from tuberculosis), overlooking Rome’s Spanish Steps, we were close to the Via Condotti, the present street address of the Sovereign Military Hospitaller Order of Saint John of Jerusalem of Rhodes and of Malta. Robert Matthew Festing, the seventy-ninth Prince and Master, is a former Sotheby’s auction representative who also served in the Grenadier Guards. When interviewed by media proprietor and journalist Evgeny Lebedev, the Grand Master evidently conveyed the sense that the Hospitallers are ‘more Rotarian than Hellfire Club’. Insofar as they remain crusaders, the zeal of the Knights Hospitaller is clearly focused on a caring rather than a military role. But that’s reality, while those sinister, shrouded Templar warriors of The Da Vinci Code do make for good airplane entertainment!

  As killers, though, even if there are mediaeval knightly assassins working quietly among us, they can only be minor players compared with that much more ancient scourge of humanity, the influenza A viruses. By mid 2012, the US Centers for Disease Control and Prevention was reporting 248,000 worldwide deaths from the ‘mild’ H1N1 (2009) pandemic ‘swine’ flu strain!

  There’s no major film about a flu pandemic but Contagion (2011), which gives a pretty good account of what might happen if a rapidly spreading human pathogen went global, earned less than $140 million. Released in 2006, The Da Vinci Code movie grossed $750 million. It seems we much prefer fantasies about murderous monks to realistic depictions of the mayhem that practitioners (like the Hospitallers in their day) of the art and science of medicine seek to reverse when we’re hit by some horrific infection emerging from nature. Bad guys are much more fun than bad bugs! But we’d do better across the planet with more of a compassionate Médecin sans Frontières/Red Crescent/Red Cross and less of a confrontational warrior (whether jihadist or crusader) culture!

  CHAPTER 7

  Vertical city

  OUR FIRST EXPERIENCE OF Hong Kong was in 1971 when, returning to Australia after five years living in the United Kingdom, we stopped over to visit my childhood friend Jeff and his wife Annie. Their government-owned apartment overlooking the Happy Valley Racecourse was considerably more opulent than the accommodation we’d just left in Edinburgh! Jeff trained as a lawyer in Brisbane, worked as a parliamentary draftsman in Canberra, then moved on to do the same job for the British Crown Colony. He met Annie in Hong Kong. As I recall, they were living on the lower levels of the hill, though, if they’d stayed around for long enough, promotion could have led to being moved up to a higher and cooler altitude. This was, as a last outpost of Empire (the British would leave in 1997), I guess, a reflection of the well-oiled (partly with alcohol) hierarchical system that allowed the imperial shell game to survive for so long.

  Just as Hong Kong has long served as a gateway to China, it has also been a portal for influenza A viruses that jump (via domestic chickens and pigs) from their avian wildlife reservoir to infect people. Through the 1990s and beyond, I often visited the outstanding University of Hong Kong influenza group, led by Sri Lankan and Oxford-trained medical researcher Malik Peiris, to interact as a member of their scientific advisory committee. My memories are of intense discussions, giving the occasional lecture, sitting in committee rooms, enjoying great food and experiencing the bustle and vitality of Hong Kong street culture. But I was preoccupied, working hard and did not, apart from the expansion of freeways associated with the new airport, take much notice of how the city was changing.

  At an evening reception held on the patio of a luxury house owned by the entrepreneur and real estate developer Ronnie Chan in 2015, we again looked down (as we had in 1971, though from much higher up) on the Happy Valley Racecourse. The green oval of the track seemed much the same as I recalled, and that was also true for the hills flanking the valley below. Hong Kong is very proud of the fact that 43 per cent of the island has been kept as (mostly hilly) parkland. Citizens can run and walk in green, open spaces, though the air pollution that blows across from the intensively industrialised mainland can be a major problem. What had changed in those thirty plus years was the evolution of a spectacular urban skyscape.

  Defined by incredibly high towers, contemporary Hong Kong is a vertical city. Fascinated by the view, the perception that some of these extraordinary, pencil-like buildings could only be a few rooms across was no doubt incorrect and a trick of distance, but it reminded me of the late Duchess of Windsor’s trope: ‘You can never be too rich or too thin.’ Great wealth and architectural elegance were on prominent display. Brightly lit and seen from above, the city stood like some extraordinary work of art. I’ve stared out from the top of New York’s World Trade Center (pre 9/11) and have had drinks admiring the panorama from Kuala Lumpur’s Petronas Towers, which were, from 1998–2004, the world’s tallest buildings. But both the flanking effect of the green hills and the multiplicity of supremely elegant, man-made stalks sprouting from th
e valley below make Hong Kong seem unique, and a vision of the future.

  All of us are undoubtedly aware that skyscrapers increasingly dominate inner-urban landscapes. That’s long been true of Manhattan, of course, where, walking the streets on a cold day, the freezing winds channelled between tall towers recall deep valleys surrounded by mountains that block both sunlight and warmth. The latter is never a problem in Hong Kong, but we can now have that experience in Melbourne, for instance, where more and more historic buildings (if they survive at all) persist only as a facade to street level with a skyscraper behind.

  This progression is inevitable and, if we’re not to cover all our arable land in concrete, desirable. When we visited Hong Kong in 1971, the global population was around 3.8 billion, up from 2.34 billion in 1940, the year that I was born, and 2.6 billion in 1950, when Jeff and I were friends in primary school. Between 1971 and 2015, the number of people on the planet increased almost two-fold, to 7.43 billion, with both the broader Hong Kong area (including Kowloon and the new and marine territories) pretty much paralleling this growth rate – 3.69 to 7.25 million. During that time, Melbourne also went from 2.5 to 4.5 million, but the big difference is that Australian cities sprawl, while Hong Kong space is limited. And though both are vibrant and culturally interesting seaports, much of the growth in Melbourne reflects that Australia is an immigrant country while Hong Kong, as a major business hub and gateway to Mainland China, attracts energetic entrepreneurs from across the planet.

  Currently, around half the world’s people live in urban environments. By 2050, that number is likely to increase to at least five billion, with most of this transition happening in Africa and Asia. This is, in fact, both the biggest challenge and the biggest opportunity for us if we are to ensure a sustainable future for humanity and, indeed, for other complex life forms that depend on the continued existence of forests, lakes and clean rivers. Hopefully we can stabilise our numbers but, whatever happens, we have to stop destroying the planetary landscape and compromising the health of the oceans. The immediate challenge of rapid urbanisation is to minimise the extent of what we euphemistically describe as ‘informal settlements’ (see chapter 13), while maximising the growth of appealing living spaces. How do we do that?