Even the dead are dangerous in the heart of the Ebola epidemic.
Two small boys waited anxiously at a cemetery on Friday for the body of a relative. They pulled their blue T-shirts up over their mouths and noses, hoping this would somehow protect them from the deadly virus.
When the coffin arrived it was sealed tight, and the boys were warned not to open it. They were not to wash or touch the body, as is traditionally done in their African culture.
One of three previous outbreaks of the Ebola virus was caused by African funeral rituals that involved cutting open the corpse.
The other two, according to the World Health Organization, started in hospitals, which is where the current outbreak in Kikwit also began.
It is the first major outbreak of the Ebola virus in 16 years and dozens have died in recent weeks, most in Kikwit, a sprawling hodgepodge of cement block houses set in lush green savannah.
Carrying palm fronds, the two boys were in a group of about 50 people waiting in a cemetery for bodies to be delivered from the fenced-in hospital 100 yards away.
Medical experts from the U.S. Centers for Disease Control and Prevention arrived in Kikwit from Atlanta on Friday to begin work to contain the virulent disease. A group of journalists, who had received permission from the Zairian government, accompanied the doctors on their flight to the city of 600,000.
The disease starts like malaria with headache and fever. Then the diarrhea and vomiting begin. Death comes within days in 80 percent of cases as blood pours from the victims’ bodies, rivers of red slipping from their eyes, ears and noses.
There is no vaccine or cure.
About 20 people - infected patients and hospital staff exposed to the virus - were inside the 350-bed hospital, which was cleared out to keep the Ebola virus from spreading.
The hospital, painted a bright blue, has been under quarantine like the rest of Kikwit since early this week. But there are no guards or soldiers posted around it, and one microbiologist said he was terrified the virus would spread like wildfire because people were sneaking into the hospital to visit their dying loved ones, possibly carrying the virus with them when they leave.
The microbiologist, Professor Jean Jacques Muyembe of the University of Kinshasa, disagrees with officials from the World Health Organization and the medical aid group Doctors Without Borders, who say the virus was caught early enough to be contained without causing a huge death toll.
Asked how many deaths he anticipated, Muyembe replied, “A lot.”
Muyembe was in the village of Yambuku when the Ebola virus was first isolated there in 1976.
“The difference is, Yambuku is in a forest with a sparse population,” he said in Kikwit. “This is more serious because it is in a city of a half a million. The possibility of expansion is tremendous.”
The number of deaths has been difficult to confirm because of conflicting reports and the uncertainty that Ebola was the cause of all deaths.
The World Health Organization said late Friday that 48 people are now known to have died from Ebola, and 17 more are hospitalized. Nearly two-thirds of the victims worked in the hospital, including three Italian nuns ministering to the poor in Kikwit.
Most of the confirmed Ebola cases were in Kikwit, with one case each in the the villages of Mosango and Yassa Bonga.
Health experts were trying to determine whether the disease had spread to a third village Kenge, about half way between Kikwit and the capital, Kinshasa, 370 miles to the west.
In Kikwit, officials shut down health clinics and schools, cut off air traffic and ordered people to stay home in a desperate effort to keep the Ebola virus from spreading beyond central Zaire. And they threw a quarantine zone around the city stretching 120 miles.
But people ignored the government’s entreaties to stay off the streets and on the surface, nothing seemed awry in Kikwit. Women bought oranges, children played in the streets and men worked.
People were aware of the disease, which like the AIDS virus is spread through body fluids and secretions, not casual contact. And they were instructed on how to keep it from spreading.
“We must wash our hands with soap before we eat, avoid other people’s blood and body fluids,” said Vincent Mapuko, a 54-year-old businessman who was on the street. “As soon as we have symptoms, we must go to the hospital.”
The precautions are difficult, however, in a country where men commonly urinate in the streets, running water is scarce and soap, for some, is an unaffordable luxury. Perhaps the most difficult thing is the prohibition on shaking hands.
Mbuka, a pharmacist who goes only by one name, said he hasn’t been troubled by requests for medicine to prevent the Ebola virus because most know the disease has no cure.
They have turned to witchcraft instead, he said.
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