The Nganga Solution

The army helicopter lands in a clearing about 300 meters from the clinic, its rotors slowing to a halt. Three men emerge from its hatch looking as if they’ve landed on Mars, wearing hazmat suits with surgical masks and clear plastic visors protecting their faces. They hop out and look around warily.

“Took the bastards a week to get here,” mutters Kasongo. We’re standing at the clinic’s entrance and, as its director, he’s summoned the men to survey our patients, who now number more than 200.

The men step carefully to avoid the numerous puddles blocking their path to the clinic. It’s September and still the rainy season in our part of the Congo. One of them, a white man, sees Kasongo and waves.

“Who are they?” I ask.

Dr. Albert Kasongo drags hard on his cigarette. He’s 50, a short, wiry man with frown lines I’ve watched deepen in the weeks since the first pirogues showed up with dying people. They’ve come at us in both directions along the Congo, east from Lisala and west from Bumba, horrible ships of fools coughing bloody mucus.

“The mondélé (white man) is Varnus from World Health,” he explains. “Behind him is Professeur Ngoy from the École de Santé Publique and following him is that idiot Banza from the Ministry of Health.”

The men approach us then stop, standing outside the clinic at a distance. Kasongo and I put on masks, but we’ve mostly given up wearing them except around patients to stay in costume.

We all bow and wave greetings at each other. Professeur Ngoy recognizes me since I studied at his school in Kinshasa.

“You’re surrounded by illness but look well, Nurse Véronique,” he exclaims. His Kinshasa Lingala is accented like mine, a foreign sound in this northern region.

“Messieurs,” Kasongo begins in French. “Thank you for coming. What you’re going to see looks like tuberculosis. We first treated it with Rifadin until we ran out, but the drug didn’t seem to work. This disease spreads much faster than TB and is killing three in four people. Inside the clinic you’ll meet the few patients who are recovering; outside lying on blankets are the majority who are dying. As you know we’re a first aid clinic. We set broken arms and treat malaria. We can’t manage a new disease outbreak.”

Kasongo stops speaking and motions for the men to enter the clinic. He leads them around the building and outside for 30 minutes. The three men remain bunched together, observing the sick at a distance. Our patients’ coughs originate with a volcanic rumbling deep in their bodies and erupt with a force that’s long since broken their abdominal wall. Their eyes bulge as they lie on the ground thrashing about on dusty blankets, drowning on dry land. The men stop to speak with our refugee staff, Soeur Domingos, the lone survivor from a local Carmelite convent, and Père Dubois, a Belgian missionary priest.

I often wonder why our little caretaker group is still alive. Last week the disease killed Nurse Charlotte, my counterpart. The three Carmelite nuns who fled their pesthouse convent with Soeur Domingos are all dead, and Domingos now works as sort of receptionist for us. Père Dubois followed his dying flock to our clinic, and, with a constitution rare for a mondélé in equatorial parts, says he’s remaining to help the sick with “their transition from this world to the next.” Marie our cook died but was replaced by Antoinette, a local villager who escorted her diseased family here and, once they died, stayed because she said she had nowhere else to go.

The three men have seen enough. Kasongo hands Banza a briefcase with patients’ blood samples that I spent the morning preparing. He’s asking something of Banza and I see the minister shaking his head and backing away toward the helicopter. In a few short moments the three are aloft, and Kasongo remains standing not far from the makeshift helipad. I walk out to join him.

“Jean is sick,” he says staring at the disappearing aircraft.

“I’m very sorry to hear that,” I say. The teenage boy is his only child.

“I asked Banza to take him on the helicopter. He said no… something about a weight limit. Something about quarantine. The army’s even blocked the N6.”

Kasongo knows blocking the road to quarantine us is an empty gesture. We’re de facto quarantined here when the rains turn the unpaved N6 to mud.

We turn to walk toward the clinic. Kasongo tells me they’ll run tests on the blood samples in Kinshasa and Geneva.

“Did they promise relief?”

“Now they’ve seen our situation we’ll get some help eventually,” Kasongo sighs. “But I don’t think they’re sending anyone before they look at the blood.”

“And they know we have no medication?”

Kasongo nods. We have perhaps a two days’ ration of grape cough syrup from a truck that somehow made it through on the N6 shortly after the sick started arriving. I spoon it out in five milliliter doses because it’s the only thing I have to give them. The patients are relieved to see me dispensing medicine in my white lab coat and mask. It’s what they expect from a nurse, and, lacking everything else, I’m determined to live up to expectation.

Our refugee staff has also found jobs that reassure patients. Their roles result from personality traits that in other contexts might be judged as defects, but in our unfortunate situation are advantages. Soeur Domingos is a commanding presence, a big-boned Angolan woman with a loud voice and severe, piercing eyes. Her Lingala is awful, her French laced with Portuguese. I can’t imagine what she was doing at a Carmelite nunnery in northern Congo, her manner better suited to directing traffic at a Luanda intersection. And indeed, that’s what she does here, standing at river’s edge in her habit as the north-central Congo basin points its pirogues and barges toward our little landing. It’s comforting to patients to be greeted by clergy, even if that clergy member is barking at them in some horrible, garbled patois. And while some might be overwhelmed by the volume of patients and their suffering, Soeur Domingos is unflappable. She processes incoming patients like an earth-bound Saint Peter, taking their temperature, separating them into groups, dividing the dying from the merely sick.

