are often richer in biodiversity. Living things find it easier to survive along edges, margins, boundaries, where different communities come together and mix, and where opportunities for feeding abound. Birds often congregate along ecotones—birds flock and feed along the edges of woods and along shorelines.
Mbwambala was a little ecotone, a narrow stretch of forest in the cleared country, running for a bit more than two miles along the stream. It contained groves of African corkwood trees. They had sprung up rapidly after the old, tall, primeval trees of Mbwambala had mostly been cut down. He walked along the stream, making his way under nightshade bushes the size of rhododendrons. There were small pigeonwood trees growing by the stream. Here and there, a few old forest trees remained—pale Tola trees and heavy, valuable Bomanga trees. These trees were 150 feet tall and maybe a century or two old. They were the remnants of a tropical forest canopy. Their crowns waved and flickered in the sunlight. In their tops lived bats, birds, insects, mites of the canopy—creatures that probably rarely came to the ground, if ever.
G.M.’s main profession was that of charcoalmaker. For years he had been cutting down trees in Mbwambala with an ax. He felled the trees and hacked up their branches and limbs and trunks into pieces, and made charcoal from them. The way he made charcoal was to dig a large pit, five feet deep, and fill it with pieces of wood. He set the wood on fire, then covered the burning wood in the pit with a layer of earth. The wood turned slowly into charcoal under the layer of earth.
Most cooking in Africa is done with charcoal. G.M. sold his charcoal to city people. That day, G.M. had just finished a session of charcoalmaking. He had recently removed a load of charcoal from his pit, and he now wanted to refill the pit. He spent the morning chopping down trees, lopping off their limbs, and moving the pieces of wood closer to his fire pit, in order to refill it with fresh wood.
What lived in the crowns of the trees he was chopping down no one really knows. Roughly half of all the species on earth are thought to live only in forest canopies. No one can say how many species exist on earth. Many biologists believe that most species on earth have not yet been identified and named. Most of these unnamed, undiscovered species (or life-forms) are viruses and bacteria. There are also thought to be many, many arthropods that have never been discovered. An arthropod is a small animal with an exoskeleton and jointed appendages—for example, an insect, a spider, or a shrimp.
HALF A YEAR LATER, when the disease hunters finally explored Mbwambala, they found a small, narrow hole that G.M. had dug during one of the last days of his life. The hole went down two feet among the roots of a tree. They wondered if he had dug up something in the hole and had eaten it. It might have been a tuber or a burrowing rodent with a nest of babies, or perhaps he had found a snake or some edible grubs there. Caterpillars are also a favorite food in Congo, especially a particular caterpillar that has a hard, shiny black head and a soft body and can grow up to five inches long. People in Congo roast it over a charcoal fire. Perhaps G.M. found some unusual wild caterpillars in the leaves of a tree he had cut down and ate them. He kept a few snares and traps in Mbwambala, for catching small animals, which he brought home to his family to eat. Perhaps he’d visited his snares, perhaps not; no one knows. Perhaps an animal bit him while he was taking it out of one of his snares; no one knows. The animals that turned up in his snares were mostly wild rats, including the giant African rat, which can be the size of a small dog. Some local people claimed, afterward, that G.M. had stolen an animal from someone else’s snare.
Later in the day, he headed farther up the creek, deeper into Mbwambala. There, he visited a couple of maize fields he was tending. He had carved these fields out of the forest. During the heat of the day, he took a nap under a small shelter in one of his fields. Perhaps he was bitten by a spider or insect while he slept in the shelter. He returned to the city at dark. He had traveled twenty miles that day.
He would never visit the place again. Over the next few days, he began to feel unwell. He stayed home at his family compound in Kikwit. He ran a high fever; his eyes turned bright red. He got the hiccups, and they simply wouldn’t stop. His face assumed a masklike appearance. He began defecating blood into his bed. His family took him to the Kikwit General Hospital, in the center of the city, where he died on January 13, of what people in the city would later call
2. Maternity Ward
BY LATE JANUARY, three members of G.M.’s family had died of
Then it got into the Kikwit Maternity Hospital. This was a small collection of buildings in the south-central part of the city where pregnant mothers went to have their babies delivered. When a pregnant woman came down with it, the first sign was brilliant red eyes. The eyelids would eventually ooze blood, and the blood would stand on the edges of the eyelid in beaded-up droplets. The urine turned red—the kidneys were hemorrhaging; then the kidneys failed, and the person stopped urinating. The infected women in the maternity ward developed a masklike facial expression, and they became disoriented. Some had seizures. The disease was attacking the central nervous system. Some of them abruptly went blind. The skin became covered with a rash, a sea of tiny bumps, like goose bumps. The patients suffered from disseminated intravascular coagulation (DIC), in which the blood formed tiny clots throughout the body. At the same time, some of the patients were having hemorrhages, including bloody noses; in many patients, the stomach became distended and they began vomiting blood.
The illness invariably caused pregnant mothers to abort the children they were carrying; the fetus or baby was always either born dead or died shortly after birth. None of the babies of ill mothers survived. During the delivery, the women experienced profuse, body-draining hemorrhages from the birth canal, and they died of hypovolemic shock. This is the shock that occurs when much of the blood has been drained from the body.
The doctors and nursing staff who worked in Kikwit Maternity Hospital did the best they could, but the hospital suffered from a shortage of basic medical supplies, such as rubber gloves. The doctors thought that they were dealing with an outbreak of dysentery.
On April 10, a medical technician who had been working with dying mothers at Kikwit Maternity Hospital came down with severe stomach pains. I will refer to him as the Maternity Technician. He went across town to the Kikwit General Hospital to get himself examined and treated. A doctor there suspected that the Maternity Technician had typhoid fever with peritonitis—a bacterial infection of the abdomen that is fatal if it isn’t treated immediately. The doctors at Kikwit General Hospital put the Maternity Technician into surgery.
A group of Italian nuns worked in the hospital as nursing sisters. They were known as the Little Sisters of the Poor, and they came from a convent in Bergamo, Italy.
One of the nuns, Sister Floralba Rondi, assisted two surgeons and a nursing team in the operating room on the day they operated on the Maternity Technician. The lead surgeon made a vertical cut down the center of the technician’s abdomen, opened him up, and looked into his abdominal cavity. They were expecting to see pus. Pus occurs with a bacterial infection. There was no pus; there were no bacteria. (Viruses are not bacteria.) The surgical the team took out the man’s appendix.
The next day, however, the Maternity Technician grew worse. His abdomen became very swollen and distended. Wanting to see what was causing the distension, the doctors inserted a hypodermic syringe into his abdomen and extracted a sample. The syringe filled up with blood. The blood had a runny, homogenized appearance. It wouldn’t coagulate.
The doctors brought him back into the operating room and opened him up through the same incision as before, in an effort to find the source of his bleeding and stop it. They couldn’t find any source for the bleeding. The blood seemed to be coming directly out of his organs, as if from a squeezed sponge. They sewed him back up. By the time the surgical team had finished the surgery, the team members were probably smeared with the Maternity Technician’s blood and probably had it all over their hands. Some or all of the team members performed the surgery without gloves, with bare hands.
Two days later, the Maternity Technician died.
In the next ten days or so, nearly every member of the team that had operated on the Maternity Technician also died, including Sister Floralba and two surgeons. Other medical staff who had been caring for the Maternity Technician, including Sister Dinarosa, died as well. At this point, it was clear that there was a dangerous disease
