As I’ve mentioned previously, the study site I worked in was beyond the Peace Corps Line. It was beyond the Blender Line. And it was beyond the Beer Line. Out here in this arguably very remote area, we were never short of remoteness. Every year the study site become more and more remote, as roads deteriorated, air strips grew over, bridges became more and more questionable. Over the previous decades there had been more of a missionary presence in this area, but the missionaries had withdrawn and now only passed occasionally down the ribbon of mud we laughingly referred to as the “road.”

One day a rabid dog appeared out of nowhere, bit three or four goats, killed my cat, and bit six people.

The dog disappeared into the forest never to be seen again. The people who were bitten were not concerned because the bites were minor. Rabies, it turns out, was not a disease on the consciousness of the people living here. Grinker and I spent a long time, gathering elders and other influential individuals together, showing them medical books, explaining the nature of the disease, trying to convince the community to convince these six people that they were in danger and that we needed to do something to save them. We were quite prepared to try to save their lives, but we needed their cooperation first. Then, well, we’d figure something out…

The realization that rabies was a real disease, what it meant and how it looked, and that these six individuals may well have been exposed to it came to everyone in the crowd that had gathered at our research site, including the six bitten and their families in a flash. The twenty or thirty people standing and sitting around listening to us went from thinking we were nuts to totally getting it in in a single moment of time. I credit Grinker with making this work.

We had been explaining rabies, talking about symptoms, telling people it was a disease that did not manifest for days after bite, and trying to convince people that once symptoms showed up it was too late … death was inevitable and it would be slow and painful.

No one was getting it. This was due, in part, to the lack of day to day discourse on disease theory, infectious disease, and so on. And partly because it was very very unusual that we, the outsiders, would know something that they, the locals, would not know. We had spent a very long period of time and a great deal of effort convincing the people here that we did not have much to offer them, but that they had a lot to offer us in terms of knowledge, and indeed, the knowledge generally flowed one way, from them to us. It was against our policies to have much knowledge flowing the other way. That would often constitute undue interference. We wanted them to teach us, not the other way around. That may be the main reason that no one was getting it.

Finally, here’s what happened: Grinker handed me one of the medical books that had a description of the rabies symptoms in it, and said “Read this out loud for everyone to hear, one sentence at a time. I’ll act it out.”

So we made a bit of space in the middle of the crowd, and I translated the descriptions of the symptoms of rabies as Grinker acted them out. Grinker sucks as an actor, but he did a pretty good job at foaming at the mouth, convulsions, and hydrophobia. Finally, I threw a glass of water on him and he screamed and screamed at the top of his lungs, rolled around in a convulsive fit for a while, and died.

The crowd fell silent. Suddenly, one of the men from the village next to our base camp started saying something — in an agitated fashion — in the language that these people speak that we only understood a few words of. But I heard the word dog, and the word for illness. Someone else started to speak and I heard the mention of a year, a date a few years back, and someone’s name and the word for “old woman” and the word for “to die.”

Others joined in. People were remembering a story. They were piecing together previously unconnected events that had happened several years ago. One of the men stood up and shouted something out and pointed to Grinker and said in KiSwahili “Just like that. There was a woman here, seven or eight years ago, who was bitten by a dog and two weeks later she died just like that!”

Bingo. Now everyone had it.

Now, the rest of the story is long and involved, but I’ll tell you the simple version of it. We got the six people who were bitten up to the old mission station, 36 kilometers to the north. We had heard rumors that there was a radio there that might be convinced to work.

I suddenly was glad for my days as a kid playing around with amateur radio, because I knew enough to figure out what pieces of gear should be pulled together, how to wire them up, how to set up the antenna, etc.

We had information on when the local missionaries used the radio, and when they listened for signals from remote stations. Every main mission had a radio and every day a volunteer would staff the radio and carry out the relay procedures. But we did not have a working receiver, just a working transmitter. Without a receiver we could not really know if the transmitter was working. So several times during that day and the next morning, we got on the radio and this is what we said:

Attention, attention. This is Andudu Mission. This is Andudu Mission. We are the Ngodingodi researchers. We have no receiver, only a transmitter.

