No Time to Lose: A Life in Pursuit of Deadly Viruses (4 page)

With an airy wave of his hand, Pattyn then also volunteered me to visit the infected Kinshasa nurse with Sureau—“my young colleague will accompany you.”

We were driven to the Clinique Ngaliema in a Fométro four-wheel-drive car. It suddenly began to rain heavily; I was not yet used to tropical storms. The Clinique Ngaliema was actually a hospital for the wealthy. It was near the Congo River, in Gombe, one of the nicer parts of town, which in colonial times had been a neighborhood reserved for whites. But still, the roads were gashed with deep potholes and the earth beneath was red. Even something as ordinary as the ground you walked on was different here, more vivid and alive.

There was a very fearful atmosphere in the corridors of the clinic. Dr. Courteille, the director of Internal Medicine, who received us, briefed us first about safety precautions. After the deaths of the two Belgian nuns—and their infection of nurse Mayinga—their mattresses were burned, and their rooms locked up and fumigated with formaldehyde vapor on four successive days. Disposal of bodies was carried out by wrapping them in cotton sheets impregnated with a phenolic disinfectant, and the fully wrapped bodies were sealed inside two large, heavy-duty plastic bags before being placed in their coffins.

Courteille, who was taking care of the nuns and of Mayinga, was careful not to accompany us to the sick nurse’s bedside, and it seemed that all the personnel kept a guarded distance from their former colleague. But Sureau had already visited Mayinga and he seemed at ease. Despite our cumbersome protective garments—balaclava-style bonnet, surgical robe, gloves, overshoes, and goggles—he had obviously struck up a rapport with the young woman. She was very sick, and completely desperate, and convinced she was going to die.

Mayinga had been hospitalized on Friday, October 15, with a high fever and a severe headache. Now, on Monday the 18th, she began bleeding; there were black, sticky stains around her nose, ears, and mouth and blotches under her skin where blood was pooling. She had uncontrollable diarrhea and vomiting. She clung to Pierre, who soothed her, telling her about the serum that Margaretha Isaacson would administer, which contained antibodies that might strengthen her immune system to fight the virus. Sadly the serum didn’t work and Mayinga died a few days later.

We drew blood to perform a number of blood tests that would guide the decision to prescribe supportive treatment for intravascular coagulation, which we thought might be the cause of death in hemorrhagic fever. We took the vials of blood over to the hospital lab to look at them under the microscope—Mayinga was lucky to have been hospitalized in her place of work, because Ngaliema was a private clinic for privileged people, and it did have some basic equipment. But none of the technicians or personnel was willing to handle Mayinga’s samples for some good reasons, as the hospital lab did not have a containment facility.

I examined her blood, and it was a catastrophe. The platelet count was terrifyingly low. As green and unimaginative as I was, the real lethality of this virus began to sink in, and my hands shook a little as I handled her blood. Who knew how this virus was transmitted—by insects, or body fluids, or dust.

We also visited Pavilion 5, the isolation ward. Clinique Ngaliema was constructed in the colonial manner, with separate pavilions connected by covered walkways to maximize the potential for isolating contagious patients and to keep as much air as possible circulating around. About 50 people were quarantined at that point, either because they had cared for the two Belgian nuns from the Yambuku mission or because they had had close contact with Mayinga. They included a fourteen-year-old girl who had eaten from the same plate as Mayinga the day she developed a fever; there was even a pregnant woman, quite visibly only days away from giving birth.

We checked them out briefly; although clearly frightened, and perhaps depressed, they seemed physically normal. They remained in isolation for nearly one month, but none became ill.

We returned to the Fométro for a quick shower before the International Commission’s second meeting of the day. Once again we all filed into the large meeting room, to discuss details of the trip that Sureau, Breman, Koth, and I would take. I noted that an obviously important white man was already seated at one of the chairs along the wall. Broad-faced, with a trim gray moustache, he wasn’t taking notes—didn’t even look as though he was paying much attention—and I swiftly forgot about him. But at the end of meeting, he took over.

“So we’ll need a C-130 transport plane,” he began to dictate, speaking French with an extreme American accent. “We’ll need a Land Rover, with supplies of gas . . . ” and he listed an improbable amount of equipment and supplies.

At some unseen command, an assistant holding a wooden box entered the room. Inside the box was the coolest contraption I had ever seen. It was a mobile phone—the kind of thing you saw only in movies in those days. Bill Close picked up the handset and said in his funny accent, “I want to speak to General Bumba”—the commander in chief of the Zairean Air Force, who had the same last name as the town where we were headed.

“Mon vieux,” he drawled. “I’ll need a C-130 tomorrow morning at 4
A.M.
sharp to drop a team in Bumba, OK? Merci!”

