Covering an Mpox Outbreak in Congo: Mile After Mile of Muck

We set out again at sunrise, and soon arrived at a mud pit in a hillside. There an industry had emerged in pushing and pulling vehicles up and down the hill. There were belching diesel fumes, and a great deal of yelling. I nicknamed the place Mordor, after Tolkien’s hellscape.

Scrambling up the hill, I thought about how everything entering Kamituga — construction material, clothing, rice, wheat, beer — travels this route. Which means that everything needed to respond to an epidemic, every vaccine, virus sample and latex glove, comes this way, too.

Just before noon, we rolled into Kamituga. At the hospital, a collection of one-story brick buildings, I met Dr. Steeve Bilembo and Fidèle Kakemenge, the doctor and nurse who, a year earlier, had identified the first mpox case at the Kamituga Reference Hospital. It was a virus they had never seen before, and the international alert they raised brought epidemiologists and virologists trekking to their door. We donned protective equipment to enter the mpox isolation ward and talk to patients; the youngest was five weeks old.

Then we went to what’s called a maison de tolérance to speak with sex workers. The women sat on upturned beer crates and spoke of how painful their infections had been. Their children sat wide-eyed in the chaos of the establishment; a young boy, feverish with what was likely malaria, was passed from lap to lap. Their vulnerability, and the conditions that had fueled the transmission of mpox among the women and their clients, were on clear display.

The way out of Kamituga was even more challenging than the way in. We got stuck in the mud in Mordor; at one point, one of my legs sank, mud reaching up to my waist, and a passerby had to pull me out. Caleb, who is well over six feet tall, went in with both legs and was immobilized until a pack of small children burst from the bush to dig him out in exchange for a few hundred Congolese francs.