Page 2 of Soul on Fire
A never-ending streamof humanity flowed from the forest, from the north provinces of Ituri and Kivu, and into the shattered country outside the embattled United Nations base at Sake, outside Goma.
There was no place for the refugees in Goma, a city decayed in places and swallowed up by the volcanic igneous flow off from Mount Nyiragongo from the eruption a decade before. It was hard to live in Goma, with overcrowded streets and hunting for food that wasn’t always there in the markets, and trying to find a way past the bewildering checkpoints of a dozen rebel factions holding a dozen different neighborhoods as their territory. The throbbing, surging mass of humanity always pressing in. Never-ending construction projects that seemed to go nowhere and turned the city upside down, more so than the volcano had, pushing people even closer together. Goma was a pressure cooker, the pin on the grenade that was Kivu and Ituri Provinces.
But still, the refugees came. The rebels were slaughtering villages again, they said, and there was nowhere for them to go. The rebels were coming south. Sake and Goma were going to be hit. The rebels would slaughter everyone in the city if they came.
Unease spread like a fever. Those who could, fled, heading further south. Panic replaced frustration, the frantic anticipation of what would come with the setting sun. Everyone knew, the rebels came at night.
Refugees waited for their opportunity to move south in the camp outside Sake, the last village before the forest began on the road west of Goma. It was supposed to be temporary, a transition point for refugees fleeing both the rebels and the sickness burning through the forest. The United Nations Force Intervention Brigade was there, but they were a weary-worn, ragged outfit of Tanzanian and Malawian soldiers who had tried and failed to stop the years of war and rebel attacks on civilians, and were now facing an advance from the north coming to their doorstep. Exhausted, they retreated to their base to plan, leaving the refugees to sort themselves out as they camped in the volcanic valley at their gates.
Aid organizations came up from Goma and down from Europe, opening field hospitals and setting up refugee housing, turning a desolate expanse of hardened lava flow into an organized, livable camp.
It wasn’t a comfortable life. Families lived in huts made of plastic sheeting stretched over bamboo poles or scraps of wood. Overcrowding made tempers flare. There wasn’t enough room for the tens of thousands who came out of the forest, but the camp was a sanctuary, a place of salvation, a piece of land under the watchful artillery of the UN. There, at least, they were safe from the rebels, they believed.
There weren’t enough toilets dug, or water stations, and people turned to the lake for both. Cholera swept through the camp, then measles. There wasn’t enough food for a thousand people, let alone tens of thousands. Ration cards were issued, and the World Food Program flew in rice, beans, and flour.
Ikolo Ngondu braced himself over the water bucket, closing his eyes as he swayed. The heat was getting to him, the humidity of the afternoon rising like a wave breaking against his face, trying to drown him. His dark skin glistened with sweat beading down his neck, his back. He hadn’t slept in two days.
The water was warm when he plunged his hands in. Blood flowed off his gloves, spun in red tendrils and twirled away as he washed the stained latex as best he could. They were getting thin. He’d have to get a new pair soon. But not yet. He could pull a little more use out of these. He peeled them off and carefully hung them to dry, then pulled another old pair of washed and dried gloves from the frame of the tent and put them in his pocket.
It was amzunguhabit, his staff teased him. He’d picked it up from the whites. The rest of his nurses, his aides, didn’t wear gloves. There weren’t enough gloves in the hospital for the whole staff. There were barely enough gloves for him, if he washed and dried them and reused them carefully. But a whole hospital using gloves for each patient? Preposterous. They laughed at him.
He grabbed a drink of warm water from his water bottle, closed his eyes, and tried to stop the ground from swaying.
Time for rounds again, and to check on his people. His rounds never stopped, not in a hospital that served a refugee camp of thousands.
They were a hospital in the loosest definition: tents he’d set up in a field around an open grassy courtyard where patients waited, sometimes for over a day, to be seen.
Already, they’d delivered twenty-four babies in the obstetrics tent. Nineteen had survived, and three mothers had postpartum hemorrhaging. They had to operate on two women. He’d gone into obstetrics before the sun rose, and now it was noon.
