FROM THE ARCHIVES
Curtis Abraham
Bill Close examines twins aboard Mobutu's hospital boat as Mobutu
himself and the president of Chad look on.
In 1960, at the dawn of the country's independence, Dr. William Taliaferro Close was, for a while, the only surgeon in a fifteen-hundred-bed hospital in what is today Kinshasa, the Democratic Republic of Congo capital. He later became chief doctor of the Congolese army and personal physician to President Mobutu Sese Seko. He was also responsible for the renovated general hospital of two thousand bed in the capital city. Dr. Close is a fellow of the American College of Surgeons and a fellow of the American Academy of Family Physicians, is also the recipient of an honorary degree of Humane Letters, from the University of Utah. He received the Ordre du Leopard (Order of the Leopard), the Congo/Zaire's highest honor from President Mobutu in 1969 for his dedication and unselfish service to the people of Congo.
During the 1976 Ebola Hemorrhagic Fever (EHF) outbreak in Congo, the first in sub-Saharan Africa, he supervised logistics for the international medical team. And when EHF broke out again in 1995, he acted as an unofficial liaison between the Centers for Disease Control, the Zairian government, and other concerned national organizations. Dr. Close is now in his fifty-fifth year of medical practice. He had been married to Bettine Moore for 63 years and they have four kids, Tina, Sandy, Jessie, and Hollywood actress Glenn Close.
Bill Close is the author of "Ebola: Through the Eyes of the People", "A Doctor's Life: Unique Stories", and "Subversion of Trust". His latest book is "Beyond the Storm: Treating the Powerless and the Powerful in Mobutu's Congo/Zaire".
He died in 2009.
HOW DID YOUR PASSION FOR SURGERY DEVELOP?
My passion for going into surgery came about when I was seven or eight years old in 1932 from very simple tours of the American Hospital in Paris where my father was the Managing Governor. The tours were given by Miss Elizabet Compte, the hospital’s head nurse and a wonderful Swiss woman who would take me by the hand and we’d take the elevator up to the surgical floor and she would open the swinging doors to the operating rooms just a little bit so I could peep inside and smell the ether. I would be very excited about that and seeing these people in long white gowns and crisp aprons leaning over a stretcher outside one operating room and I thought: “Boy, I want to be part of that world”. I thought it was going to be a great adventure and an honor to be called doctor and to be a surgeon with all the responsibility that went with it.
YOUR ACADEMIC CAREER AT HARVARD WAS FAR FROM IMPRESSIVE. HOW DID YOU GET INTO COLUMBIA COLLEGE OF PHYSICIANS AND SURGEONS IN NEW YORK?
I got in with great difficulty. I went to Harvard College for the first two years during the Second World War. Then I decided to get married and later in 1943 to join the Army Air Core Cadets program. My grades at Harvard were average and I was in the Air Corps flying during the war for three years. But at that time the better medical schools allowed one year of college credit for three years of service. Many medical schools were accepting students with three years of college. So armed with my transcripts from Harvard and my Air Corps papers, I marched up the steps to Cornell medical School in New York City. The Dean of Admissions looked over my transcript, which were full of Cs, and laughed . "There is no way you can get in here with these grades". I was so embarrassed.
However, I knew that grades weren't the only thing they looked at in their applicants and if the door was closed to his school, I would go somewhere else and approach my next interview differently. When I went to see the Dean of Admissions at Columbia College of Physicians and Surgeons in uptown Manhattan, I told him frankly: "I know my grades are lousy and that I only have three years of college credit, but I want to go to P&S, and I will do whatever has to be done to get in and will keep applying until I do get in."
A man called Severinghaus was the Dean at the time and he didn't laugh. He scrutinized my transcripts and told me that I would need to take biochemistry and physics again and pass them with at least a Bs. I would also need more college credits. He advised me to attend Columbia night school.
Later, I found out that my Father-in-Law, Charles A. Moore, heir to the Moore part of the American manufacturing firm Manning, Maxwell and Moore, wrote a letter to the Columbia College of Physicians and Surgeons that I think probably was helpful in getting accepted in medical school. He wrote: “My son-in-law wants to become a doctor. Personally, I have no use for the profession. However, his determination is such that I imagine he’ll make a good one!”
BUT IT WAS AT ROOSEVELT HOSPITAL IN NEW YORK CITY THAT YOUR PASSION FOR SURGERY AND THE CARE FOR YOUR PATIENTS REALLY TOOK OFF?