We have six people who were bitten by a rabid dog. Repeat. Six people were bitten by rabid dog. We have a trained nurse but no doctor. We need rabies vaccine in cure dose.

This is Andudu Mission by Nepoko. Drop six cure doses of rabies vaccine on the old airstrip. We are clearing airstrip now. Drop vaccine now, we will call later if we need evacuation.

And we said that whole thing five or six times each on the appropriate frequency at the appropriate times throughout the day, but we had no way of knowing if it was being heard.

At the same time we organized a group of people from the mission to clear the airstrip of vegetation and termite mounds. This airstrip had not been used in years, so this was quite a bit of work. As we did this, we also implemented a system of keeping the airstrip cleared, figuring, with all this work, why not have this as an emergency resource?

We did not have a working vehicle that would make it to town at the time that could carry the six victims. Our plan was to walk with the six victims and enough people to carry them part way (to keep their metabolism low and thus slow down the progress of the rabies) to a place 54 km north where we felt sure we could flag down a truck and bring them 200 km or so to the nearest hospital. But as we were working out that plan, something else happened.

A small plane, a Cessna, buzzed the airstrip once, passed overhead again, and dropped a package on the area where workers were clearing away vegetation. The workers brought us the package, and we opened it.

Six cure doses of rabies vaccine, and six reusable, new needles, packed in such a was as to easily survive a drop from a passing small plane. The nurse, who happened to be living at this mission, started treatment right away. Everyone lived.

~~~

Over a year later I was in the city arranging to fly into the very airstrip we had cleared. I was speaking with the Missionary Air Fellowship pilot about this.

“You are going to have to navigate, because I have no idea where this is.”

“No problem” I confidently replied, having no idea if I could do this or not.

“If you can’t find the airstrip … or if I don’t like the looks of it … we fly on to Beni and you’ll actually be farther from your destination than you are now.”

“I’ll take my chances. No problem,” secretly calculating how I was going to get to the study site from Beni should that happen.

“By the way,” he suddenly said. “I’m the pilot who dropped that rabies vaccine last year!”

“You are! Well, thanks, you saved six lives!”

“Well, that was God’s work, I was just helping,” he laughed. “By the way, how are they doing?”

“Fine, all six are just fine.”

“Are they back in the ‘States?”

“Huh?”

“The States, are the six who were bitten back in the States?”

“Well, ah, no, they were Zairois, from a nearby village. They weren’t Americans.”

Silence.

Then … “Well, OK, I’ll see you in the morning at the airport. Bring your map!”

So the next day I met up with the pilot, and we found the airstrip, and landed with no difficulties. Well, the landing was not really without incident, but that is another story for another time. But in any event, I got to the project area in a day or two.

Then, a month later, someone passing by the research camp stopped in with a bag of stuff.

“This is from Andudu, some mail that was dropped there for the Americans,” he said.

“Thanks.” … and when we opened the mail, there was an item from the Missionary Air Fellowship.

It was a bill for over $600.00, for rabies vaccine and the cost of flying the vaccine from Nairobi, Kenya. Some 16 months after the fact, and we just got the bill. And the date the bill was written was one day after that conversation with the pilot.

I am not going comment on the shifting rationals that must have been … well, shifting and stuff, for this sequence of events to have happened as it did. But I will tell you what I did next.

It occurred to me that the six bitten men were all living in a village down by the river which was initially set up by missionaries back when they were still working in the area. This village hosted the Christmas and Easter celebrations, and they maintained a hut for any Evangelical missionaries that might pass through the area. Which they they never did, but nonetheless the hut was maintained.

In other words, the six bitten men were part of the mission station, a remote and forgotten part, yes, but essentially they were “with” the mission. They were not “my” people or “our” people. They were not just some random people. They were “their” people ….

So, I got a sharpie and I wrote on the bill:

“This came to us, but these were your people from the Mission Village. Bill sent to us by accident. Cheap at twice the price!”

And mailed it to the missionaries. Never heard back on that one.

