Continent for the Taking: The Tragedy and Hope of Africa

by Howard W. French

  On this particular day we were looking for a much smaller plane; anything, really, that could ferry us to Kikwit, 370 miles to the southeast. In our rather desperate circumstances, Robert and I, together with David Guttenfelder, a photographer from the Associated Press who had been working the Ebola story for nearly a week, were willing to spend a couple of thousand dollars. With speculation rife about a coming quarantine, just about everyone else was trying his or her best to flee Kikwit, so we had to find a pilot who would wait for us on the ground there until late in the afternoon, rather than taking someone else’s money for the return run. Otherwise we would never make it back to Kinshasa in time to file our stories and pictures—or, for that matter, to eat a meal free from worries of contamination.

  David, who had flown in and out this way a couple of times since the start of the epidemic, had a lead on a small, two-engine plane, and within forty-five minutes of arriving at the airfield, we were taxiing for takeoff. We had a surprise guest, however, in the form of a potbellied Zairian colonel in full khaki uniform. Presumably, he had finagled a seat for far less than we had paid.

  All over the continent, I had made a practice of turning down soldiers attempting to hitch rides in my car—including many with guns. It was a matter of safety, yes, but of principle, too. Almost everywhere ordinary people associated soldiers with thievery, repression or worse, and I didn’t want any part of those associations. As we watched the colonel load several duffel bags full of Zairian currency into the small plane’s hold, though, I began to think that this time luck might be on our side. The pilot had whispered to us that the money was meant to pay the troops in Kikwit, which seemed like an inspired decision by Mobutu, aimed at avoiding mass desertions amid the general panic brought on by the virus.

  From the air, with all its greenery Zaire looked like a set for Jurassic Park. As Kinshasa’s huge sprawl slowly receded and then finally disappeared, the landscape molted suddenly and repeatedly. We went from forests as thick as heads of broccoli bundled tightly together, to golden savannahs resembling the American Great Plains, and finally, as the earth began to rise and fold upon itself, to extraordinary mesas. Green and flat, rising sharply from the surrounding plains and neatly covered with grass, they looked as if Norse giants had conceived them for putting practice. A trancelike state of relaxation settled over me with the unexpected nature show. It was a precious instant to be savored, like a final cigarette before an execution, and then, just as suddenly as it had begun, the sound of the small plane’s deceleration and initial descent snapped me out of my reverie.

  As the plane taxied, the simple cinder-block building that served as a terminal came into clear view. It sat near the edge of one of those steep escarpments we had been admiring from the air. In my lap I clutched a small plastic bag containing what I realized at that instant was a thoroughly silly emergency medical kit: rubber gloves, disinfectant and bandages. Suddenly, the reality of our destination and the plague that we had decided to visit was upon me.

  Our little airplane had the effect of chum on sharks, and the soldiers who were guarding the landing strip began making their way toward us even before the engines were cut. As we deplaned, though, I realized just how correct my intuition about the colonel had been. The soldiers smiled at the sight of him and jostled one another to help with his bags. Normally, this would be the moment of our arrest, but we made off with scarcely a show of our papers after agreeing with the pilot to meet at the latest possible hour, which he said was 5 p.m.

  A battered old taxi bore us creakily into town, toward the hospital that had been ground zero of the epidemic, in search of the kinds of stories we had been reading and hearing—stories almost too terrible to believe, scenes of patients whose very innards were dissolving into blood and mucus, expelled in agonizing bouts of diarrhea that ended in death. Italian missionaries from an order known as Little Sisters of the Poor had run the small hospital, with its pastel blue walls, but the Catholic sisters, who had always imposed a strict order on this place, preserving it from the powerful tug of equatorial decay, were themselves among the first to die in the epidemic.