Yes. I did all but six months of my surgical residency at Roosevelt Hospital. It was a wonderful general surgical residency program and the professors were all really good surgeons and they spent a lot of time with the residence. When you got to be a senior resident you had major responsibility in the operating room and really good back up from extraordinary teachers. In those days general surgeons were really general surgeons they did plastic surgery, fractures, intestinal surgery, cancer, etc. So, that you were exposed to everything. I did a thirty-six hour stretch of duty at Roosevelt Hospital in uptown New York City and it was during this time that I became intensely preoccupied with my patients and generally with becoming a good surgeon both in the operating room and at the bedside. After a successful operation, I practically walked on air. But there was heavy price I had to pay. This meant that I was rarely at home in Connecticut to see my wife and two daughters at the time. This eventually put a great strain on my family life.
Dr. William Taliaferro Close with his daughter Hollywood actress Glenn Close
WHY DID YOU DECIDE TO JOIN THE MORAL RE-ARMAMENT MOVEMENT AT THIS TIME?
Bettine and I met two Mormon missionaries one day and later invited them for dinner at our home. It was interesting to meet people who believed wholeheartedly in something bigger than themselves. Not long after that Bettine was at a ceremony for alumni of Edgewood School in Greenwich, Connecticut who were killed during the Second World War. She was representing her late brother whose ship had been torpedoed in the Mediterranean. During the ceremony she met Ron Mann, a young English man, and his American fiancée. Ron was a member of the Moral Re-Armament and later he told us about MRA’s four standards: honesty, purity, unselfishness and love. Ron made a point that if people wanted to change the world they had to change themselves first. He told us stories of how certain people had made this change and in turn had changed others around them.
Over the next couple months we would hear more anecdotes of how changed individuals had brought about solutions to problems affecting their community or workplace and were spreading the gospel that human nature could indeed change. So, the idea of a “world mission” that would change people and nations led me to resign from my surgical residency at Roosevelt Hospital six months early and commit to MRA full time.
YOUR PROFESSORS AT ROOSEVELT HOSPITAL MUST HAVE THOUGHT YOU WERE MAD TO THROW AWAY A PROMISING CAREER AS A SURGEON AND RUN OFF WITH A RELIGIOUS SECT?
They did and they couldn’t have been more concerned. Two of them took me to their clubs for lunch to try and talk me out of it. Frederick Amendola, my surgery professor and a friend told me: “It takes time to earn people’s trust, Bill. Only then will they let you look behind the shield that guards every heart. Only with time and trust can you help them choose to be happy, productive human beings.” But I sort of got bitten by the bug and committed myself. They understood but were disappointed. Actually, I had a pretty good offer from one of the senior surgeons. There’s no question I would have had a typical, probably quite successful surgical practice in New York, which in itself didn’t really turn me on. Maybe because I had been in the war and had been brought up in England and had a taste of the world rather than climbing the hierarchical ladder in the surgical department. We were supposed to be in the Congo for six week but I ended up there for sixteen years!
WHAT PROMPTED YOU TO GO TO AFRICA IN THE FIRST PLACE AND WHY CONGO IN PARTICULAR?
We went to an MRA meeting at their headquarters in the village of Caux, Switzerland, just below Lake Geneva, in May 1960 and they were putting together a team to go to the Belgian Congo at the invitation of a grand chief of the Lulua tribe, a man called Kalamba. At the meeting, Chief Kalamba was persuaded to that MRA might be able to play a constructive role in the settlement of the bloody conflicts between the Lulua and Baluba. The chief invited an MRA team to fly immediately to the Congo with the goal of changing the current politicians into men and women committed to MRA standards. I was chosen to go because I was bi-lingual in French and had a black medical bag. I wanted to get out of the headquarters and do something useful.
DID YOU KNOW ANYTHING ABOUT AFRICA BEFORE GOING THERE?
The only image I had been when my twin brother and I, we were about seven, went to the International Colonial Exposition in Paris in 1931 and we had our picture taken in front of the African pavilion with big elephant tusks. We also saw colorful colonial troops. But that was the only exposure I had.
WHAT WAS BASIC HEALTH CARE AND EPIDEMIC DISEASE CONTROL AND PREVENTION LIKE AT INDEPENDENCE?
