Gorilla Doctors

Grooming session with Umoja, Nyiramurema, Kwitonda, and others.

Six days after Umoja’s surgery, Magda returned from checking on him with a worried expression. Her report sounded exactly like mine from the day before: he was alert, whimpering, crawling, nursing well, and nibbling—but not swallowing—bamboo leaves. Umoja could still develop complications, and we’d both hoped his appetite for solid food would return by now. He could have an abscess brewing in the muscle layer where we’d placed the sutures, or the wound on his wrist could become infected. Or—the worst possibility—his intestinal tract might be damaged. He could have a stricture.

Umoja riding on Nyiramurema’s back favoring his right leg.

Alternatively, Umoja may simply be content for now with the milk and comfort of his mother. Because of his broken leg, he’s unable to wander around, try out new foods, or play with other infants. His behavior resembles that of a very young infant rather than that of a two-year old. Maybe he simply lacks the energy to manipulate bamboo. He burns extra calories every time he crawls after his mother. Moreover, the healing process increases metabolic rate. The pain from his wrist and leg may make him too uncomfortable to eat. Still, we worry about intestinal pain or cramping if he does have some scarring.

Umoja resting with Nyiramurema.

Elisabeth checked Umoja one week after surgery, a time frame we viewed as a mini- milestone. She and the trackers started out expecting to find Kwitonda where he’d been all week, close to the park border. Instead, they found evidence of a fast-moving journey up the mountainside. They could hear hoots and chest beating. Nyakagezi Group was back, and Kwitonda was on the move, following them. Elisabeth and the trackers stayed with the Kwitonda group for several hours. Fortunately, there’d been no fighting. Nyiramurema carried Umoja most of the time. If she put him down, another gorilla immediately picked him up.

Grooming session with Umoja, Nyiramurema, and silverback Kwitonda.

Nine days post-surgery, I made the next recheck. We were early, and found several gorillas still in their night nests. Kwitonda was resting on his elbows. Nyiramurema walked over to him, leaving Umoja sitting quietly about ten meters away. As she started to groom the silverback, the infant got up to join them. Instead of crawling, he walked on both hands and his left foot, favoring the right hand a bit and holding his right leg entirely off the ground. He made no sound. I was relieved that at least he could now limp normally!

Umoja, nine days post-op, riding on his mother’s back.

I decided to continue on and do a routine check of the entire group on this visit. While picking my way through the bamboo with Leóndace, I temporarily lost track of Umoja. By now Kwitonda was sitting in a shady thicket with several juveniles playing around him. I had my binoculars focused on this group when I heard a familiar noise to my left: gorilla crashing through bamboo. Nyiramurema appeared out of nowhere, only a few meters from me. She stopped and stared at me for a few seconds, then moved quickly toward Kwitonda. Umoja crawled from where he’d been sitting, hidden from view, and climbed on her back as she moved away into the thicket.

Umoja climbing up on his mother’s back.

I looked at Leóndace. He didn’t seem concerned. Nyiramurema’s behavior was natural and normal. She’s always been a very protective mother, and we’d unknowingly broken a basic rule–never get between a mother and her infant, let alone an infant you’ve darted. But after silently chastising myself, I realized our blunder had yielded a positive piece of information about Umoja I hadn’t yet picked up on: he’d been where a normal, healthy gorilla infant should be, playing near the silverback while his mother foraged.

Umoja, nine days post-op, with Nyiramurema and Kwitonda.

Unless something happens to Nyiramurema, Umoja will survive his injuries. He may have a visible a wound at the surgery site for some time, and bits of suture may migrate out. He may never walk completely normally, or recover full use of his right hand. But the fact that he managed to survive those first few days before our intervention shows he’s every bit as strong as his tough-as-nails parents. He kept his appetite for milk even with his intestines sticking out, and had enough strength to drag a broken leg behind him while holding onto his mother’s back with one good arm and leg. As Magda remarked, if Umoja lives to be a silverback, he’ll be quite something.

Nyiramurema carrying Umoja one year ago, Kwitonda Group, Rwanda.

For the better part of a week, I woke up at odd moments during the night thinking about Umoja and Nyiramurema. I felt sorry for the mother with her injured eye and missing foot, yet amazed by her strength and stamina. I wished we could relieve Umoja’s pain. Magda told me she wasn’t sleeping well either. Circumstances were beyond our control, as is often the case in wildlife medicine. We’d begun by worrying about whether we’d have a chance to treat the infant and waiting for the two gorilla groups to separate. After the intervention, we wondered if we’d operated in time.

Umoja in June 2007, a healthy infant in Kwitonda Group, Rwanda.

Only during the two hours when the gorillas were anesthetized were we in control. It was clear that Umoja was slowly dying. Surgery was his only chance, despite less than ideal conditions for a procedure involving an open abdominal cavity. Both puncture wounds went through skin and muscle straight into the abdomen. They’d begun to heal, clamping down on his intestines. We did our best—Magda and I, Elisabeth, and the five trackers, Pierre, Peter, Leon dace, Aaron, and Jerome. But was it good enough?

Nyiramurema with Umoja after his surgery, Kwitonda Group, Rwanda.

As soon as the infant and his mother rejoined the group, our ability to influence the outcome ended. We could give Umoja more antibiotics after 72 hours, if we felt it would make a difference and if we could get a dart off; but the main event was over. If he suddenly weakened or the wounds reopened, it was unlikely that we could or would intervene a second time. Vets have post-operative control of their patients in many situations, especially when the animal can be confined or hospitalized, but not in this one. The next few days were up to the two gorillas. Umoja would either heal or develop complications. His mother would continue to carry him and let him nurse—or not.