If Soeur Domingos is the gatekeeper to our clinic, Père Dubois is our St. Joseph, a comforting presence for the ill. He too wears clerical costume, his collar the only patch of white in his clothing. Bald with a graying fringe, he kneels next to the sick and mumbles the Our Father in a soothing tone. The dying, while never very demonstrative, welcome his presence. Some no longer have energy to cough and just lie still, staring at the sky, waiting for Père Dubois’ valediction. I’m uncertain whether they understand what he’s saying since he’s never learned Lingala in ten years of ministering here and our patients’ command of French is often shaky. Still, the calm sound of his voice is proving more important than what he’s saying.

As for me, I’m insensible. Time has slowed since the plague arrived and the remove I feel from the terrible events around me is likely psychic self-preservation. I arrived here 18 months ago, a newly minted nurse from an educated Kinshasa family, hoping to see a new part of my country and help local people. I also chose this post because I was eager finally to manage on my own. Kasongo gave me and Nurse Charlotte considerable latitude in treating patients, which was necessary since he had to travel to Lisala or Bumba to conduct any business with the Ministry of Health or our suppliers; we have no internet or cellphone service here.

I’m also insensible early the next morning when I hear rumble of our launch’s outboard motor. Kasongo uses the clinic’s flat bottomed boat to make his frequent trips into town, but this time is different. I see three figures: Kasongo, his wife, and Jean, and the vessel is loaded with their possessions. I run to the landing just as the family is pulling away, and Kasongo casts me a sheepish look. He would have preferred to leave without a farewell party.

“Please take care of the clinic,” he shouts over the outboard’s rumble. I watch the boat and wave as it becomes smaller and smaller on our enormous, black snake of a river.

I’m alone now.

Well, not quite: Soeur Domingos approaches and asks where the launch has gone.

“Kasongo’s taken it, gone to Lisala.”

She nods. The boat’s now too distant for her to see that Kasongo’s fled and there’s no sense telling her. That might only weaken her resolve.

Is Kasongo’s departure a dereliction of duty? There’s no point thinking about this: He’s gone now. I don’t know what I’ll do once our cough syrup runs out.

I walk back to the clinic’s kitchen, where I’ve been rapidly depleting my supply of sour-sweet hard candies. They’re my pleasure here. Before the plague I rationed myself to one a day, but now I don’t limit myself since the illness could take me anytime. The little ball of candy sits on my tongue, its sweetened tang dissolving all thoughts but the joy of its flavor.

Antoinette walks in as I’m stashing my candy, and for the first time I get a closer look at a pendant she’s wearing. It’s a miniature version of a triangular mask with heavy lidded eyes and a tightly coiled hairstyle. It’s made of ivory that has acquired a yellowish hue with age. She notices me studying it and blushes, putting her hand over it.

“It’s pretty. What is it?”

“My ikhokho. It protects me. It’s why I’m alive.”

“Where did you get it?”

“There’s a nganga near my village. He gave it to me.”

She’s still blushing but allows me to inspect it.

“You’re a woman of science,” she continues. “This is nonsense to you. But it’s what some people in our villages still believe.”

“I know about ngangas,” I say. “My mother was from the villages and talked about them. I hope the ikhokho continues to work.”

“It helped me but didn’t help my family.” She’s looking down.

“I’m sorry.” I’m uncertain what else to say so I thank her for cooking for us.

The next day I wake to Soeur Domingos’s booming voice calling my name. She’s standing riverside and when I join her, she points to a barge heading toward us from the direction of Bumba. There must be 120 people on it.

“We don’t have enough blankets,” she says.

“Tell them to stay on the boat. I’ll come with medicine.”

I run to the clinic and unlock what remains of the cough syrup. I suit up in my lab coat and mask and rejoin Soeur Domingos, who’s bellowing at two sickly men who’ve rowed up to our dock from the barge.

“These men will take you to the boat,” she says, pointing at two skeletons with bulging eyes.

They’re coughing spasmodically, but both manage smiles as I struggle to find my balance on their pirogue.

What awaits is a symphony of disease. Even before boarding, I recognize the different stages of this illness by listening to the coughing’s timbre. There’re the sharp, rat-tat-tat coughs of the newly sick, whose still vigorous bodies are attempting to repulse the invader. Then there’re the deeper rumbles of those whose lungs reveal the prolonged and disastrous accommodation of the enemy. And finally, there’re the fainter coughs — whispers really — a signal that our foe is finishing with its host and moving elsewhere.