Basic health care at independence in 1960 and a couple of years after that was very good. The Belgians colonials were very anxious to keep their workers healthy and strong because they were the people who extracted the minerals, rubber and ivory from the early colony. They had a very good medical system. Dr. Marcel Pirquin, the old surgeon who I write about in BEYOND THE STORM, was typical of the devoted Belgian doctor who took care of the ‘natives’. They had the tse tse fly control program was under the control of a Belgian NGO and Sleeping Sickness was almost eradicated because of this program. The major epidemics were under very good control as they are not now.
However, by the time of independence the colonials had not trained a single Congolese doctor.
WHAT WAS IT LIKE DOING TRAUMA SURGERY WHILE AT GUNPOINT AT THE HOPITAL DES CONGOLAIS IN KINSHASA IN 1960
Yes, we were often at gunpoint while doing the operations and it was extremely tense. Independence sort of broke out and there was a huge army mutiny and tremendous exodus of people, mostly Europeans, out of the country. So I went over to give them a hand in surgery and I ended up as the only surgeon in a 1,500 hospital and really loved it.
Basically, if you’re a doctor and especially if you’re a surgeon and your taking care of all sorts of people with different political views and different tribes and nationalities you are very well received. The only personal threats I received was from an Italian pharmaceutical company when I took over central agency for the buying and distribution of pharmaceutical products it was in the central depot. I canceled a lot of contracts that had been put together by a Congolese minister of h Italian Mafia!
HOW DID YOU BECOME THE PERSONAL PHYSICIAN TO THE LATE CONGO/ZAIRE PRESIDENT MOBUTU SESE SEKO?
At the time I had just become the physician for the First Parachute Battalion and his house was in the paratrooper’s camp. We were having huge amounts of trauma in the operating rooms and I had been told by the British military attaché that Colonel Mobutu was the most effective guy in the army. So, as a sort of typical naïve American, I waved for his car to stop as he was leaving his house and said: “Bonsoir, mon colonel. I am the surgeon at the Hospital des Congolais, and I wondered if you do something about all the violence in town so we can catch up in the operating room.” He looked at me and sort of raised his eyebrows and said “Oui. C’est possible.” And then rolled up the car window and sped away.
Mobutu knew about the work we were doing in the hospital. He sent the man who later became the head of his personal security detail to fetch me in the operating room and asked me to come and see one of his great aunts who had a fishbone stuck in her throat. So we drove over and luckily I was able to see the fish bone and pull it out. Then there was another great aunt who lived in a little house in the slums. This old skeletal lady was lying on an army cot covered with mothballs. She was dying. So I stayed maybe ten minutes then went back to see Mobutu and said: “I’m afraid your aunt is probably dead by now.” And he said I know that. Then he asked “How long did you spend there?” and I said ten minutes. Then he said I should go back and just sit with the family, it would mean a lot to him. I did. And from that I learned a very important thing that becomes very important when you’re an old doc and that’s the importance of an act of just being there.
WHAT WAS MOBUTU LIKE AS A PERSON?
Early on I was struck by his easy charm and his natural thoughtfulness. He introduced me as le docteur or Docteur Cloooose. He loved his family. But he was tough on his sons, too tough, thought the Jesuit priest who was their tutor. Mobutu stood tall and straight-backed and would cock his head and smile when he met you or asked a question like “Et comment va madame — And how is madame?” At the beginning he really wanted to know; later, comment va madame became his code for “I don’t want to talk about it.”
His voice was as clear as it was strong and often passionate. With backers, and certainly his doctor, he could banter and laugh; he was a master at imitating stuffy diplomats. Although gentle with a sick child, he had little patience with fools. I learned later that his tolerance of people on the take, especially members of his family, was normal in African society. A successful and powerful leader was expected to provide for his relatives. His wealth was admired by his family as long as their trickle-down share was adequate. As the leader’s power and wealth grew, so did the numbers and demands of his expanding extended family. The survival of his identity depended upon his being an intimate and valued member of the clan. He could not, without losing his identity, turn them away. This pressure and duty to tradition was above and beyond all other pressures and would sometimes drive a sociological novice like me around the bend.
At thirty-one years of age, his authority came from fearlessness and attention to details, which he filed away in his mental vault. He was a voracious reader. Machiavelli’s The Prince had an honored place on his bedside table along with heavy volumes with soporific titles dealing with economics, geopolitics, and history. Napoléon and de Gaulle were his historical mentors.