Kwitonda silverback with his family, February 2007, Kwitonda Group, Rwanda.

Magda checked on Umoja the day after surgery. When we’d left the group after the intervention, we felt optimistic about his immediate survival, but I didn’t relax until she called with an update. The trackers had found the group near where we left them—in a shady stand of bamboo. Umoja was clinging to his mother and his surgical wound looked intact. Not unexpectedly, Kwitonda had singled out Magda and displayed with a false charge, letting her know that he knew something had happened. Nyiramurema was nervous, too, though she allowed Umoja to nurse in front of Magda. So far, so good. Magda kept her visit short, knowing the gorillas would relax if left alone.

Umoja, 2-days post-op, riding on his mothers back as they leave their night nest.

The next day I did the Umoja recheck. As we walked quietly through the forest, I could sense the trackers’ relief. They’d observed the infant nursing many times during the previous day after Magda’s visit, and he’d regained some strength. I heard Umoja whimpering even before we reached the gorillas, who were just leaving their night nests. The sound was a good sign. He’d been too weak or depressed to make any sort of vocalization for three days. I snapped my only photo of the day (it was too dark further inside the forest): Umoja riding on Nyiramurema’s back, bright-eyed and alert.

Kwitonda silverback, Kwitonda Group, Rwanda, May 2008.

We followed the group slowly, in the hope that I could get a good view of the abdominal incision. Akareveru, the older of two black backs, felled a tree filled with flower buds and began to eat. Several other gorillas moved in to join him. Suddenly, Kwitonda appeared out of nowhere and ran at us. He stopped just a meter away, puffing out his upper lip and glaring at me. I stepped behind the tracker, Pierre; the silverback moved forward, backing us up further. I was aware that Nyiramurema was approaching from the left, and clearly Kwitonda was, too. I got the message: he knows me as well as Magda, and isn’t happy about either of us. As soon as the female sat down to eat, Kwitonda did the same.

Umoja, three days post-op, riding on his mother’s back; his surgical wound is healing.

Nyiramurema didn’t seem to notice me, or if she did, she felt safe in Kwitonda’s presence and showed no reaction. She pulled up a bamboo shoot and let Umoja slide to the ground. He rolled onto his back and lay quietly. Through my binoculars I could see that the skin around his incision was puffy and moist on the surface. A major concern has been that the sutured tissue will break down, or dehisce. Since we expect some inflammation at 48-hours post-operatively, this was no cause for worry, especially given that other gorillas had undoubtedly been picking at the wound.

Umoja, three days post-op, nursing.

Nyiramurema got up to find another shoot, leaving Umoja several feet away. He whined, turned over on his belly, and immediately crawled over to her dragging his broken leg. Though he whimpered the whole way, he covered the distance quickly. A few minutes later, he nursed for some time. Once I was away from the group, I called Magda and Elisabeth with the good news: Umoja was stronger, vocalizing and still nursing, and that the incision looked okay. On the following day, Magda’s photos showed an even brighter and stronger Umoja. He nursed at every opportunity. The swelling around the incision had decreased and the surface was dry.

Kwitonda Group gorillas eating bamboo, Rwanda.

Elisabeth checked Umoja on the fourth day after surgery. He whimpered throughout her visit, but nursed well and appeared strong. When I returned on day five post-op, the trackers were all smiles. We found Kwitonda and his group eating bamboo shoots in a dark, vine-filled patch of forest, close to where they’d been foraging all week. The trackers believe—and I agree—that the silverbacks know not to move too far or too fast when a member of the group has a problem. (This is noticeable when there’s a newborn baby.) Kwitonda stopped eating briefly to glance sideways at me. We found Nyiramurema nearby, sitting upright with her back against a tree.

Umoja, seven days post-op, (photo courtesy of our friend Louise Hurst who visited Kwitonda Group as a tourist.)

At first, I couldn’t see Umoja. He lay on his back on the ground behind his mother. As she had the other day, Nyiramurema got up to look for more food, walking calmly past me at a distance of about four meters. She moved up hill, doubling the distance between us, leaving Umoja behind and to my left. He stayed quiet for a few seconds, then began to crawl after her, using his elbows and left knee while holding his right leg off the ground—and whimpering loudly. Halfway there, he turned to look at me and started to scream. He screamed all the way until he climbed onto his mother’s back. She simply continued eating.

Jerome looked at me, smiling, and whispered, “They think you are the enemy, the doctor is the enemy.” But never mind—I’ll take that in exchange for a healed patient any day.

Nyiramurema carrying Umoja the day before surgery.

Nyiramurema seemed to realize her mistake. She turned sharply and headed uphill before the trackers even got close. Still woozy from the anesthetic, she tried to run, limping as usual, and stumbling in the effort to carry her infant. It didn’t help that she’s blind in one eye. I followed her dark outline through the dense vegetation. She navigated several obstacles, holding onto Umoja, then fell on her belly. Umoja slipped off her back. He barely moved and made no sound. Nyiramurema didn’t even glance back at him as she rose; instead, she took off at a run. In a few seconds, she’d disappeared.

Umoja nursing from Nyiramurema the day before surgery.

A wave of fear hit me. Healthy juvenile gorillas can find their way back to their mothers and family group if placed nearby, but this was a two-year old with a broken leg. If Nyiramurema rejoined the group without her infant, would she look for him later? If Kwitonda figured out that we’d intervened, he might move even faster uphill, away from the infant. Umoja needed his mother’s milk, body heat, and protection. The group might not find him in time. Or, he might be rejected.

