Authors: Howard W. French
I had been snared in this Catch-22 so many times already that by now I regarded it as one of those weary, immutable facts of life. You reach your destination with all of your paperwork just right, only to have some red-eyed official blow smoke in your face and invent yet one more piece of paper that you are supposed to be carrying. Often, there was no way forward except to pay a bribe.
Outsiders might call it corruption, or perhaps even anarchy, but for Zairians the games officials played with “formalities” was an unremarkable part of what was called “Système D,” for
the French verb meaning “to make do.” Stealing was not just all right in Zaire; it had become an absolute imperative—a matter of survival, especially for unpaid officials assigned to distant provinces.
Early the next morning we drove to Kinshasa’s general aviation airport, which was run-down even by the standards of this run-down country. First and foremost, it was a boneyard, the final resting place for the rusty DC-3s and other workhorses that had flown incredible numbers of hours with minimal maintenance ferrying Mobutu’s troops and his private merchandise—diamonds, gold, pineapples, cassava— around this huge country. Mobutu had largely given up on territorial control by this stage of his rule, having concluded that it was as tedious as it was costly. The one thing that counted, he had concluded belatedly, was control over markets, and from this point of view, the president’s fleet of planes, though barely airworthy, was his most vital asset.
Every few months one of these loose-riveted aircraft would crash somewhere, typically in a remote forest. It was the kind of thing that people around here shrugged off as happenstance. This casual fatalism changed forever a few months after our trip, though, when the inner-city airport itself was the scene of a dramatic crash: A Russian Antonov running guns and diamonds back and forth to Angola did a belly dive, plowing through the adjacent, zinc-roofed shantytown and killing scores of residents in its huge fireball.
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
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-infection 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?