dans son demi-cercle
entre les nuages de plomb
et un ciel éclatant
a accompagné la première écoute
qui a été à la hauteur de l’attente.
Mes proches me sauront profonde inconditionnelle de Radiohead. Leur dernier album In Rainbows vient de sortir sur Internet et on a réussi à l’obtenir (via la France et une nouvelle capital-log efficace) un mois plus tard. C’est un plaisir que le logisticien français et moi partageons, même s’il les a découverts une décennie plus tard que moi. Jusqu’à la fin de nos missions respectives, nous serons branchés sur la même musique sur nos Ipod Shuffle.
Au début de mon séjour à Shamwana, je ruminais sur la paucité matérielle comme remède au malaise existentiel inhérent à la vie moderne – une des raisons inavouées pour lesquelles on s’engage dans une mission MSF. A l’arrivée, l’écriture et la réflexion distillées ont sainement occupé l’espace vacant laissé par l’adrénaline familière (à l’urgence, toujours dans un avion, sous l’eau) et la techno-dépendance. Contempler de la musique, sentir les paysages de brousse en courant le matin, et jongler avec les mots sont revenus comme plaisirs tout simples et vrais à savourer. Tout cela a aussi aidé à réaccorder un peu d’harmonies intérieures.
Mais maintenant la paucité gastronomique nous pèse. Nos réserves de bouffe fraîche ont tari et on mange des saucisses hot-dog en conserve sauce tomate avec du riz mal cuit depuis une semi-éternité. La gastrono-gourmande que je suis se surprend à presque sauter des soûpers par manque d’appétit. Une autre raison inavouée de partir en mission, en tout cas pour une fille, c’est de perdre quelques kilos sans effort. J’espère que ça va m’arriver, car le prix d’inappétance est déjà payé! Les conversations de table, autrefois épicées et amusantes, tergiversent présentement autour de la nourriture. Lorsque je regarde des épisodes de Six Feet Under, je remarque avec envie les rosbifs maison de Mrs. F ou le take-out sushi de Brenda. Même les métaphores des discussions quotidiennes semblent vaguement alimentaires. “C’est grrrave”, diraient les Congolais en roulant joliment leurs ‘r’.
En tout cas, les mangues ne manquent pas...
Pont typique de la région et les problèmes qui s'ensuivent
* * *
Work is sinning by its abundance in contrast to our bleak food choices and means of distraction. Our hospital admissions for the month of October have jumped up by 60%. I practice hunting and fishing at the base for patient materials. Mattresses, wooden bed bases, bednets and blankets. Pills and injectables, in constant rupture. The cholera epidemic in Kishale has thankfully abated, giving a little bit of rest to our nurses. However, cholera reared its ugly head “chez nous ici à Shamwana” with a single case in Kabusonji, the village next door, so we have to dedicate one of our tents as a Cholera Treatment Unit just in case. Moreover, the expat surgeon is here and monopolizing my Congolese colleague (who loves to cut) and needing an extra tent for post-op patients, so I am rounding alone on the busy ward. Hence the tardiness in my monthly statistical reports and bimonthly e-mails, apologies.
My latest butt-in with an ancient disease was dramatic. In Western folktales, one should not walk in horse dung or on rusty nails because of tetanus. We now know that the spores of Clostridium tetanii are heat-resistant and can be found in most soils – nothing to do with metal or horses. Back home, people are vaccinated against tetanus in childhood and whenever they end up having to go to the hospital for wounds or sutures. Here, oh well, here... “c’est le Congo”, with dismal rates of vaccination and wound infections, which is really one catches tetanus. The tetanus toxin binds to nerve endings and stimulates muscle contraction spasmodically. It was a seven-year old boy who was referred from a village. The story will never be clear: the parents said that they brought him to the traditional guérisseur after the signs started, but traditional practices usually consist of herbs and scarring, which could have constituted the point of entry. The child came with generalized stiff spasms, crying between episodes. The image of the nurse placing him on the bed, rigid as a wood plank, is embedded in my mind. Straight from Harrison’s Textbook of Internal Medicine once again: the spine curving abnormally backwards ie. opisthotonos, the taut facial spasms ie. risus sardonicus, the impressive lockjaw ie. trismus. I had seen a case in Cameroun, but not nearly as severe. I learned that any stimulus, sound or light or voice, can trigger the dreaded spectacular spasms. One can only imagine the suffering behind a body that has gone out of control. Without batting an eyelid, the excellent nurses knew to place him in isolation, in a dark and quiet room away from the noisy paediatric ward. Poor child. We emptied our stock of tetanus immunoglobulin and were generous with the muscle relaxants. A day later, he was finally eating mango and fufu, a respite after four days of lockjaw-induced starvation.
* * *
Earlier this year, there was a BBC news clip from Congo-Brazzaville where a concert of music from all local ethnic groups was held. Pygmies were invited, but instead of hotel rooms, they were offered huts at the zoo. Throughout Africa, pygmies exist in most countries at this latitude. They are widely segregated against and viewed as only semi-human. In Rwanda and Burundi, during the conflict between the Tutsi and the Hutu, because they belonged to neither group, they were spared by the génocidaires. Here in Katanga, the Mai-Mai rebels hunted them like animals because they were thought to have collaborated with the government army.
Yesterday, along with the expat surgeon, we went to meet our local pygmies. In the village of Nsangwa, a mere kilometer North of Shamwana, lives a pygmy group of about 13 families. They call themselves Semi-Bantu or Batembo, and have their own language, Kitembo. Longstanding mixing with the not-so-tall local Baluba made them taller than expected – but still slightly shorter than the Baluba. Nonetheless, their physionomy is definitely distinct. And their way of life is completely different from the Baluba. Most pygmies throughout the continent are hunter-gatherers and experts in the bush – which is why the Mai-Mai accused them of helping the army in our region. They are nomadic and travel in groups of a few families. In Katanga, where they are few, they form their own quartier of a few houses right outside of an established village and stay there for a few months or years, until there is no more bushmeat to hunt. They work the fields for the villagers, getting paid with a few handfuls of manioc flour or clothes. The poverty they live in is staggering: they had absolutely nothing but the rags that they were wearing. Children played in sand. Babies were naked. Men wore torn shirts the colour of dirt. Huts appeared fragile and overcrowded. Because of the segregation, they are reticent to send their children to school or to benefit from the free MSF-supported health care. Yesterday, we discussed with their leader how shy they are to send their children to the school in Nsangwa. He said, word for word, that he did not know if the teacher would allow his children to class because they are Batembo. Moreover, teachers must be paid by parents because the government salaries haven’t been delivered in years, so poorer families have less of a chance. Yet, because the chief of Nsangwa insisted on it, all men of the village, including the Batembo, are to contribute voluntarily to the building of the new school, supported by the materials of Concern our neighbouring NGO. It leads to the paradoxical situation whereby the pygmy families worked on the school building but cannot send their children there. I’ll go speak to the people at Concern about that. And maybe we should somehow create a Save the Pygmy Fund...(Ah, for once I just wish that this last statement wasn’t just irreverence...)
Batembo family
Papa Chef Batembo
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