Clouds of darkness

The Sick Ones: Clouds of Darkness

North Kivu, in the eastern Democratic Republic of the Congo, is a land on the dangerous margin of things. Life and death have no boundaries, faith falters and evil is a tautology formed throughout the ages.

Africa, Democratic Republic of the Congo, North Kivu; Beni, 29th July. Following the outbreak of the epidemic in August 2018, checkpoints were set up along the main transport arteries and at all the points of entry into the cities of the North Kivu and Ituri provinces

A sky of dark clouds hangs over the harsh, green and black forest that surrounds and overwhelms everything. At once you encounter the malignant nature of equatorial Africa. Your legs trudge through mud, your lungs gasp in the humidity and your soul becomes infected with the stories you hear. Here, in a present of unrelenting misery, a brutality that seemed dead has reappeared as if by a curse. People are killed for the richness of their subsoil, tortured and pillaged for a pittance and violated to silence, mercy and the slightest echo of remorse. Today they are also dying, devoured by a disease that is as terrifying as the plague. In the dark depths of the Congolese forest, the first outbreak of Ebola in the context of war is spreading. It is is the worst epidemic recorded for the number of child victims.

Africa, Democratic Republic of the Congo, North Kivu; Butembo, 30th July. A glimpse of Butembo

At a check-in point presided over by the military and police, a line of people wait to have their temperature taken and wash their hands with a solution of water and chlorine. At the same time through the speakers comes a metallic and ghostly voice, unrelentlessly chanting the precautions to be taken. Ever since the infection broke out, barriers have been set up at the entrance to towns in the Congo where meticulous checks are conducted. Healthcare and law enforcement personnel examine everyone who passes through and perform the operations wearing masks and gloves. No one dares to reach out a hand to you in the lands stricken with Ebola. A nudge with an elbow is as good as a formal handshake, otherwise there is no contact, no greeting, no concern for others. Each person is alone with his psychosis. The megaphone never stops squawking, broadcasting the existence of the virus. Everyone submits to the washing of hands and the taking of body temperature. Then the barrier is raised. There’s a sign showing the stages of the infection drawn in great detail, illustrating how you die of the virus. After passing the information poster, you enter the town of Beni. This is the epicentre of the outbreak.

Since August  2018, in the northern regions of the Democratic Republic of the Congo, a country devastated by decades of civil war, among the poorest in the world and with over four million internal refugees, over 3000 cases of the illness have been registered and more than 2000 deaths, 30% of which are minors. The mortality rate, around 67%, is among the highest ever recorded. Moreover, despite new treatments having been introduced and an experimental vaccine, the infection keeps spreading and the World Health Organisation has proclaimed an international emergency.

Africa, Democratic Republic of the Congo, North Kivu; Beni, 27th July. In the ETCs, all the material the healthcare operators take in to the high-risk area must be sterilised with a solution of water and chlorine and then burnt in an incinerator

The carriers of the Ebola virus are wild animals such as fruit bats, monkeys and rodents. It is spread by contact with any biological fluid from an infected person. The incubation period goes from two days to 21 and once it appears causes fever, migraine, nausea, vomiting and diarrhoea. As the disease progresses, it causes internal bleeding, the collapse of organs and systems and finally, death. But now in the Congo, as a result of Ebola, conspiracy theories and plots are also rife. Even more people, pressured by popular beliefs, political exploitation and social hardship, believe the disease does not exist and that it is a strategy of vested interests to exterminate the Congolese people. The local communities have begun to show hostility towards the activities carried out against Ebola. Clinics have been looted, health centres have been set on fire and health workers live under continuous threat. Some doctors have been murdered. In this climate of suspicion, psychosis and collective hysteria, the disease is the only gainer. It continues to proliferate and reap victims.

Africa, Democratic Republic of the Congo, North Kivu; Butembo, 24th July. Following the outbreak of the epidemic in August 2018, checkpoints were set up along the main transport arteries and at all the points of entry into the cities of the North Kivu and Ituri provinces

“Ebola is a lethal disease and there is no specific cure for it, unlike malaria or other diseases. The only possibility of survival for those who contract it is to go to a health centre as soon as the symptoms start. It’s a race against time. Ebola makes no distinction of gender, sex and age. But since the outbreak of the epidemic, we’ve seen high numbers of children infected. The situation is really dramatic because at present the disease is not receding. Much of the population refuses to believe in the existence of the virus and we’re also in the middle of a war. We’re faced with a truly dramatic situation that could easily get worse.”

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Dr Joel Efoloko explains the situation in Beni to us. He works in the Treatment Centre, where the sick are taken. The hospital was built as a fortress against the disease, a trench in the front line of the war against the epidemic. The staff prepare a sacred repetition of gestures and the donning of protective clothing by the physicians and nurses before they make their entry into the high-risk area. Then they march wearing hermetic armour and protected by masks and boots, into transparent rooms where the patients are hospitalised.

Africa, Democratic Republic of the Congo, North Kivu; Beni, 26th July. Some doctors getting ready for their shift in the red zone, where they cannot stay longer than two hours. In the Ebola treatment centre (ETC), healthcare operators must wear hermetically sealed bodysuits every time they enter the high-risk area, and adopt extremely tight safety measures to prevent contact with the virus

So begins the incessant struggle against time to save lives. In a tent, there is a pregnant woman, in another, two new-born babies and a child with its body covered with sores. Nearby, Eliel, 10 years old, in a blood-stained T-shirt and trousers, is in a coma and breathing with an oxygen mask. His father watches him from outside the tent, his eyes swollen with those tears that reveal his acceptance of the separation, with the survivors condemned to serve their sentences in the company of hope.

Africa, Democratic Republic of the Congo, North Kivu; Beni, 26th July. There are over 700 confirmed cases of children who have contracted the disease, 57% of them under five years of age

Abandonment causes people to feel an acute sense of injustice and makes them aware of their vulnerability to fate. The future does not exist when hundreds of fathers and mothers have buried their children while the number of sick children continues to grow. An off-road vehicle adapted as an ambulance arrives at the Treatment Centre in Beni. Inside it is Este with Betinette, her seven-month-old daughter, in her arms. Impressed on her body, the girl has the signs of the disease and her mother clutches her. She does not want to give her to the doctors. She knows that she will never see her again, and will never be able to kiss her and lull her to sleep. Infectious disease specialists and nurses insist, stretching out their arms, speaking of therapy, the final attempt to cure her, but she hugs the little feverish body, now without strength, caressing her head dangling with sweet abandon in her arms and pleads with them to allow her a little longer to say goodbye.