Bill Close with daughter Glenn in Zaire/Congo around the time of the first Ebola outbreak in 1976
HOW DID YOUR POSITION AS MOBUTU'S PERSONAL PHYSICIAN BENEFIT THE HEALTH OF THE CONGOLESE PEOPLE?
If you become a physician for a head of state you are in a position to do a lot for the population. For example, in 1968 Mobutu asked me to become more or less the administrator of Hopital des Congolais, which was later re-named Mama Yemo Hospital after his mother. The hospital had become a death trap and rampant nepotism meant that the staff was overloaded with unqualified personnel, relatives of those who ran the hospital for their own personal gain. I thought about Mobutu's request for a while and finally presented him with a written statement saying that I would re-organize and rebuild the hospital on conditions that I reported to Mobutu only; that I would have full hire and fire authority without any interference from his cronies and others. Surprisingly, Mobutu agreed.
So we formed FOMECO or Fonds Medicale de Coordination, which was responsible for the old hospital and surrounding health institutions including the prestigious laboratory of the Institut de Medicine Tropicale (IMT). I became President of FOMECO's board of governors. My main jobs were to run the monthly board meetings and yearly budget exercises and to keep Mobutu abreast of our problems and progress. We recruited doctors from the US, Canada and Europe. People like Dr.Georges Bazunga was the hospital's director general while Dr. Roger Youmans was the hospital's chief of staff. I think the secret of FOMECO's success was that those who made policy were the same as those who implemented the policy. This made the distance between the bosses and workers very small. I knew next to nothing about managing a large public hospital I managed to hire some extraordinary men and women who were experts in their fields and, more importantly, were enthusiastic members of a team characterized by hard work and a sense of humor
After a few years we had renovated and staffed the hospital. This included the renovation of two city blocks of hospital wards, clinics, walkways, operating and emergency rooms, kitchens and offices. The sewage system had to be completely dug up and rebuilt. All electrical wiring was replaced. The one non-functioning telephone was replaced by a switchboard open twenty-fours a day with 15 outside lines and 192 extensions. Some businessmen, like my old friend Pepo Eskenazi, owner of Solbena-Plastica, supplied the hospital with one thousand new red plastic mattress, pillows and sheets. Another businessman friend of Mobutu donated television sets for all the pavilions. We got other donations of refrigerators, an ambulance, a mini-bus and countless other items.
Our staff of almost two thousand cared for nearly 1, 600 daily inpatients. By 1972, the number of major operations was over ten thousand almost double from what it was two previously and out maternity ward delivered an averaged of 130 babies every day.
MOBUTU USED TO VISIT YOUR PATIENTS AT HOSPITAL. WHAT WERE THESE VISITS LIKE?
I would see Mobutu first thing in the morning and just on a hunch or a whim I'd suggest we check on some of the patients. Occasionally, I drove him to the hospital in my car, without bodyguards, and we would make the rounds together. He was impressed with the cleanliness and order in the wards and admired the equipment and efficiency of the nine new operating rooms, surgical supplies and the expanded emergency services completed during the early Seventies. He shook hands with the doctors, nurses and technicians and thank them repeatedly for their good work. His encouragement was thoroughly appreciated.
The rounds that were special for both of us, I think, were when we spent time, usually in the Intensive Care Unit (ICU), visiting with patients and their families. these rounds were never announced. On these private visits , I saw a side of Mobutu's character that was more engaging and simpler than his public, self assured persona. One woman patient, who could only watch us through a peephole in a heavy bandage around her head and face because her husband had thrown acid at her, grasped Mobutu's hand and pressed it to slit in the gauze by her swollen lips. He said to her: "Mama, bon courage" and then turned to me and said that he would help pay for some of her hospital care. Usually, Mobutu's personal contact with the patients, his questions about their conditions and their families, brought smiles and shy responses from the patients. As far as the effect of these visits on Mobutu, they brought him closer to the people.
BUT WHEN YOU RETURNED TO CONGO TWENTY YEARS LATER IN 1994 YOU DISCOVERED THAT ALL THE GOOD WORK YOU AND THE STAFF AT MAMA YEMO HOSPITAL HAD DONE WAS UNDERMINED BY CORRUPTION AND NEPOTISM BY MOBUTU'S CRONIES
Yes. In 1994, Zaire Prime Minister Leon Kengo wa Dondo who had been a patient of mine, telephoned me in Wyoming to say that he had informed the press that I was returning to Kinshasa to rebuild the emergency service and nine operating roomsat Mama Yemo Hospital. to which my response was: "Tu m'as mis dans la merde- You put me in shit". Then he said that they wanted to renovate the hospital's surgical ward as a first step in renovating the entire hospital. Anyway, Kengo said that he had allocated $2.5 USD in an account and that I would oversee that money. Leon hoped that by investing in the rehabilitation of the hospital, or part of it anyway, the Congolese people would take his government seriously. Later, I talked it over with Bettine and told her that at least I can get things started.