Nyiramurema moving through dense bamboo.

I looked at the trackers, raising my eyebrows in an effort to signal “Should we carry him to the mother?!” (They speak mostly Kinyarwanda.) I asked the same to Elisabeth in English. Nobody moved or said a word. For a moment, we were all at a loss. We could no longer hear Nyiramurema. I asked Magda what she thought. My instinct was to pick up Umoja and run uphill in the hope that we could still find his mother and set him down near her, ideally on a trail leading back to the group.

Umoja covering his eyes, a sign of agitation and discomfort (the day before surgery.)

Magda agreed we should make the effort. Elisabeth nodded her head. I put my mask and gloves back on and picked Umoja up with my right arm under his buttocks, trying not to knock his broken leg or touch the surgery site, and my left under his left armpit. It didn’t feel right to be holding a wild gorilla so closely, but I didn’t see any other way. The infant barely reacted, raising his hands over his head. I began climbing, knowing I’d need help from one of the trackers soon. We needed to quickly get between the mother and the rest of the gorillas so that we could leave the infant in her path.

Kwitonda Group trackers during the intervention to remove Magayane’s snare (see blog); Pierre is in the middle.

I ran out of strength after ten minutes. Umoja weighs only about 15 pounds, but I’m not used to carrying that weight up hill on uneven ground. I didn’t want to slip and fall, or run completely out of energy. The vet work might not be over. I asked again for help from the trackers. Pierre, the tallest and strongest of them took the infant from me. He carried Umoja carefully, and with ease. Elisabeth called back and forth on the radio, trying to find out from the trackers where we should be heading. Suddenly, we heard gorillas. We stopped, hoping to intercept Nyiramurema as she caught up with the group.

Dr. Lucy Spelman tries to warm up Umoja without getting too close to him.

I took Umoja back from Pierre, thinking we should set the infant down in the vegetation near the gorilla group sooner rather than later. But our patient now felt cold, and his hair was damp. He had been relatively dry at the end of his surgery, but had since been carried through the wet forest on his mother’s back. If I put him down, the other gorillas ignored him, and the mother didn’t appear soon, he could become hypothermic. Sweating from the effort of having carried him uphill, I decided to sit with the infant in my lap, let my body heat warm him, and wait quietly, hoping Elisabeth and the trackers would soon confirm the mother’s location.

Kigoma, one of two black backs in Kwitonda Group.

A few minutes later, I caught a glimpse of a gorilla in a tree to my left nearby. Magda and Elisabeth confirmed the group was very close. Umoja’s older sister Chiri was also nearby, a good sign. I hoped they couldn’t see me holding the infant. They would have every right to charge me. Umoja had begun to warm up and regain some strength, moving his arms a bit and opening his mouth. His broken leg trembled but he seemed amazingly calm otherwise.

Nyiramurema eating bamboo shoots with Umoja lying on his back nearby, after medical intervention.

Seconds later, the vegetation crackled to my right. No matter which gorilla it was, I was in a dangerous position with Umoja in my arms. We thought it could be the mother. I put the infant on the ground in a pile of recently eaten bamboo shoots. He rolled downhill a bit, and we all backpedaled. Seconds later, Nyiramurema appeared. She paused only briefly, picking Umoja up matter-of-factly, as if she’d expected to find him there and went on her way. Twenty minutes later, we watched her eating bamboo with the main group, the infant at her side and Chiri once again nearby.

Umoja’s mother, Nyiramurema.

The infant lowland gorilla at the National Zoo whose wound I’d repaired grew up with no recognition of me as a bad person. His mother, however, has never forgotten. Every time I’ve gone back to visit, she regards me with what I would characterize as a glare. Nyiramurema never saw the dart, and never saw me holding her infant, but will she know me or Magda? We’ll find out soon enough. One of us will check on Umoja every day until he’s out of danger. We’re crossing our fingers that he’ll live long enough to learn to recognize his doctors.

Nyiramurema and others groom Umoja.

We gave up after three hours. The group stayed together, and the opportunity to dart never came. We did watch Umoja nurse, and we photographed his wounds. We could see holes in the exposed intestinal tissue, and interpreted them to be in the omentum, the fatty tissue that covers and protects the bowel, rather than the intestinal wall. Had his intestines been punctured, we didn’t think he’d still be alive, let alone have an appetite. At one point, three gorillas gathered around the infant and groomed his wounds, licking and picking at bits of dead tissue. We could only hope we were right about those holes.

Umoja with Nyiramurema; parts of his small intestine protrude from a wound in his abdomen.

Magda, Elisabeth, and I returned to the forest first thing the next day. After spending another hour and a half in cautious pursuit, I finally had my chance. Nyiramurema sat down to eat a bamboo shoot. Umoja lay at her side. There were other gorillas nearby, but not Chiri. All were busy eating. I darted the mother. She pulled out the dart, dropped it on the ground, got up, and walked away to the next bamboo shoot. Five minutes later she wobbled to her knees and fell asleep, anesthetized. I darted Umoja while he clung to her side. He too was unconscious a few minutes later.

Umoja anesthetized, ready for surgery.

My job over the next hour or so was to keep the two gorillas safely under anesthesia, with Elisabeth assisting, while Magda did the surgery. Our operating theater was a tiny clearing surrounded by bamboo and vine-covered trees. I felt a bit trapped, but also sure that none of the other gorillas in the area knew anything out of the ordinary was taking place. If we tried to move to a better site, they might hear us. The trackers stood quietly thirty feet away, listening for the rest of the group, ready to chase them away if necessary.