And then without really waiting for a reply, he put down the handset and his assistant closed the box. We all just gaped at them.

Bill Close (incidentally, the father of the actress Glenn Close) had come to Congo just before Independence as a missionary worker, though he was a trained physician. Somehow he became President Mobutu’s personal physician as well as director of the biggest hospital in the country, Mama Yemo Hospital in Kinshasa (it was named for Mobutu’s mother). But this didn’t fully explain the extent of his power and influence in Zaire. He was a mysterious man, thoroughly likable, with an unmatched knowledge of Zaire and connections at all levels in society. A year later, he left Zaire, disillusioned by the Mobutu regime. We stayed in touch until his death in Wyoming in 2009.

AFTER THE MEETING
broke up, it was suddenly nightfall, the abrupt equatorial sundown another new and surprising experience for me. I hadn’t had lunch and I was ravenous, so a few expatriate Belgians took me out for a night on the town. They filled me up with stories of the epidemic—how pilots were refusing to fly to Bumba because birds that caught the mystery disease were falling out of the sky; how Zaireans believed the virus was caused by witchcraft and was impossible to escape.

In sum, these expats were eager to tell the greenhorn all about the realities of “Darkest Africa.” Although there were of course exceptions, I didn’t much like what they said—a lot of disrespectful, sneering stories about those Zaireans.

But I immediately loved Kinshasa’s night scene. The music was terrific—a very elegant, intricate rumba-type sound—and the dancing was fascinating: in Zaire people moved their hips, not their feet, swaying in a minimal space, creating a wave that was subtle, suggestive, complex. In Belgium at the time, we discoed, jerking around. This was beautiful.

It was a different planet, and yet I felt part of the scene—completely natural, not scared or threatened in any way. That slight beat of panic at the foreign and unknowable nature of this country fell away, and it came to me that everything would be absolutely fine.

CHAPTER 3

The Mission in Yambuku

I
N THE 4
A.M.
darkness, with a pulsing hangover, I watched our military pilots striding angrily back and forth on the tarmac. They were clearly bursting with resentment at the prospect of flying to the epidemic zone. They refused to help us load the aircraft. Finally they agreed to fly us to Bumba as instructed, but they told us they wouldn’t stop there—just drop us off and fly on.

A Land Rover was driven on board and secured. We loaded in some gasoline, a few crates of protective gear and medicine, and some supplies for the Belgian mission. We settled into the military-style seats along the walls and braced for a rocky ride to Bumba, the capital of the subdistrict.

As the sun rose the pilots loosened up a little. They let us move, one by one, into the cockpit, where we could take in the incredible vision of the tropical rain forest that flowed beneath us like a vast, heaving green sea punctuated now and then with a hamlet of fragile huts. The plane was basically following the Congo River—huge, nine miles wide in places, the other bank often barely visible. Again I heard the story of pilots watching birds fall dead over the forest around Yambuku, struck midair by the mystery virus, but there was a new twist: dead human bodies lining the roads.

We landed in Bumba, a riverside town of then perhaps 10,000 people and the administrative and trading capital of the district—a territory half the size of Belgium, with mostly dense forest interspersed with coffee, cocoa, rice, and palm plantations, almost all owned by Unilever corporation. For about two weeks the entire zone had been in quarantine and under martial law, cut off from the rest of the country. And this had occurred during the crucial rice and coffee harvest, the area’s main (if not only) source of cash. The timing could not have been worse for the population and for the few businesses struggling to survive in this forgotten corner of the globe.

As soon as the C-130 came to a standstill, I moved to the hatch at the back, impatient to get to work. What I saw through the open loading dock is permanently imprinted in my memory: hundreds of people—the whole town it seemed—were standing on the red-earth airstrip in the burning sun, first staring at us and then yelling, “Oyé
!
Oyé!
”

When Ruppol drove the Land Rover out of the huge plane, the crowd cheered and a steady murmur of comment began. The crowd was yelling because they were expecting supplies of food and basic goods—this was the first plane to land in several weeks. When they realized we were not delivering foodstuffs, the more desperate pushed forward, hoping to board the plane, but the military police beat them back.

As soon as the last box was unloaded, the pilots shouted, “
Bonne chance”
(Good luck!), with a look of pity and, if I’m not mistaken, scorn, before gunning the engines and taking off. We too were now part of a quarantined population. As soon as the noise of the engines died away, Ruppol, who had grown up in Zaire, addressed the crowd in Lingala, with the natural authority of a man born to rule.