Comments

  1. #1 mdiehl
    June 26, 2009

    I am appalled by the lack of the missionaries Christian charity, and applaud your correct assessment of the situation in remedying the bill!

  2. #2 Jason Thibeault
    June 26, 2009

    Just doing God’s work. *facepalm*

    Way to go, sir — saving six people’s lives and putting the disgustingly self-interested missionaries in their place. Hell of a victory.

  3. #3 cicely
    June 26, 2009

    I am appalled by the lack of the missionaries Christian charity

    From my observation, “Christian charity” is, in the opinions of many Christians (as judged by actions, rather than words), best reserved to Christians. Frequently, to Christians of their specific denomination.

  4. #4 Tsu Dho Nimh
    June 26, 2009

    I’m speechless!

    What happened to the example of the Good Samaritan, who didn’t send a bill after arranging medical care and lodging?

  5. #5 Arjay
    June 26, 2009

    Check out Douglas Adams’ “Last chance to see” that I profiled recently in http://protectingourplanet.blogspot.com/2009/05/douglas-darwin-and-doubts.html
    As he flew across to Zaire in the MAF plane he chronicled how the missionaries were discussing how to get their ivory & rhino horn out of the country…

    He also had a comment on self righteous smiles that “made him want to bite them”. That said, I owe my own life to those MAF pilots and am only glad that God’s imperfect communication systems led to the saving of 6 other lives through your intervention.

  6. #6 Barn Owl
    June 26, 2009

    I applaud your solution to the delayed bill, Greg, but I would have been tempted to reply with “WWJD? Would Jesus send a bill for the rabies vaccine and transport?”

    Here in the southern US there have been a few rabies cases in humans that were not associated with known dog or wild animal bites. The speculation is that the individuals (in one case, a young child in Houston), while sleeping, were bitten by rabid bats, so that the exposure remained unnoticed. These are, of course, small bats, and I don’t know whether similar species exist in the part of Africa where you were working.

  7. #7 Jadehawk
    June 26, 2009

    clever solution. but fuck me, that was ass-holy. Is that normal? (yes I’m that kind of sheltered)

  8. #8 Troy
    June 26, 2009

    Reminds me of Mother Teresa, a woman who was only tooo glad to dispense leprosy meds.. to all but the lepers…

  9. #9 travc
    June 27, 2009

    Barn Owl,
    Rabies is co-evolved with bats, so I imagine that just like everywhere else in the world, bats are the most common carrier.

    However, people don’t really interact with bats much. Also, rabid bats typically aren’t aggressive like other infected mammals tend to get. I think rabies infections in bats are more mild generally. So people’s close contact with dogs and infected dogs’ propensity to get really aggressive when infected with rabies probably accounts for the normal association between rabies and dogs.


    As for the missionaries. I wish that the science guilds had the financial and public backing that evangelical religions do. (I’m thinking of “instead of the religions”.) Imagine the networks of field stations we could maintain! We’d also probably have an easier time putting together a corps of good bush pilots… I for one would feel much safer with a pilot who didn’t think that weather was a supernatural manifestation.

  10. #10 Arjay
    June 27, 2009

    Strangely, travc, the MAF pilots don’t trust a supernatural navigation system; they seem to have more confidence in technology or the 3 Rs (follow rivers, roads and railways).

    By the way, any of you guys enjoying Greg’s posts would likely enjoy Ricky Gervais early standup dvd “Animals”. Good insights into how the world was made and why snakes are legless….

  11. #11 MadScientist
    June 28, 2009

    I’ve heard that sort of complaint from friends who have worked in remote areas – as soon as some people realize that they were helping one of the locals and not a whitey they’d get upset. There are a few occasions where I might just have avoided such a situation. “There you go, hope you feel better soon!” I’ve trained myself to say “thanks, I’m sure I will” rather than “thanks, but it’s not for me.”

    It’s great you got the vaccines to those folks; I’ve seen people die of rabies (in one instance because the parents couldn’t pay for the vaccines but refused to accept the vaccines for free) – it’s a really horrible disease. I’m surprised the locals hadn’t associated rabid animal bites with death – then again it could be tricky since symptoms can show up anywhere from a few weeks to over a year after being exposed and people may not remember the victim being bitten. Or is being bitten by animals very common for them?