MGVP’s Dr. Magdalena Braum prepares Umoja’s injured abdomen for surgery; he had several loops of bowel protruding through two puncture wounds.

Magda zeroed in right in on the surgery. On Umoja’s right side, she found not one but two gorilla canine-sized punctures through the skin into the abdominal cavity with several short sections of bowel protruding through each one. Umoja’s intestines were intact, but the skin had begun to heal around them, constricting the herniated tissue. Magda removed small bits of unhealthy tissue, rinsed all with sterile fluids, released the pressure on the bowel loops, pushed them back in, and then closed the wounds with buried sutures.

ORTPN vet tech Elisabeth Nyirakaragire treats Umoja with fluids and antibiotics.

While Magda worked, Elisabeth gave Umoja subcutaneous fluids and injections of antibiotics. I collected blood samples from him and Nyiramurema, satisfied that the anesthetic drugs (Medetomidine and Ketamine) were working well, but not entirely comfortable with the situation. It’s challenging enough to anesthetize one mountain gorilla, never mind two at the same time. I kept my focus on anesthetic depth, frequently checking both patients for an increase in muscle tone. If Umoja began to wake up, surgery would be disrupted. If she woke up too soon, we’d all be in trouble, given our cage-like OR.

Umoja lying next to his mother the day before surgery, favoring his injured right wrist.

Umoja’s right wrist was badly damaged by a deep gash, more severe than we’d anticipated. One of two major flexor tendons running along the underside of the arm was severed, and the joint capsule was torn open. The end of the ulna, one of the two bones in the lower arm, was exposed. Magda sutured the tendons and a piece of muscle, knowing the repair might not hold but hoping to protect the tissue temporarily. Umoja may never regain full use of the wrist, but the wound should heal eventually. At worst, if the bones become infected or necrotic, he could lose his hand.

Umoja’s right foot is curled as he guards the break in his leg above the ankle; his left foot is uninjured.

We palpated Umoja’s lower right leg and confirmed a fracture of both the tibia and fibula, midway between the knee and ankle. While this injury is the least worrisome in terms of healing (young animals heal major bone fractures quickly), it is clearly the most painful. Umoja will not be able to walk, climb, play, or feed normally for weeks. While waiting for a chance to dart the day before, we’d watched as one of the other infants tried to start a game of rough and tumble. Umoja pushed his former playmate away, tucked his head, and curled up in a ball.

MGVP’s Dr. Lucy Spelman administers the anesthetic reversal to Nyiramurema at the end of Umoja’s surgery.

The scary part came at the very end of the procedure. As mother and infant recovered from anesthesia (I gave each a reversal drug), Nyiramurema started moving away in search of the group, stumbling a bit as she struggled to burn off the remaining anesthetic. Umoja rode on her back. In her pursuit of a gorilla trail, she had to make her way through a dense thicket. Our patient hung on—at first. Unfortunately, Nyiramurema headed downhill, the wrong way. The trackers quickly fanned out around her, forming a semi-circle to encourage her to reverse direction.

To be continued…

Two-year-old Umoja hiding in the vegetation, unable to move after sustaining multiple injuries during a fight between his family, Kwitonda Group, and Nyakagezi Group.

Jean Felix got the first call about Umoja. The two-year-old mountain gorilla infant had been badly injured during a fight between his family, Kwitonda Group, and Nyakagezi Group. Sometimes these two groups interact peacefully, but not this time. Umoja’s intestines were hanging out, and he couldn’t walk. Jean Felix relayed the information to me, adding that trackers felt there was nothing we could do at this time. The situation was unstable and likely to remain so for several days.

Silverback mountain gorilla, Kwitonda.

We intervene with medical treatment when a problem is life-threatening or human-induced—and only then if we can act without undue disruption to healthy gorillas. It sounded as if Umoja needed surgery, which meant we’d have to dart him, and probably his mother as well, with anesthetic. Kwitonda and his family were already nervous and would be especially protective of the injured infant. We’d need to drive them away with loud noises, adding to the tension and raising the risk of another aggressive encounter with the Nyakagezi gorillas.

With a broken leg, cut wrist, and herniated intestines, Umoja was able to crawl, but very slowly.

I knew we could do nothing until the gorillas went their separate ways, unless Umoja lagged behind. But I’d treated a similar case once before and knew the infant had a chance if he survived his initial injuries. I asked for more history. What was happening right now—was the infant alert, moving, vocalizing? The answers all came back Yes. He was calling for his mother, Nyiramurema, to carry him. She’d picked him up a few times but hadn’t held him for long. This female had lost a foot years ago, probably from a snare, and had all but stopped carrying Umoja in recent months. He’d grown too big. His older sister, Chiri, carried him instead.

Umoja clinging his mother, Nyiramurema, surrounded by other gorillas.

As we later confirmed, Umoja had two puncture wounds in his lower abdomen, a broken right lower leg (tibia and fibula), and torn flexor tendons in his left wrist. Even so, he was able to hold onto his mother, nurse, and crawl short distances. I thought back to a Sunday-morning emergency at the National Zoo in Washington DC. The lowland gorillas had a fight and the youngest member of the group, an infant male, got caught in the middle. Though several loops of bowel hung from a hole just below his ribcage, his intestines had not been damaged. We closed the wound surgically, and he lived.

Umoja’s mother, Nyiramurema, in Kwitonda Group.