When I got there I found listless, bedraggled people slouched around the open gate. People came and went as they pleased. The plaster ceiling of the walkway that connected the pavilions sagged with rot. In the orthopedic ward I remember that all the mosquito screens were torn and useless and the place reeked of sweaty bed sheets and purulent dressing. Mama Yemo had received no funding for the better part of a decade. The country was back to 1960, but the situation was much, much worse. At this time the salaries averaged $1.50 a month or about the price of about two bottles of Congolese beer. There were no syringes, dressings, plaster, sutures, etc. Patients had to buy their own operating room supplies anesthetic agents and I.V.s from the local drugstores at inflated prices.
MOBUTU ALSO HAD AN INTEREST IN SCIENCE ISSUES. FOR EXAMPLE, HE WAS THE ONLY AFRICAN HEAD OF STATE TO HAVE INVITED THE APOLLO 11 ASTRONAUTS FOLLOWING THEIR HISTORIC MOON LANDING IN 1969. TELL ME ABOUT THIS.
Yes, not even a minute after Neil Armstrong stepped onto the moon on 20th July 1969, Mobutu wanted to be the first African head of state to invite the astronauts to Africa. I informed our ambassador that night, and he relayed the message to Washington D.C. The three Apollo 11 astronauts, Neil Armstrong, Buzz Aldrin, and Mike Collins, visited the Congo on 24th October that year and, during the celebration with music and dance, received the Ordre du Leopard (Order of the Leopard), the Congo's highest honor, from Mobutu. In turn they presented him with copies of the plaque they had left on the Moon.
Bettine and I had the pleasure of having their flight surgeon as out guest for the night. Over dinner I remarked that taking care of these astronauts must be quite a challenge. "Not really," he replied. "They're former test pilots. All they need is a routine commercial pilot flight physical." The doctor told us that when one of them felt he needed exercise, he laid down until the feeling subsided. The Congo was the first and only African country the Apollo 11 astronauts visited, and the Congolese danced to a song: "Apollo onze, cha-cha-cha-".
MOBUTU, LIKE PRESIDENT MUSEVENI IN NEIGHBORING UGANDA, LED THE CAMPAIGN FOR HIV-AIDS AWARENESS BACK IN 1985 WHEN THE DISEASE FIRST EMERGED IN AFRICA’S HETEROSEXUAL COMMUNITY
Back during the mid-1980s AIDS was considered to be a disease of the four H’s: homosexuals, hemophiliacs, Haitians and heroin addicts. Most governments in Africa and elsewhere did not want to deal with a disease that at that time was limited to politically insignificant groups of outcasts. But in June 1985, as evidence of the heterosexual spread of the disease emerged, the Congolese Minister for Health at he time was a man called Mushobekwa. He and Dr.Miatudila, his technical advisor and co-author of BEYOND THE STORM, met with Mobutu and told him of the urgency for an infomation and communication program that would tell people about how the disease is spread and how they can avoid it. Initially, Mobutu was skeptical and apprehensive about the negative publicity the country would attract.
However, a few weeks later Mobutu removed all constraints dealing with AIDS and an aggressive multimedia campaign was launched against HIV. Francois Luambo Makiadi , nicknamed 'Franco', one of the Congo’s most popular musicians at the time was drafted into the HIV/AIDS campaign. ‘Franco’, who ironically is suspected to have died of AIDS some years later, wrote a song called ‘Attention Na SIDA’ (Beware of AIDS) about how the disease is acquired and what can be done to prevent transmission. Franco's intervention, which was heard all over Kinshasa and in most parts of the country, in all the various bars and on television and radio, had an immediate impact in exposing the taboos, making it possible to tackle the disease effectively and energetically. Mobutu’s intervention was directly responsible for the Congo keeping its national HIV prevalence at an astonishing 5 percent despite the prolonged years of armed conflict throughout the county.