  Our first glimpse of the outbreak was of the parties of mourners who gathered under the eucalyptus trees that surrounded the small complex, aged women shrouded under lengths of colorful printed cloth who sat on the ground or on straw mats rocking back and forth. It was impossible to tell if they were mouthing words or simply moaning, but their powerful and eerily rhythmic wailing was painful to hear, and clearly bespoke the recent or imminent death of loved ones.

  The moment we got out of our car, our noses were assailed with the stinging odor of chlorine. Healthcare workers in uniform, volunteers recruited for the task, were constantly spraying the area with a powerful solution of the disinfectant; where traffic was heaviest, nearest to the wards, the chlorinated ground had even turned muddy in patches.

  Officially, there had been three hundred or so deaths so far, and most of the sick had ended up in this hospital, working their way from one makeshift ward to the next as their horrible symptoms grew relentlessly worse. First came the sore throat and headache, and then came the violently bloodshot eyes and runaway fever. Finally, the commencement of vomiting and constant diarrhea irrevocably confirmed the diagnosis.

  Katuiki Kasongo, a forty-two-year-old army doctor, received us in as friendly a manner as one could hope for under the circumstances. Herds of Western reporters had galloped and brayed through the very scene that stood before us, jamming their cameras into the faces of terrorized, dying patients and their relatives, and now they were gone, although the tragedy had still not completely run its course.

  Dr. Kasongo did a quick calculation and said there were fourteen remaining patients. But after a glance into Pavilion 3, the last stop for patients, those practically beyond hope, he corrected the tally. A couple of men draped in sheets lay inside, moaning faintly but showing few other signs of life. “The dangers are different, of course, but for us, the medical staff, the treatment is the same as for our AIDS patients,” Dr. Kasongo said. “We don’t treat them. We only try to comfort them. With all of our training, we feel totally helpless and discouraged, especially given the risks we are facing here. We are doing our best, but being incapable of offering people anything more than a couple of Tylenols eats at you. It is a terrible situation.”

  There was no sign of pining for recognition when he said matter-of-factly that Kikwit’s small medical community had been sounding alarms for weeks about the strange and sudden apparition of people struck down by violent bouts of bloody diarrhea. He spoke with a depressingly familiar African weariness that comes from fighting against long odds, waging an extraordinary struggle with few means at your disposal—least of all the attention of outsiders. It would be easy to mistake his tone for fatalism. It was the sound of being completely alone in the world, a supposedly interconnected world, and it is a feeling that many Africans, particularly well-educated people like Dr. Kasongo, experience every day.

  In matters of knowledge, science and medicine in particular, the outside world has never grown accustomed to listening to Africans, or respecting their knowledge of “serious” matters. Listening to Dr. Kasongo, I recalled a story I had often heard when I was in Haiti. During a debate about that country in the United States Senate early last century, Secretary of State William Jennings Bryan had expressed surprise to learn that black people could speak the language of Molière. “Imagine that,” he said. “Niggers speaking French!”

  Kikwit emerged from obscurity when the number of deaths had simply become too great to ignore, and perhaps most important, when foreign missionaries began to die along with the villagers they had attempted to treat. So many of the gripping stories I had read or heard, outside of the vignettes of blood and death themselves, were of the intrepid Afrikaner “bush scientist” or the brilliant French doctor or the American experts who had landed from the Centers for Disease Control as if beamed down from a spacecraft with their impressive anti-infecti
on suits. The Africans were simply the victims, like props in a play, and the surfeit of suffering and the preternatural modesty even of the frontline workers like Dr. Kasongo combined to make them ideal for the role. Few of us had stopped to notice, but these were the real heroes.

  The head nurse, Césarine Mboumba, a sturdy thirty-six-year-old woman dressed in a faded blue uniform, had worked at the small Kikwit Hospital for the last six years. She was present at the terrifying start of the epidemic, and had watched her closest colleagues die one by one for reasons no one understood. All she could think of was that God, for his own obscure reasons, had decided to spare her, because they had all been doing the same work.