I suggested we check Umoja if possible and at least document his injuries. Jean Felix called Elisabeth, the park’s vet tech. She agreed but warned we might not be able to get all the way into the group. I added surgical packs to our field kit just in case. My mind flipped through the options as we drove to the park. Maybe the interaction between the gorillas would be over by the time we reached Umoja, and we’d be able to intervene. We might be lucky and find him alone with Nyiramurema. She’s blind in one eye, the result of another recent fight, which might enable me to get off a dart off without her seeing it.

Umoja injured.

We hiked about forty minutes into the park and met the trackers. Instead of welcoming us with smiles, they looked serious. We found Umoja and Nyiramurema easily—but in the midst of other gorillas. The infant lay uncomfortably at his mother’s side while she nibbled on a vine. When she got up to move, he whimpered and reached out toward her. She picked him up once, but not a second time. He tried to follow, dragging his right leg. A bundle of red tissue bulged from his abdomen on the right side. Through our binoculars, Jean Felix, Elisabeth, and I were unable to determine if the intestines were damaged or simply exposed.

Kwitonda and Nyakagezi Groups often interact, especially during bamboo shoot season.

Light rain began falling. The mist rolled in. The Kwitonda Group gorillas formed a big circle, huddling together with females and infants in the middle to protect them from their would-be aggressors. We could hear the Nyakagezi gorillas in the bamboo nearby. We looked at each other in silent agreement: there was no way to intervene. I tried to convey my apologies to the trackers. Umoja could live on for three, maybe five days. Watching him die would be hard and sad, but nature is not always gentle. We left for the day with plans to return if and when the trackers thought intervention possible.

Injured infant mountain gorilla, Umoja, nursing.

I spent the next morning reorganizing the field kits and lab supplies while I waited for an update, too distracted to sit down at my desk. The report came in mid-morning: the Kwitonda gorillas were still very nervous and had charged the trackers. The Nyakagezi gorillas remained nearby. Umoja could no longer drag himself along the ground and was being carried by his mother and several other gorillas, including Chiri. The good news: the infant was nursing.

Umoja, two days after the fight with his mother, Nyrimurema, in Kwitonda Group.

On the third day, Elisabeth called from the forest. It was safe to intervene—the gorilla groups had gone their separate ways. Umoja appeared weak, she said, but continued to nurse. Magda and I hurried to the site (Jean Felix was off for the weekend.) I made two darts, one for Nyiramurema and one for the infant. We began patiently following the group, waiting for the right time and place to fire the darts. It would do no good to anesthetize Umoja and his mother in a situation where another gorilla—mostly likely Chiri—might carry him off. And if I missed and the gorillas noticed, we’d only upset them again.

To be continued…

The latest snare case: a female mountain gorilla in Nyakagezi Group, Uganda, has wire wrapped around her elbow.

Last week started with bad news: we heard about another snared gorilla, the second case in less than a month in Uganda’s Nyakagezi group (March 17, 2008). The trackers found a young gorilla with a wire snare around her arm and immediately called Dr. Benard Ssebide, our field vet in Uganda. They reported the gorilla seemed normal otherwise, with no sign of injury or swelling in the hand. That indicated there hadn’t yet been any permanent damage. We quickly prepared for an intervention the following day.

Last month’s case: a male mountain gorilla, Rukundo, Nyakagezi Group, Uganda, has wire wrapped around his right hand.

Gorillas can sometimes pull right out of a snare. If not, they can usually break free by biting or pulling on the wire or rope until it snaps. Unfortunately, this causes the loop to cinch even tighter around the snared finger, arm, or leg. Because of the gorilla’s thick hair, the only sign of the snare may be the frayed loose end of rope or wire. In this recent case, the first thing the trackers noticed was something shiny sticking out from the gorilla’s right elbow. The problem was much more obvious in Rukundo, last month’s case: he had a loop of bicycle brake cable wire encircling his hand.

The young gorillas in Nyakagezi Group usually move with one of the three silverbacks.

The morning after the report came in, I packed up our intervention kit, drove to the Uganda border, did all the paperwork so I could cross, found Benard in Kisoro, a small town near Mgahinga Park, and continued with him to the park boundary, where we met the trackers. Our group reached the gorillas a little after noon, just as clouds began to fill the sky. We found our patient quickly and confirmed the problem. She walked past us and sat down near Mafia, the group’s young silverback. As she ambled by, we caught a glimpse of silver wire around her right elbow.

Gorillas cannot untwist the bicycle brake cable wire used for snares.

The gorilla eyed us a bit nervously for several minutes. Then she calmed down and began to eat bamboo. Though the wire wasn’t all that tight, there were several frayed ends poking out. It looked like (and turned out to be) bicycle brake cable. There are reports that gorillas have sometimes been able to remove their own snares. So when a snare is loose, we may have the option of giving the animal a day or two under close observation. But no one has ever reported a gorilla untwisting a wire snare stuck near its elbow. Rukundo couldn’t untwist the wire around his hand, either.

Dr. Benard Ssebide, MGVP field veterinarian, Uganda.

As I had during the snare-removal procedure for Magayane, a female gorilla in Rwanda who also had a brake cable wire snare around her hand, I assumed the role of photographer/videographer while Benard administered the anesthetic dart. Our patient stayed close to one of two young silverbacks, which meant Benard had to wait patiently for almost an hour and a half before he got an opportunity to fire the dart gun. His dart and the anesthesia worked fine. We began the procedure just as rain began to fall.

Dr. Benard Ssebide and Ugandan Wildlife Authority (UWA) tracker Ishmael position the anesthetized gorilla for snare removal.