And yet not everyone is sick. When I board, a woman with caged chickens asks me how far it is to Lisala, where she hopes to sell her stock. Two goatherds are playing cards, their animals tethered to a hatch at the barge’s center. But many more are doubled over coughing, and I presume it’s they who requested the stop at our clinic. I dispense as much medicine as I can, but there are so many patients I need to triage. Those with the whisper coughs no longer need me but Père Dubois, who will soon arrive to lay on hands, murmur the Our Father, and tell them that a place with no suffering awaits. He’ll carry them from the boat and once they die, he’ll transport the bodies with somber decorum to a trench he’s dug in a field next to the N6.

That evening I sleep fitfully. The barge finished our supply of cough syrup, and I don’t know what to do next. I’m also aware of something else: The numinous presence of the newly departed souls. Even a secular woman like me can’t ignore it. They’re here observing and, perhaps, guiding us. Because that evening, tossing in wretched wakefulness, I hit on a plan.

The next morning, I devour some hard candy and await Antoinette in the kitchen, sipping a Nescafé.

When she arrives, I waste no time: “Can you take me to your nganga?

She studies me for a moment, puzzled. “Yes… of course. But why?”

“Do you think he could help us with the illness?”

Antoinette puts her hand on her pendant. “Maybe.”

“Does he make medicines?”

“Yes, he’s an herbalist.”

I nod. “Good. Can we go visit him this afternoon after the patients’ lunch?”

“I don’t know if he’s still alive, but we can go see. It’s an hour’s walk. He’s a hermit, but you should still bring some francs to pay him,” she advises.

That afternoon we journey east on the N6. The puddles and rainwater-filled potholes are easier to negotiate on foot, but sometimes the route is so flooded we detour into the bush. The way is clear of all vehicles or pedestrians, and the thatched-hut settlements we pass are all empty save for runty dogs who scowl and bark as we pass. At length Antoinette turns onto a pathway that winds its way through a thick forest to a hut situated on the bank of a Congo tributary. It’s a picturesque location ideal for solitude and river fishing.

It’s at this moment I realize we’re not alone because my nose picks up the pungent odor of cannabis.

“You smell that?” I ask.

“Ah yes! This means the nganga is alive. Come!”

She grabs my arm and leads me closer to the hut, calling out that she is alive and has come to visit with a nurse from the engumba (city).

A thin glassy-eyed man in his sixties appears squinting at the hut’s entrance, his hair matted and clothes unkempt. His appearance gives me pause: He looks like a stoned beggarman.

“You haven’t visited. No one has visited.” His voice is a rasp, and he looks dazed, as if awakened from a dream.

Antoinette explains a plague has struck the region, and that people have fled.

The nganga strokes his chin.

“A few men with coughs came to me. One asked for an ikhokho, the other for medicinal tea. They were the last people I’ve seen.”

Some force now pushes me forward: “We need your tea. This disease floods the lungs. We need tea that will allow breathing and calm the coughing. Can you help us?”

“I can make something,” he says.

I explain we’ll need enough tea for 300 people and that we’ll likely need more.

His eyes widen. He says he needs time to forage but can deliver the tea tomorrow. He wants payment up front, and I give him all my francs because money now feels valueless.

My coughing starts on the way back to the clinic. It feels like feathers floating in my bronchus, lightly tickling the walls of my upper respiratory system. I know what’s happening to me, but at least the realization is less dreadful for being familiar.

Antoinette looks worried but says nothing as we skirt the N6’s lacustrine potholes.

Soeur Domingos scolds us when we return. I didn’t want to reveal that we were seeing a nganga.

“You left me alone with these poor dying people! Where did you go? Why aren’t you here giving out medicine?”

Then I cough and her face falls and I witness something awful in the indomitable Carmelite sister: Fear.

“It’s going to be ok,” I reassure, and she takes a few steps back, looking as if about to faint.

The next day I awaken hungry and devour my remaining sweet and sours. I’m still coughing but feel stronger, and my spirits rise further when the nganga, true to his word, arrives with a woven basket full of leaves, twigs, and bark. Antoinette takes him to the kitchen to find a stockpot for him to combine the tea and water. Fifteen minutes later Antoinette emerges with a cup filled with murky liquid. I won’t administer the tea to my patients before trying it myself, so I brace myself and drink deep. It tastes strongly of Chamomile, and I wait an hour before signaling to Antoinette that she and the nganga should prepare pots of the drink. It’s soothed my throat and made me sleepy, a good sign.

It’s started raining, and I’m helping Père Dubois carry the very sick under the clinic’s eaves, while Soeur Domingos scurries to collect their blankets so they remain dry. The clinic is already over capacity, and the dry spaces under the eaves are filling with bodies. Some patients won’t escape the rain. I’m soaked and coughing, but my heart fills with gladness when I see the nganga ladling the tea into patients’ mouths as if a priestly communion. My mind is now at peace and the air free of spirits.

 

 

Image: “The new way of crossing” by Julien Harneis, licensed under CC 2.0.