  “At the beginning we had no idea that this was an epidemic, never mind an Ebola epidemic,” she said as she walked me through the wards. “I was the nurse who operated on the very first case. My anesthesiologist died, the second nurse died, then two of my assistants died.”

  That initial patient had himself been a laboratory worker named Kimfumu, she said. He was transferred to Kikwit Hospital complaining of severe abdominal pain. With new patients trickling in, complaining of similar symptoms, and invariably progressing toward the same bloody diarrhea and vomiting that announced their pending death, worry mounted, and the alarms started sounding for outside help. Two weeks later, two of the Catholic sisters succumbed. And two days after that, another pair of sisters followed them.

  “When this began, the only thing we could consult was an old book on tropical medicine,” Mboumba said. “It says nothing about the kind of bleeding that we have been witnessing, but when people ask me if I want to leave Kikwit, I say absolutely not. My work is here. I am no longer afraid.”

  Near Pavilion 3 sat a faded lime-colored building that now served as the morgue. Just outside, a dozen or so bodies that had been wrapped in heavy plastic sheeting lay in the shade of a high row of flaming red flowers, awaiting burial. Every now and then, I could see workers in masks and gloves leaving the morgue pushing wheeled carts atop which perched flimsy wooden coffins. When I left the hospital, I discovered their destination.

  Just down one of the narrow dirt roads that led to Kikwit Hospital, fresh trenches had been dug by heavy machines. There, the virus’s poor African victims were being given hasty burials. I arrived on the scene to find a delicate young woman dressed in a simple cloth wrapper, striking even in her grief as she used a narrow little shovel to fill in the dirt over her mother’s grave. “Today it is my mother I’ve come to bury,” said the woman, who gave her name as Julienne Kinkasa. As she spoke, another younger female relative looked on. “The other day it was my sister. She was a trainee at the hospital.”

  When I asked her if she thought she, too, was now at risk of dying, she said, “At this point I am not afraid of the disease. What I am afraid of is starving to death. We have been abandoned by society. People are so worried about the epidemic that they flee from us. What will we do now to survive?”

  I decided to drop in on the headquarters of the foreign scientists who were said to be tracking the virus like bounty hunters, competing to discover its source both for the resulting good and perhaps also for the personal recognition and gain it would bring them. I found them in a dimly lit building not far from the hospital, a handful of men poring over computer printouts, composing messages for transmission by satellite fax back to their headquarters. Occasionally they looked up to exchange tightly clipped remarks among themselves.

  It was clear from the moment they noticed me that they had already seen more than enough of my kind, and one of them announced, sharply, that they were all very busy. No longer expecting an interview, I pressed for a few leads. Could they tell me which neighborhoods of Kikwit had been particularly hard hit? Were there still new cases being reported? Where might we find someone who was newly sick?

  At this, one of the foreign experts, a Frenchman named Rodier, snapped, telling me that the hordes of poorly behaved foreign reporters had made it nearly impossible for them to work. “We have had enough of your types looking for people with blood coming out of their ears,” he said. “The epidemic is over. You are too late. Go back home!”

  With what time we had left, I told our driver that I wanted him to take us through Kikwit’s poorest neighborhoods, where we could inquire if there had been any reports of unusual deaths. The mention of poor neighborhoods in this city of half a million—a place without lights, telephones or even running water for most people—appeared to create some confusion. Poverty was everywhere, and in such circumstances its very definition begins to change. But within fifteen minutes, after winding and crossing back through a dusty quarter called Mkwati, where mud-walled houses were separated by bramble hedges, we had found what we were looking for.

  There, a man who sat in the shade repairing a bicycle near a bend in the road told us what the all-knowing WHO experts had been unable or unwilling to say. “Six people died in that house right there,” said Mpouto Kalunga, a peanut farmer who wore a worried look and said he lived nearby. “There are others dying, too. They are not my friends, just my neighbors.”