We can only estimate the age of this female. She transferred from one of Rwanda’s wild gorilla groups to this one several years ago. She’s about the same size—around 40 kilograms (or 88 pounds)—as the case from last month, Rukundo, a young male. They’re probably also about the same age, between six and seven years old. I learned that she hasn’t been named yet. Nyakagezi Group moves around a lot, and the composition of the group kept changing for many years. Now that it’s more stable, I hope the Ugandans will give her a name.

Benard and Ishmael remove the snare.

The snare proved difficult to untwist or cut, despite the efforts of two men, Benard and tracker Ishmael, and two Leatherman tools. In the future, we need to carry even bigger wire cutters for these thick brake cables. Finally, they managed to loosen the cable, and we slipped it off over the gorilla’s hand. It started to rain harder as we moved on to the next part of the exam. Benard asked the trackers to hold a rain poncho over us, which worked well enough initially, except for the hole you put your head through. We should have pulled the tarp out of the kit earlier, when we had time.

After loosening the snare, we easily slipped it off the gorilla’s arm.

Sheets of rain began to fall just as Benard started collecting blood samples, a routine step whenever we anesthetize a gorilla. The improvised tarp above us sagged under the weight of the water. When one of the trackers holding the poncho moved a few inches, a bucket of cold water poured down my back. I managed to smile. Better me then Benard, I thought. Then, as if someone had turned on a faucet, a stream of water poured through the hole in the poncho onto the gorilla’s belly. I swiped it away, looked up, and got another small shower.

MGVP field vets anesthetize mountain gorillas very rarely, intervening only if the problem is human-induced as in this snare case, or life-threatening.

About 40 minutes after the gorilla went down under the effects of the anesthetic, she began to move. We hadn’t finished everything we usually do during an intervention, including taking body-size measurements and other routine samples. Even so, we’d accomplished our main goal, removing the snare. Gorillas tend to hunker down in the rain, and we wanted this one to find her family sooner rather than later. So rather than supplementing her anesthetic, we let her wake up. She recovered surprisingly quickly. She rolled to one side, got up, and walked away from us a few minutes later, heading right toward her group.

Last year’s bicycle brake cable wire snare was Magayane, a female in Rwanda’s Kwitonda Group (August 16, 2007.)

Once again, I can’t help worrying about the rule of threes. We’ve had two nearly identical cases in Uganda. I’m crossing my fingers that there won’t be a third. Maybe Magayane’s case counts as the first. She had a snare of bicycle brake cable wire wound tightly around her middle finger. It damaged the blood supply and caused significant swelling. We didn’t amputate the finger, hoping it would be okay. It wasn’t. She kept the wound clean until the damaged tissue fell off (see blog). Magayane’s case was the first metal snare in years. Maybe these two cases in Uganda will be the last.

Farmland near Mgahinga National Park, Uganda.

The rain let up slowly during our trek back. The minute we left the forest to walk the last kilometer through farmland, the sun came out. Oh well—at least our patient would soon be dry. The next day the trackers reported that she was fully recovered and with her group. Meanwhile, we’ve asked that the anti-poaching patrols in this region of Mgahinga be stepped up.

Kwitonda silverback eating a stalk of bamboo, Kwitonda Group, Rwanda.

A few months ago, I received an email from Samantha Newport (then communications director at WildlifeDirect) with an offer of medical supplies from a woman in Switzerland, Jackie Sonderegger, who works for a company in Switzerland that makes medical diagnostic test kits. Jackie was planning a stay in Mombasa, Kenya, and Samantha knew we’d save a bundle on shipping if we could coordinate getting the supplies to Kenya first, and from there to Rwanda. Jackie invited me to check out her company’s website MD Doctors Direct and pick out what might be useful for the gorillas.

MGVP lab manager Jean Paul Lukusa.

One of my goals has been to find tests we can run “in-house” to screen the gorillas for diseases. For most samples, including those Jacques and Magda recently collected from Mapendo, we can do some tests in our regional lab—at least when the power is on! We often wait weeks to months for other types of tests while permits are processed. Various instant-result-style lab tests have been developed for humans in recent years, and I’ve been trying to learn more about them, especially those that screen for viruses and bacteria that cause respiratory infections. Our lab manager, Jean Paul, is more than willing to run new tests.

Jackie Sonderegger in the mail room at MD Doctors Direct in Switzerland, preparing box of supplies for MGVP.

To my surprise, the choices from Jackie’s company included easy-to-use and instant-result test kits for influenza, respiratory syncytial virus, and streptococcus, all respiratory diseases that we worry about. These tests use a Q-tip like swab to take samples from the back of the throat, or pharynx. The swab is placed in a special snap-test chamber; the color change indicates positive or negative similar to that of a pregnancy test (her company donated those, too!) I made a wish list and sent it back to Jackie, who responded immediately that she’d do her best to pull all the items together.

Grauer’s gorilla Mapendo is bonded to her caretakers but even they cannot place a swab up her nose.

Unfortunately, we won’t be able to use these new tests on wide-awake gorillas, even the orphans. Mapendo nearly bit a hole in my stethoscope the other day, and I wasn’t trying to put it anywhere near her mouth. But we can run the tests on samples taken from anesthetized gorillas. We can also use them for our employee health program. It’s a long shot, but we might also be able to use these new test kits on other types of samples, like feces—the most easily collected gorilla sample.

Silverback Isabukuru with bamboo shoot in his mouth, Rwanda, which he later dropped to the ground.

