Dec 2003

CONGO BRAZZAVILLE :: INTO AFRICA
This is an extract from an article by Joanne Harris, recently published in The Sunday Telegraph in the United Kingdom.

Determined to witness the struggle against fatal sleeping sickness, the novelist Joanne Harris travelled to the Congo with Medecins Sans Frontieres - a venture her friends and family dismissed as madness. Here she looks back on her perilous journey into the heart of darkness.

I was invited by Médecins Sans Frontières in order to raise awareness on projects in the region. I like Médecins Sans Frontières. It doesn't build churches. It doesn't pass judgement. It doesn't advertise, campaign or harass. It doesn't waste money on administrative costs. It won the Nobel Peace Prize, but its members don't go on about it.

In the Congo Médecins Sans Frontières energies are concentrated on fighting sleeping sickness, a foul disease which, although almost eradicated in the 1960s, has returned on an epidemic scale, killing about 66,000 a year throughout Africa.

© Tom Craig
The author shows children photographs on her camera

© Tom Craig

First, some facts. The Congo is a French-speaking west African country about the size of Germany. Most of the population (just under three million) live in the capital, Brazzaville, or its coastal counterpart, Pointe- Noire.

Its leader is Sassou Nguesso, who took power in 1997, having toppled the elected president. Much of the interim has seen conflict between government militia and rebels, with whom an uneasy peace agreement has now been reached.

Left, testing for sleeping sickness at the mobile clinic

Today we begin the journey to Mossaka, where Médecins Sans Frontières has its new sleeping sickness programme. It will take two days, one by road, one by river.

At dusk we arrive in the village of Tongo. This is where the road ends: from here we must travel the remaining distance to Mossaka – about 30 miles – by pirogue. The Médecins Sans Frontières pirogue is a hollowed-out tree with an outboard motor tacked onto the end; the trip will take at least six hours.

© Tom Craig
The mobile clinic, testing for sleeping sickness

© Tom Craig

This is what I have been most looking forward to – the sound of the engine, the rush of the brown water, the fishermen in their tiny pirogues skating along the banks.

When we stop to refuel, the orchestra begins: monkeys, frogs, birds, cicadas. The river is several miles wide at this point; no one knows how deep.

Left, the author en route from Tongo to Mossaka by pirogue

Today we visit the hospital where the new screening programme for sleeping sickness is under way. Mossaka is a good place to begin; there are 10,000 people living here on the river in mud-brick huts, without sanitation or medical supplies, and when the rainy season begins in a couple of weeks' time, the whole region will be underwater. Insects love it - the malaria-carrying mosquito, the tumbu fly and, of course, the tsetse fly, which harbours the trypanosome parasite that causes sleeping sickness.

Right, the author meets children at the MSF clinic in Mossaka

© Tom Craig

© Tom Craig
Doctors and MSF staff plan their journey

It begins with a pinprick, a blood test. The mother takes it first; the children begin to cry, then to scream in fear at the sight of blood. The team works steadily and with unflinching good humour as the day wears on. The heat grows and the smell of sweat and chemicals becomes almost overwhelming. And the people keep coming - old women with hip problems, children with malaria, old men who have gone blind. The team has screened the entire village - 712 men, women and children - in a single day. It's a relief – and a triumph for all.

The five-year-old, Josiace, shows a positive result. More tests are needed; a physical examination of ganglia (clusters of nerve cells) in the neck, then a sample of fluid from a lymph node. The little boy is close to panicking. The nurse tells him to be brave. Another blood test, this time from the vein, must be taken. If this shows positive, the doctor will need to make a lumbar puncture, tapping fluid directly from the spine. It is a painful, frightening process.

As Josiace waits his turn, we can see the preceding patient – a young woman – weeping silently as the long needle drains.

© Tom Craig
A queue of villagers outside the clinic at Mossaka

© Tom Craig

Europeans tend to assume that Africans take this in their stride, that they get used to it, somehow; as if the death of an African child were somehow less important, less heartbreaking than that of one of ours.

It isn’t true: children are valued here more than anything else, and even their names – Désiré, Joyeux, Bien-Aimé, Je T’aime – reflect the joy they bring their parents.

Left, Josiace, five, and his father await their results.

A group of young boys in defiance of the NO BATHING sign, take it in turns to hurl themselves into the current, dodging the rocks and the deadly undertow, to emerge, breathless and laughing, 500 yards downstream.

I ask one boy if it's dangerous, to swim in the rapids. He grins. 'Everything's dangerous,' he says. 'Don't you know there's a war?'

© Tom Craig
Boys risk the rapids, leaping into the river at Brazzaville

Médecins Sans Frontières first worked in Congo in 1997. In April 2002, renewed fighting between government troops and rebel militia in the Pool region in the southeast prompted Médecins Sans Frontières to send a team to Kinkala to evaluate and respond to the needs of a large group of people displaced by the fighting. The current Ebola epidemic is the third in less than three years. Ebola is a disease that causes internal bleedings and almost always ends up in death. The virus gets spread through direct physical contact and the only way to stop the spreading is by isolating infected people.