“Good morning men and women of Bumba. We know that you are suffering from the terrible epidemic of Yambuku fever. We know that you all suffer from the quarantine. We have been instructed by President Mobutu Sésé Seko to come and help you, to stop the epidemic so that the quarantine can be lifted and the harvest can be shipped to Kinshasa. We ask for your cooperation in respecting the quarantine, isolating any person who falls ill, and reporting them to the authorities.”

The crowd responded with approving calls of “Eh” and “Oyé.”

A determined Flemish man appeared, perhaps 10 years older than I, wearing dark glasses and a local shirt made of African
wax
material. He introduced himself to us: Father Carlos, from the Order of Scheut, thus a colleague of the Catholic missionary priests who had died of the virus in Yambuku. I was startled—priests, to me, were old and wore vestments—but Carlos drove us to his mission, where a photo of Mobutu adorned the fluorescent green wall alongside the smaller wooden crucifix. (This bright green was, I soon discovered, the color of Mobutu’s “Party of the Revolution.”) We were plied with steak and French fries (from the mission’s cows and potatoes) and whisky and beer and cigars (at noon!).

Though very committed to the well-being of his flock, Father Carlos was also a very practical man, and he briefed us about the epidemic. It had all started in Yambuku in the first week of September, when the headmaster of the mission school, who had been traveling through the north on vacation, returned and fell ill. After his death, crowds attended his funeral, and within days the mission hospital began filling with other sufferers, including the headmaster’s wife. They suffered high fever, headache, hallucinations, and usually bled to death. One after another, his caregivers at the Yambuku mission hospital fell ill, along with members of his family, other patients, and dozens of other, apparently unrelated, people. Father Carlos listed their names, emphasizing—perhaps naturally—the Belgian nuns and priests who had succumbed to the epidemic: Sister Beata, who acted as midwife; Sisters Myriam and Edmunda, who had been transported to Kinshasa and died there; Father August, Sister Romana, Father Germain. With the Zaireans every patient was preceded by a kind of rough genealogy—“the son of”—so I grabbed a notebook.

Nobody knew how many people had died, but all those who fell ill died within eight days. The few nuns still alive at the Yambuku mission were convinced they too would die soon. Only one person was known to have recovered from the virus. As for current cases, there were some in Bumba, and several people who had traveled to Bumba from Yambuku and were being kept in quarantine.

After lunch Pierre and I strolled down to the river, 16 miles wide at Bumba—almost half the entire coastline of Belgium!—and choked with blue floating-hyacinth flowers. The entire town of Bumba had to come here to get water to drink and wash with: though the colonial administration had installed pipes to bring running water to some of the houses, the system had already, 15 years after Independence, fallen into disrepair. There was also no electricity in the town apart from a few privately owned generators.

We circled back to the Portuguese grocery store, Noguera. The shelves were bare—a bit of powdered milk, salt, matches, white flour, cooking oil, cylinders of gas. There were, however, some cans of pilchards and blue workers’ overalls: both Pierre and I liked the idea, and bought them. They seemed more practical than the few clothes I had packed, and better adapted to the unbearable humid heat.

It was time to pay our respects to the
Commissaire de Zone
(District Commissioner).
Citoyen
Ipoya Olonga was almighty in the region, second only to the military commander and the chief of the feared state security service. Citoyen Olonga also represented the omnipresent MPR—the
Mouvement Populaire de la Révolution
—Zaire’s sole political party, of which every newborn automatically became a member. After President Mobutu visited China, Zaire was completely organized into the propaganda terminology of Maoism and riddled with official corruption, the country quite openly structured into a sort of fiscal feudalism, in which each level of tax collector took a cut of the tax he’d collected and sent the rest up the hierarchy, until President Mobutu placed a great portion of his citizens’ earnings into his own bottomless pockets.

I found myself enduringly fascinated by this totalitarian, nearly Orwellian, type of organization, which gave a creepy, fascistic overlay to so many kinds of interactions that would otherwise have amounted to simple gangsterism. Everyone complied with the command to call each other
citoyen
, betraying a very pervasive fear; in every type of relationship in Zaire you could smell this corruption and abuse of power.

Our meeting with Citoyen Olonga was pointless but necessary, the first of many empty protocol visits I would have to endure in my life. We were kept waiting for the obligatory hour, so that we would be impressed with the
Commissaire’s
power. Fortunately we had a chance meeting with the director and doctor of the Unilever plantation in Ebonda, 10 kilometers from Bumba and the main employer in the region. The epidemic was an economic disaster for PLZ (the Lever plantations in Zaire), because they couldn’t transport their harvest and many of their workers had fled. Together with the missions, they provided the only logistical support that we could count on in Zaire. They had come to ask advice on how to handle funerals of patients dying with hemorrhagic fever; they had seen several deaths and feared for the lives of two sick children aged three and five years old. We agreed to see them the next morning, on our way to the Yambuku mission.