The timing of Jackie’s donation couldn’t have been better for another reason. Recently, Mike and I accepted a summer student from Tufts veterinary school, Tierra Wilson, to work on a small research project, a technique for recovering saliva from uneaten bits of gorilla food. Tierra submitted a grant for her study and got it. She arrives in June. If her study works, we could have a whole new type of sample to test. Though saliva is not a respiratory secretion, it does mix with fluids that come from the nasal passages and, if the patient is coughing, from the lungs.

Chimpanzee wadge of ficus fruit (fig) in Nyungwe Forest, Rwanda.

The saliva recovery study is not a new idea, and it may not work in gorillas. It’s been successful in chimpanzees, but this species naturally leaves behind a perfect sample, a “wadge” (a word coined by Dr. Jane Goodall) of uneaten food. Chimps do this most commonly with fruits. During my recent visit to Nyungwe Forest in Rwanda, we found fig wadges everywhere. By contrast, gorillas don’t wadge their food at all, and they have access to fewer fruits—and no figs. Until Tierra conducts her pilot study, we’re not sure if gorillas leave enough saliva behind on a stalk of bamboo, for example, to recover as a sample.

Orphan Grauer’s gorillas foraging at the Interim Quarantine Facility, Kinigi, Rwanda.

When Tierra arrives, we’ll ask the caretakers at Kinigi to collect uneaten bits of forest food from the orphaned gorillas for the first round of testing. She’ll centrifuge it and run tests for the presence of saliva. In preparation, Tierra has arranged through her mentors at Tufts to collaborate with the nearby New England Zoo that houses Western lowland gorillas. She’ll test uneaten food samples collected from these animals and evaluate alternate methods of saliva sample collection, such as ropes or other objects for the gorillas to chew on that might retain bits of saliva. We may find these techniques don’t work and/or that there’s no way to apply them to free-living gorillas, but we won’t know until we try.

Adult female mountain gorilla chewing on leaf she later dropped, Shinda Group, Rwanda.

Though I’m excited about the possibilities of Tierra’s study and Jackie’s test kits, we have a number of hurdles to clear when it comes to verifying test results. Because gorillas and people are so closely related, we have good reason to believe the results are accurate. But to verify them would mean giving a rare creature a disease just to prove a test works, something we’d never do in a mountain gorilla. There’s another challenge with the saliva recovery study in particular: gorillas sick with respiratory disease often don’t eat very well.

Letter of donation from Jackie’s company sent in the hope that officials would waive the customs fee; they didn’t.

As it turned out, our first challenge was getting Jackie’s test kits to Rwanda without paying exorbitant shipping. Because of the security problems in Kenya, Jackie never made it to Africa. Instead she offered to ship us the samples. Since FedEx turned out to be very expensive, Jackie suggested Danzas, a division of DHL. We said okay, not realizing that the shipment would arrive as freight and thus incur a customs fee. Even with a donation letter from her company, the Rwandan authorities would not waive the fee. Understandable. Rules are rules. Jackie graciously offered to make a donation to MGVP equal to the amount we had to pay to get the box.

Than and Allen at MD Doctors Direct in Switzerland packaged the supplies for MGVP and did all the paperwork for the donation.

The tests arrived in time to run them on the little Grauer’s gorilla orphan, Mapendo. Magda and Jacques had no trouble with the gorilla under anesthesia, and all results were (thankfully) negative.

When Jackie offered to make a donation, little did she or her company know that the supplies would help get a small research study going and also give us new ideas about screening park staff and gorilla caretakers for respiratory diseases. As we learn more, we’ll report back. Lots to do. THANK YOU, Jackie, and all at MD Doctors Direct. And thanks, too, to Samantha, for pointing Jackie in our direction.

Mapendo falling asleep under anesthesia, March 18, 2008.

MGVP director Mike Cranfield and I were finishing up a meeting when Magda returned from Goma, where she’d spent the day working with Jacques. “So, how is Mapendo?” I asked. Magda smiled broadly and replied, “A bit fat!” She and Jacques had just given the orphan gorilla a physical exam under anesthesia. Even better, Mapendo’s ringworm is resolving and she shows no signs of rickets, the nutritional disease that contributed to the death of her companion, Vumilia.

Dr. Magdalena Braum and Dr. Jacques Iyanya examining Mapendo, March 18, 2008.

Magda and Jacques had collected samples for a variety of routine tests, including fecal parasite check, blood cell count, serum chemistry analysis, and infectious disease screening. They tested Mapendo for recent exposure to tuberculosis by injecting a tiny amount of a reagent, tuberculin, in her upper eyelid—a standard TB screening tests for primates. And they vaccinated her for measles, rabies, tetanus, and polio. We vaccinate the gorilla orphans in our care because they spend so much time with humans; it’s easy to do, and we can check on how well the vaccines work by measuring blood antibody levels in the future.

Mapendo eating clover, March 25, 2008.

The TB test is read at 72 hours, so we get this result quickly. If the gorilla has recently been exposed to the organisms that cause tuberculosis, either the human or bovine form, or has an active TB infection, the eyelid swells. This test can be confusing in gorillas, however. False positive reactions have been known to occur in gorillas exposed to related bacteria that live in the soil, requiring a battery of additional tests. Fortunately, Mapendo’s test was negative. We’ll test her again in a few months and then every year she lives in captivity. With TB on the rise in human populations, I worry a lot about this disease. Not only is diagnosis difficult but treatment requires daily oral medicine with a cocktail of drugs, a protocol that would be impossible to administer to the mountain gorillas of Virunga and Bwindi or to the Kahuzi-Biega Grauer’s gorillas.

Mapendo with caretaker, February 19, 2008.