  Kalunga was clearly wary of us. A carload of foreigners was a rare sight in this neighborhood, and in these times of plague it was unlikely to mean good news. We told him that we were journalists, but he seemed scarcely mollified. All over town there had been wild rumors of suspected carriers of the virus being rounded up and disappearing.

  “After the first deaths, the foreigners came and sprayed all of the houses,” he said, as if he hoped we would disappear. “Are you going to spray again?”

  We insisted that we merely wanted to see the sick, and finally he pointed up the slope toward a house on the right. There, three young women, girls really, their heads shaven in a sign of mourning, sat morosely in a dusty courtyard. I asked them if a relative had died from the virus, and immediately regretted having been so direct. “Our father died of the hiccups that he got from eating bad fruit,” said the eldest of the sisters.

  She was the only one of the three who could manage a bit of French, which made it easier for me. She continued in her defensive vein, “The disease you are looking for is not around here. It is in the hospital. You must go back there.” As she spoke, a man arrived on a bicycle and interjected himself casually into the conversation of total strangers, as had happened so often to me in Africa. As Westerners, the privacy we are accustomed to is one of large homes and separate living quarters, of a life with telephones and automobiles. This, I was reminded, was the world of villages, where secrets were much harder to keep.

  “Their father died of Ebola,” he shouted, once he had confirmed our interest in the outbreak. “Don’t believe what they are telling you.”

  With that, a small fight broke out, and though I did not understand the specifics, it was clear that an exchange of insults was under way. We continued onward by foot up the red dirt road’s incline. One block away we found Mula Kinvita, a slender twenty-nine-year-old man wearing pink rubber gloves, washing himself painstakingly with a bucket filled with soapy water. “My mother died this morning at ten a.m.,” he said, confirming my suspicion that there had been a death in his house. “She got sick with a fever last week, and it just kept getting worse and worse. Yesterday she began vomiting and having diarrhea. This morning, she just lay there trembling, and then she was dead.”

  I asked why he was washing himself this way, and he told me that he had just finished washing his mother’s body in preparation for her burial. When I asked where she was, he pointed meekly to their one-room, mud-walled home.

  Sure enough, inside his house, lit at this hour only by the fading rays of late-afternoon sunshine that streaked in through a small square window, lay his emaciated mother. She was stretched out on a straw mat, partially covered with a sheet of faded cloth.

  The washing of cadavers is a solemn family duty in the Central African hinterland, and in a world of short lives and infrequent joys, sending one’s loved ones off properly into the hereafter becomes all the
more important. By tragic coincidence, this ceremonial preparation of the dead had become one of the prime means of transmission, and yet even after it was known that the virus was spread this way, it was difficult to persuade people to forgo their last rites.

  Kinvita insisted that nobody had warned him of the danger. “A couple of days ago, when the Red Cross people came through here, I told them about my mother and they gave me some Tylenol to give her. When they returned in their truck this morning, I asked them to help me bury her, but they told me they are not allowed to carry the dead, and drove away in a hurry.”

  With the hour of our charter’s return flight to Kinshasa fast approaching, numbed by our neighborhood tour, I asked our driver to take us back to the airfield. We boarded the plane with a minimum of fuss from the soldiers there. Once again, the colonel sat in the front seat of the plane. Back in the capital, only he would know how much of the soldiers’ pay had actually reached the troops. Indeed, back in Kinshasa, only he would care.

  Once airborne, we spoke little among ourselves. Perhaps as a release, David took pictures as we flew. My thoughts turned to Kinvita. I had urged him to go to the hospital and tell the people there about his mother’s death. I had no idea if he would heed my advice, but I was skeptical. What good had the hospital ever been to him before?

  Perhaps he would be coming down with the headaches soon, I thought. Perhaps the virus would kill him next. Perhaps there would be others in the neighborhood. It seemed clear that I would never know, and perhaps neither would the experts who sat in their makeshift office compiling their reports.