WHY DID YOUR RELATIONS WITH MOBUTU GO SOUR?
By 1974-76 it was obvious that things were going badly in the country economically. There were some external things behind this including the Arab oil embargo, which hit the developing world harder than the West. Independence wars against Portugal shut down the railways in Angola and Mozambique.
Over 80 percent of the Congo's revenue came from the sale of copper, and the railroad was the most efficient way of exporting it from the mines. Also, the Vietnam War was winding down so the strategic metals and minerals such as copper and tin needed to keep the war going had less value. Mobutu used money to buy loyalty but that’s a very slippery path to be on because what happens is that you end up needing more and more money, and if the source of your cash, such as minerals and a few agricultural products, start losing their value on the world market then your in trouble.
This economic crisis affected state-run schools and hospitals including Mama Yemo Hospital. One morning in 1976 I went to see Mobutu and told him that we needed more money to feed the patients at Mama Yemo, particularly the children. His response was: "I cannot authorize any out-of-budget expenses." so I said: "I know that, Patron, but I have an idea. Independence Day comes next week. Air Force jets will fly over the grandstands as they
have in the past. Why not cancel that and give me the fuel money to buy food?" So he told me he couldn't do that and said, as he so often did, that I known nothing about politics! "But we need to feed at least the people in the hospital who are sick. Most of the kids have kwashi. They're in terrible shape. Surely feeding your people is good politics." I said raising my voice. Then Mobutu got really annoyed and said: "You cannot speak to the chief of state that way!" Eventually, though he asked me how much I needed and instructed the Governor of the national bank by telephone to give me the money I needed.
But following this episode it became more and more difficult to see Mobutu. The writing was clearly on the wall.
I think relations went sour also because I had gotten really fed-up with puppy-dogging one person around the country and around the world. Mobutu was never really sick until that minor stroke in 1969 and then his pressure went up. We became good friends but when he had the stroke I had to be with him all the time. As a presidential physician you are basically on –call all the time and should be close by in case of an emergency. In most places there are two, three or four physicians who share that responsibility.
The final break came at the end at the Baden Baden, Germany trip in 1974 when I expressed my disgust to Mahele, the man in charge of Mobutu's security detail, about all the people who were hanging around Mobutu. He got really annoyed that I would criticize him to somebody else. Then he told me to go back to Kinshasa. I hated being fired but on that train ride along the Rhine I was relieved of carrying that heavy black bag all the time.
WHAT WAS YOUR INVOLVEMENT WITH THE FIRST EBOLA HEMMORAGHIC FEVER OUTBREAK IN 1976?
I was back in Wyoming when we heard that there was something mysterious killing people in northern Zaire. I decided to go back to Zaire a little early since I had to hand over my responsibilities to other people there in any event. On the flight over I met Karl Johanson, at that time he was the head and founder of Special Pathogens and the Level Four, Maximum Containment Lab at the Centers for Disease Control and Prevention in Atlanta, Georgia, and Joel Breman, a senior epidemiologist. After a few days in the country they appointed me head of logistics and working with the Minister of Health at the time, Dr. Martin Ngwete, we mobilized the personnel of the National Pharmaceutical Depot.
But I didn’t get up to Yambuku until 1988 when my daughter Glenn and I went up there to work on a possible movie or a book about the first outbreak in Zaire. In Yambuku we met many of the people who were involved in the epidemic. This outbreak and the epidemic at Maridi in South Sudan in 1976 were the first outbreaks on Ebola in sub-Saharan Africa. The Maridi epidemic was a different strain though. But, yes the Yambuku outbreak was the first real one.
IN YOUR BOOK ABOUT EBOLA YOU FOCUSED ON THE CONGOLESE RESPONSE TO THE EPIDEMIC/ WHY DID YOU TAKE THIS APPROACH?
It was the only effective approach. What the Congolese did during the Ebola outbreak in Yambuku Zaire in 1976 is what they had done during the big epidemics of smallpox, typhoid and other epidemics that swept through the area and that was to isolate the communities. They put up bamboo poles across the tracks of the roads and people were not allowed to either come in or leave the village. Those who got sick from Ebola were put into grass huts at the periphery of the village. Every day someone would put food and water at their door. When they died the hut was burnt over them. That really was an effective isolation and it really prevented the Ebola fever from spreading more.