In the feeding tent, malnourished children who’d survived both the cholera and the measles outbreaks now lay with IVs running to their hands or their temples, and most had a peanut butter paste packed with calories and vitamins all over their sticky fingers and lips. Two white women, volunteer nurses with blonde hair plastered to their sweaty necks, managed the feeding tent. They tried to make the children smile as they kept track of the calories each child consumed.
Sometimes at the end of the day, they brought Ikolo little wrapped bundles: the children who hadn’t made it. He dug their graves before going to sleep, or before he was called to the next emergency.
This time, he got two thumbs up as he handed both women water bottles. No deaths since his last rounds, and the thirty children there were slowly improving. More children would be brought in later, and maybe the news wouldn’t be good the next time he passed by, but for now, this was good. Thirty children were smiling, their lips sticky with peanut butter paste.
In the intensive care tent, silent figures lay on mats in the dirt, IV lines dripping into their arms. Most were recovering from gunshot wounds and machete strikes. One man had lost half his face, another his left arm. One woman would never walk again. In the corner, there was an elderly woman who he was certain had cancer and was near the end of her time. He gave her more pain medication and she squeezed his hand as he rubbed her weary, paper-thin forehead.
The outpatient tent handled nearly everything else: the malaria and deworming medicines, sickness stations for fevers and rashes, and the wound dressing stations. There were over a thousand cases of malaria in the camp, but only the worst off were at the hospital on IV quinine. Forty casts had been applied since the last time he’d been through the tent, and over three hundred wounds cleaned, stitched, and dressed. He listened to his nurses and gave them water,lituma—plantains mashed into balls and baked—andugali. They thanked him, and Ndaya smiled warmly and tried to hold his gaze. She held his hand and stroked her thumb over his wrist as she told him about her morning.
Ikolo pulled away gently with a smile and a nod. He’d have to be careful. Very careful.
The dispensary and laboratory tents were crammed with people trying to get their medicines and waiting for their test results. They had a dozen rapid assays they could use in the field, for malaria, worms, HIV, and the other tropical diseases that plagued their equatorial band. He’d check their logs later, at the end of the night. Or when his night finally ended.
There was one last place on his rounds. His stomach hardened as he made his way across the field and down a sloping hill to the isolated and barren field of igneous rock they’d roped off for these tents. Four of them, all in a line, and far enough apart from each other that a man couldn’t projectile vomit a stomach full of blood and hit the next tent.
He downed his water bottle and then another on the walk. In an hour, he’d sweat both out of his body.
His workers had been trained by the WHO on how to suit up, and they helped him dress in the layers and layers of protective gear he needed: an inner Tyvek suit taped to his booties and gloves, another plastic yellow suit taped over the booties and gloves. Another pair of gloves, taped down. Knee high rubber boots. A hood over his head, taped down, and then a face mask. Another hood and then goggles. Thick, rubber gloves that went to his elbows and made it nearly impossible to work.
Fully suited, he could barely breathe, and sweat ran down his back in a river, waterfalled from his shoulders and down his chest, soaking his clothes and each layer of his protective gear. The heat from his own body had nowhere to go, and it radiated back toward him. He was cooking in his own heat, drowning in his own sweat. His head swam as he gave his team a thumbs up and walked into the quarantine zone.
The first tent held their suspected Ebola patients: anyone presenting symptoms who had come from the forest where the sickness was spreading, leaping from village to village like sparks blown by a fire. Headache, vomiting, sore eyes. Red eyes.
Probable cases were in the next tent: anyone who had confirmed contact with someone infected with Ebola. They waited, praying in fear and a soul-shaking panic. They counted the minutes as they felt every throb in their body, wondering if that was the headache that would signal the infection, or if it was only dehydration.
He moved three people from the suspected tent to the infected tent, and let two probable cases move to the fifth tent, observation. They’d been in the probable tent for three weeks. If their blood test was infection-free, they would be allowed to leave. Their smiles split their faces, giant grins he’d almost forgotten the shape of. Smiles weren’t common in his line of work, not like that.
The actively infected were in the third tent. His team was doing everything they could—trying to keep the patient’s fluids and their blood pressure up to help their bodies remain strong enough to fight off the virus—but it wasn’t enough, not for most of them.
