Plague returns to add to Zaire's suffering: Richard Dowden reports from Bunia that an ancient disease is going unchecked because of the country's economic chaos

WHEN old Mr Paul died in September last year they thought it was malaria. But within a few days two other members of his family fell ill with the same symptoms: a high fever, shivering, dizziness and aching. Then agonising swellings began to grow in their groins, necks and armpits. They went to the hospital, which confirmed that an ancient and horrendous disease had re-emerged and reached the town - bubonic plague.

Yesterday, standing by the small, round mud-hut where Mr Paul died, we could hear a rustle in the ill-kept banana plantation nearby which also serves as a rubbish dump. 'Have you seen any rats?' Dr Maurice Lendunga asked a group of women washing clothes. Yes, they replied, they still saw them. The banana plantation is a reservoir of rats, explained Dr Lendunga. The director of the anti-plague programme in the region, Dr Lendunga had come to check the homes where new cases were reported last week, and supervise the spraying of the houses.

We stepped back into the maze of tiny mud and thatch houses. They are packed so close together that at almost any point you can touch two at the same time. Dressed in a long white soutane, rubber gloves and a mask, with cylinders of insecticide strapped to his back, a health worker stepped into one of the houses and paced slowly round, pumping the spray as if performing a religious ritual. A small crowd of silent people gathered to stare.

Sukisa district is like a tightly packed African village which has grown on to the edge of Bunia but it is not just the poorer areas of town which are affected. Eleven out of Bunia's 12 districts are now infected and in Ruwenzori Avenue, where the houses are bigger, spaced out and well-kept, we visited another family where two children, the sons of a tailor, have had plague. Dr Lendunga had diagnosed the symptoms in time and both were saved, but bubonic plague can kill within days or even hours. Quick diagnosis is essential.

Earlier yesterday Dr Lendunga inspected two new suspected cases at his clinic. One was a tiny child who screamed when the doctor touched the swelling in his groin. 'La peste,' said Dr Lendunga quietly. But the other case was a young man and after questioning him Dr Lendunga dismissed him as clear.

Bubonic plague is spread initially by rat fleas. The fleas infect the rats and when the rats die the flea seeks another warm-blooded animal. The infected flea is unable to ingest blood, so it bites, vomits back infected blood into the wound, and then seeks another host. Bubonic plague rapidly turns into blood poisoning and in its most virulent form attacks the lungs. According to medical experts here, if you are in the same room as someone with pulmonary plague you are almost certain to catch it and that form can kill within 48 hours.

Local burial traditions also spread the disease. When someone dies the body is laid out for two days for everyone to pay their respects. This involves sitting by the body and touching it. According to Dr Lendunga, not only can people be infected by the dead body but by fleas leaving the cold corpse and seeking new hosts among the mourners. He has known several cases of the disease spreading at funerals and is campaigning for immediate burial of people who may have died from plague.

The arrival of bubonic plague in Bunia could be catastrophic for the region. The disease came with the Belgian colonialists but after outbreaks in the 1920s, it was carefully controlled by the colonial authorities. After independence the health structures and research centres fell into disuse and people were afraid to report the disease, as the government way of controlling it was to burn down huts or whole villages.

Plague has broken out sporadically in the countryside in recent years but this is the first time it has emerged in an important trading centre. Bunia has about 130,000 people but draws in thousands from the surrounding area. It also sends food to the capital, Kinshasa, which has a population of about 4.5 million. The infected fleas and rats could easily spread to the capital or other major towns.

Such a potential disaster could be managed in most countries today, but Bunia is 680km (420 miles) from the capital. There are no road links and no telephones. Even if it were nearer, Dr Lendunga could not look to a ministry of health for help. Zaire no longer has an effective government and its economy is in ruins. Seventy per cent of the health centres are closed and the salaries of medical staff are a sick joke.

The economic plight helps the plague spread. Inflation and monetary chaos means that as soon as people have money they spend it on food and store it. The warehouses and storerooms are perfect breeding grounds for rats. And when people fall sick they cannot buy medicine.

Since he first came to Bunia in 1986 Dr Lendunga has watched the plague grow to epidemic proportions. And he knows how dire it is. He contracted it himself after operating on a dead woman to remove a foetus - African tradition demands that a dead woman and her child are buried separately. Too late he realised she had died of plague when he contracted it himself and only barely survived.