SO DO YOU THINK THE WESTERN WORLD IS TRYING TOO MUCH TO FORCE ITS BIOMEDICAL MODEL ON AFRICA AND IGNORING WHAT AFRICANS ARE ACTUALLY DOING TO HELP THEMSELVES REGARDING DISEASE CONTROL AND PREVENTION?
I think there is some truth to that but maybe not all the truth. In the documentary Plague Fighters there was a very interesting thing they caught on a documentary camera which was amazing. A female Congolese nurse contracted Ebola, she had all the clinical signs. The chief doctor was an older guy called M. Masamba who had helped us in Yambuku during the first epidemic. He witnessed plasma transfusion, where you bleed somebody and put back the red blood cells and keep the plasma for the antibodies. When the nurse got sick the Congolese doctors got together and decided to do something about this nurse we could give her blood, we can check on the blood grouping and maybe on hepatitis with the rest of the things we can’t check. The Kitwit epidemic the percentage of patients who died was between 70-80 percent and they had some convalescence, patients who recovered from Ebola and they did in fact give convalescence whole blood to the nurse and she got better. But then there was a big argument with a Centers for Disease Control and Prevention (CDC) representative and a lady doctor from the Tropical Institute in Antwerp, Belgium who said you don’t give whole blood. So then Masamba said: "What else would you suggest we do? Ten more patients came in afterwards and I think they saved eight of them using this method. Now that’s using your African ingenuity in a situation where the sophistication of the West would say, ‘no, you can’t do that!’
WHAT DO YOU THINK THEN SHOULD BE THE ROLE OF THE DEVELOPED WORLD, PARTICULARLY OF WESTERN BIOMEDICINE SHOULD BE IN DEVELOPING COUNTRIES?
Let me give you an example. There was a guy called Friedman who was a classmate of mine at the Columbia College of Physician and Surgeons in New York. Later, he became a Harvard Professor of Obstetrics and Gynecology. I invited him to come over to Mama Yemo Hospital formerly Hopital des Congolais in Kinshasa, where they were averaging 140 deliveries daily, to see if he could facilitate the progress of women in labor by the simplest means. What he did was to put up a chart with plastic holes in it that represented the dilatation of the cervix and that was projected on a graph that represented time. What you did was put one, two or three fingers in one of the holes. Four or five fingers meant it was fully dilated. You could get a midwife to have a fairly accurate measurement of the dilatation and note the time that had elapsed to arrive at that dilatation and if the time was passed then she had to call a doctor. The result was we were able to with about 30 midwives and one doctor to process huge numbers of women having babies. Friedman was a well-known professor but he was able to turn something that could have been complicated into something very simple and very practical.
WERE THERE CERTAIN CULTURAL PRACTICES OR BELIEFS YOU LEARNED WHILE IN CONGO ABOUT MEDICINE OR ABOUT DEATH AND DYING THAT YOUR MEDICAL TRAINING COULD NOT HAVE GIVEN YOU?
I did realize early on that when somebody was dying that you didn’t admit that. You didn’t treat them as a dying person. You didn’t go into a sort of hospice mode.
WHAT WAS THE HEALTH SERVICES SITUATION LIKE AT MAMA YEMO HOSPITAL, AND CONGO GENERALLY DURING YOUR LAST VISIT TO THE D.R. CONGO IN 1996?
It was terrible. When I went there in December 1996, which was the last time I saw Mobutu, I went to the hospital and we had just renovated nine major operating rooms in the emergency ward and the hospital was coming back to some decent management. Dr. Malonga Miatudila, co-author of BEYOND THE STORM, I got him seconded from the World Bank back to running Mama Yemo Hospital for two six months period. We established an administrative set of rules which went a long way if not all the way to dealing with the corruption that goes on with any state institution.
WHAT ARE SOME OF THE MAJOR HEALTH CHALLENGES FACING AFRICAN COUNTRIES LIKE THE D.R.CONGO TODAY AND HOW DOES THAT RELATE TO THE COUNTRY'S POLITICS AND CULTURE OF CORRUPTION?
I think some of the major challenges deal with governance. I read in a Reuters bulletin from Kinshasa the other day that Jean-Pierre Bemba, the defeated Congolese presidential contender, is warning President Joseph Kabila about corruption! Well, that’s a brave effort. But it just means that if you want to find out what’s happening, or what will happen, just follow the money and follow the people that are chasing it. My hope is that BEYOND THE STORM can play a little part in acting as a vaccine against the lethal disease of absolute power.
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