At last we were permitted to enter the office, where we had to endure the ritual of tea and coffee and a pretense of polite conversation. Finally Ruppol, who was easily the most familiar with this sort of proceeding, broached the need to provide our short expedition—and the full team’s much longer one—with backup assistance, including transportation. It was all done with few words and some highly scripted gestures.

“How can the poor region of Bumba provide you with all this logistical help? I have no budget for this kind of assistance! We’re all suffering here, and I can’t even go to Kinshasa to join my family” (a kind of shuffling of papers, a highly telegraphic frown of worry, a terribly regretful shaking of the head).

More empathetic smiles from Ruppol, whose face must have been aching. “Ah, but we have considered that. And what we have here will help you to do it.” Suddenly a shiny, medium-sized suitcase materialized in Ruppol’s hands.

Ruppol had come with a
suitcase
full of local currency. I had never seen such wads and wads of money. Officially, one Zaire was worth one US dollar; in reality the currency was worth a fraction of that. Still, when he opened his suitcase to display its contents to the
Commissaire
de Zone
it was like a drug deal in a movie. There was no receipt, no detailed estimate, no pretense that we were hiring so many people for such-and-such a length of time. Indeed, whatever we had to do afterward we had to pay for separately.

But the suitcase had broken the ice. Citoyen Olonga told us about the very real worry of food provision in town; no boats or trucks had been allowed to enter the zone for more than three weeks, he said. The military camp in Bumba had been without food for several days.

Back at the mission, I slept like the dead. I had missed three nights of sleep—in Antwerp, on the flight to Zaire, and in the bars of Kinshasa.

The next morning we visited the small Bumba hospital, where a dozen people traveling from Yambuku were quarantined, along with one or two other patients suspected of possible hemorrhagic fever. The Clinique Ngaliema in Kinshasa was a little dirty from a European perspective, but still, relatively decent. Here I saw real deprivation, conditions that were truly shameful. The few suspected fever patients were clearly ill, but their symptoms were not spectacular: they had high fever and chest and abdominal pain, but a cursory exam gave no indication that they had hemorrhagic fever. They lay on beds without any mattress—just the bare metal springs, covered by a cloth if they had one. There were no medicines. The walls and floors were really dirty and had literally fallen away in parts. All this was apparently “normal.” These vulgar conditions had no connection to the sudden health crisis—things were always this way.

All around the hospital were women with shaved heads, some screaming and crying, others preparing food with a lack of hygiene that made me blanch. The patients themselves were in a condition little short of horrific, blood oozing from their mouths.

Dr. N’goy Mushola, the doctor in charge, was a fairly young man, accustomed to performing surgery and C-sections in conditions that would cause a European medic to faint. But he was clearly overwhelmed and terrified by the hemorrhagic fever. Several people had died in his care, and he described their violent, uncontrollable bleeding to us in apocalyptic tones.

I drew blood from all of N’goy’s patients for further examination in Kinshasa. Together with Masamba Matondo, the chief medical officer of nearby Lisala—coincidentally the birthplace of President Mobutu, the man whose photo was on every wall—N’goy gave us a quick, clear overview of the epidemic situation based on his visit to Yambuku. Again there was the litany of names: X got it, and her husband Y, and also her sister Z, and she was cared for by her aunt Z from the village of Something—so that it became quite difficult for me to follow and I grabbed my notebook and raced to get it all down. At least 44 villages in a radius of 60 miles around Yambuku were affected. Most of the first people to be affected had apparently visited Yambuku hospital but, Masamba said, many secondary cases had occurred—in other words people who had not been in Yambuku. Virtually everyone who had been infected with the fever had died within a week.

N’goy nodded: everybody died. He had heard of only one survivor, perhaps two, but none of his patients had lived.

By the time we left for Yambuku we had heard of well over a hundred fatalities. My natural skepticism began to fall away, replaced by doom. The stories of Father Carlos and Dr. N’goy, the reports at the Bumba hospital, the evident fear of the pilots and the townspeople of Bumba and their desperate attempts to flee the town . . . the apparent virulence of this disease, the high mortality—put together with the poverty and poor organization that characterized Zaire and the potential for contagion in Kinshasa—added up to a picture that Joel Breman summarized as “potentially the most deadly epidemic of the century.”

We left in two Land Rovers—one of them lent to us by Father Carlos—and drove in silence through the overpowering, unstoppable, exuberant force of uncut equatorial jungle, well over 30 feet high. All kinds of green pressed in on us, high walls of leaves and muscular lianas like something out of a Tarzan movie. I had never experienced how powerful and all-invading nature can be, and somehow it compounded my sense that we were making our way to something horrible and uncontrolled.