(Photograph omitted)

Start your day with The Independent, sign up for daily news emails
Voices
There will be a chance to bid for a rare example of the SAS Diary, collated by a former member of the regiment in the aftermath of World War II but only published – in a limited run of just 5,000 – in 2011
charity appealTime is running out to secure your favourite lot as our auction closes at 2pm tomorrow
Arts and Entertainment
Mark Wright and Bianca Miller in the final of The Apprentice
tvMark Wright and Bianca Miller fight for Lord Sugar's investment
Arts and Entertainment
X Factor winner Ben Haenow has scored his first Christmas number one
music
News
news
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
Arts and Entertainment
James May, Jeremy Clarkson and Richard Hammond in the Top Gear Patagonia Special
tv
News
File: James Woods attends the 52nd New York Film Festival at Walter Reade Theater on September 27, 2014
peopleActor was tweeting in wake of NYPD police shooting
News
Claudia Winkleman and co-host Tess Daly at the Strictly Come Dancing final
people
News
i100
Extras
indybest
News
peopleLiam Williams posted photo of himself dressed as Wilfried Bony
Sport
Martin Skrtel heads in the dramatic equaliser
SPORTLiverpool vs Arsenal match report: Bandaged Martin Skrtel heads home in the 97th-minute
Arts and Entertainment
The Apprentice finalists Mark Wright and Bianca Miller
tvBut who should win The Apprentice?
News
The monkey made several attempts to revive his friend before he regained consciousness
video
Extras
indybest
News
Elton John and David Furnish will marry on 21 December 2014
peopleSinger posts pictures of nuptials throughout the day
Life and Style
A still from the 1939 film version of Margaret Mitchell's 'Gone with the Wind'
life
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Telesales & Customer Service Executives - Outbound & Inbound

£7 - £9 per hour: Recruitment Genius: Are you outgoing? Do you want to work in...

Recruitment Genius: National Account Manager / Key Account Sales

£30000 - £35000 per annum: Recruitment Genius: An opportunity has arisen for a...

Recruitment Genius: Operations Manager

£30000 - £35000 per annum: Recruitment Genius: An exciting opportunity to join...

Recruitment Genius: Recruitment Consultant

£30000 - £35000 per annum: Recruitment Genius: We have an excellent role for a...

Day In a Page

The week Hollywood got scared and had to grow up a bit

The week Hollywood got scared and had to grow up a bit

Sony suffered a chorus of disapproval after it withdrew 'The Interview', but it's not too late for it to take a stand, says Joan Smith
From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?

Panto dames: before and after

From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?
Thirties murder mystery novel is surprise runaway Christmas hit

Thirties murder mystery novel is surprise runaway Christmas hit

Booksellers say readers are turning away from dark modern thrillers and back to the golden age of crime writing
Anne-Marie Huby: 'Charities deserve the best,' says founder of JustGiving

Anne-Marie Huby: 'Charities deserve the best'

Ten million of us have used the JustGiving website to donate to good causes. Its co-founder says that being dynamic is as important as being kind
The botanist who hunts for giant trees at Kew Gardens

The man who hunts giants

A Kew Gardens botanist has found 25 new large tree species - and he's sure there are more out there
The 12 ways of Christmas: Spare a thought for those who will be working to keep others safe during the festive season

The 12 ways of Christmas

We speak to a dozen people who will be working to keep others safe, happy and healthy over the holidays
Birdwatching men have a lot in common with their feathered friends, new study shows

The male exhibits strange behaviour

A new study shows that birdwatching men have a lot in common with their feathered friends...
Diaries of Evelyn Waugh, Virginia Woolf and Noël Coward reveal how they coped with the December blues

Famous diaries: Christmas week in history

Noël Coward parties into the night, Alan Clark bemoans the cost of servants, Evelyn Waugh ponders his drinking…
From noble to narky, the fall of the open letter

From noble to narky, the fall of the open letter

The great tradition of St Paul and Zola reached its nadir with a hungry worker's rant to Russell Brand, says DJ Taylor
A Christmas ghost story by Alison Moore: A prodigal daughter has a breakthrough

A Christmas ghost story by Alison Moore

The story was published earlier this month in 'Poor Souls' Light: Seven Curious Tales'
Marian Keyes: The author on her pre-approved Christmas, true love's parking implications and living in the moment

Marian Keyes

The author on her pre-approved Christmas, true love's parking implications and living in the moment
Bill Granger recipes: Our chef creates an Italian-inspired fish feast for Christmas Eve

Bill Granger's Christmas Eve fish feast

Bill's Italian friends introduced him to the Roman Catholic custom of a lavish fish supper on Christmas Eve. Here, he gives the tradition his own spin…
Liverpool vs Arsenal: Brendan Rodgers is fighting for his reputation

Rodgers fights for his reputation

Liverpool manager tries to stay on his feet despite waves of criticism
Amir Khan: 'The Taliban can threaten me but I must speak out... innocent kids, killed over nothing. It’s sick in the mind'

Amir Khan attacks the Taliban

'They can threaten me but I must speak out... innocent kids, killed over nothing. It’s sick in the mind'
Michael Calvin: Sepp Blatter is my man of the year in sport. Bring on 2015, quick

Michael Calvin's Last Word

Sepp Blatter is my man of the year in sport. Bring on 2015, quick