Our lab manager, Jean Paul, ran a number of routine tests on the samples from Mapendo. He found a number of parasites in her fecal sample. Most healthy free-living gorillas carry some parasitic protozoa, worm eggs, and larvae. But because they move around a lot, these parasites rarely build up in their environment. Not true for captive-living gorillas: because Mapendo lives in an enclosed space, her parasites could some day cause a problem. She’d already been treated with deworming medicine so it’s clear that she’ll need to be on a regular regimen of parasite testing and treatment.

Mapendo soon after her arrival, January 5, 2008.

Jean Paul also found that Mapendo has high cholesterol, 353 mg/dl. Not too high, but above reported normal levels for captive Western lowland gorillas and higher than what we’ve recorded for mountain and Grauer’s gorillas. We think the problem is her diet, specifically her three daily feedings of infant formula milk. Just as in humans, high-fat diets have been associated with elevated cholesterol levels and heart disease in captive-living Western lowland gorillas. Mapendo needed the extra calories when she first arrived, but no longer. The caretakers will reduce the volume of milk and switch to a lower calorie formula.

Mapendo has had an excellent appetite since her arrival, February 19, 2008.

As noted earlier, another test to be run on Mapendo’s blood samples is infectious disease screening. Here we look for evidence of exposure to a number of viruses as well as those we vaccinate against (after we give the vaccine these tests will always be positive)—possibilities that include herpes, Ebola, influenza, and parainfluenza. Unfortunately, sending samples to outside laboratories in the US or Europe takes time. We need an export CITES permit first. In Mapendo’s case, this document must be issued by officials in DR Congo. We’ve requested it, but know we’ll have to wait.

Three Grauer’s gorillas housed at the Interim Quarantine Facility, in Kinigi, Rwanda.

Though we can push through the red tape to expedite the permit process if the gorilla is sick or we’re worried about a possible disease outbreak, Mapendo’s situation doesn’t fall into this category. We do need her results before she can live with other Grauer’s gorillas, but that’s still a distant prospect. Last week, a number of the partners involved in orphan gorilla care visited yet another location in Congo that could be developed into a gorilla sanctuary. But such a facility is months, if not years, away from becoming reality. And we still need an interim quarantine facility near Goma, like the one we have in Kinigi, Rwanda.

Mapendo’s teeth (January 17, 2008)

Mapendo’s physical exam yielded one more important piece of data: her age. Though we’d photographed her teeth before—when her mouth was opportunistically open—we couldn’t be certain of her dental formula without a hands-on exam. Magda and Jacques confirmed that Mapendo has both of her upper and lower premolars but no molars, which places the her age between 2.5- and 3.5-years-old . Given her size (she now weighs 16 kg), we think Mapendo is probably about three. At this age in the wild, she’d still be nursing a bit, but would be mostly foraging on green plants and a few fruits. No wonder she’s gotten a bit plump on all that milk.

Mapendo on her climbing structure, March 25, 2008.

I visited Mapendo in Goma the week after her exam just to check on how things were going. The little gorilla avoided me. Most smaller gorilla orphans can be distracted with a tiny bit of food or the offer of a bottle when it comes time for an injection. This strategy had worked well for Magda the week before when she needed to give Mapendo her anesthetic. A quick poke with a needle is easier all around than a dart . . . but the gorillas remember who stuck them. No doubt I reminded Mapendo of Magda: we’re both white women with brown hair, and when we visit the orphans we wear similar gear—masks, gloves, and grey coveralls.

Mapendo drinking water, March 25, 2008.

Jacques suggested we humans sit on the ground, which made a big difference. Mapendo strutted around a bit and climbed briefly on her tripod. Then she sat down in the shade next to one of her caretakers, who plucked bits of clover from the grass for her to eat. When the other caretaker crossed the enclosure to the night house to get her a bottle of water, Mapendo ran like lightning to beat him to the door, and nearly succeeded. She drank the water as if it were an enormous treat.

I left feeling pleased to see Mapendo thriving, but sad that her future is so uncertain.

A wild gecko with healthy eyes, Rwanda.

We’ve had very few calls about gorillas with eye problems since I joined the vet project—until this past month, when we had two. That means we’ll have a third case soon. I believe in the rule of threes when it comes to veterinary cases. Once we’ve seen two-of-a-kind, there’s undoubtedly a third on the way, though not a fourth. There’s no logic to this rule, of course. It’s just my way of managing expectations about what the future holds, good or bad.

Metal snare on Rukundo’s hand, Nyakagezi Group, RW. Photo by Dr. Benard Ssebide MGVP.

For example, when I started working for MGVP, it had been several years since the vet team had taken a snare off a gorilla. Our last three anesthetic procedures, or interventions, have all been to remove snares. Dushishoze in Pablo Group was the first case, in July 2007. The second case turned up a month later–, Magayane in Kwitonda Group. Dr. Benard Ssebide treated the third in February 2008, Rukundo, in Uganda’s Nyakagezi group. If the rule holds—and I hope it does—we won’t see another snare for years.

Ndeze and Ndakasi play on their climbing structure in Goma, DRC.

The orphaned gorillas also fit the rule of threes. We care for one male mountain gorilla, one male Grauer’s gorilla, and six female Grauer’s gorillas. No pattern there. However, we also care for three female mountain gorillas, all of whom lost their mothers to poachers in the forest. Maisha was the first to be rescued, in December 2004. Ndakasi came next in June 2007, followed by Ndeze in August 2007. Again, I hope the rule of three holds true.

Muntu, an adult female mountain gorilla in Isabukuru Group, Rwanda.

The first eye case was Muntu, an adult female in Isabukuru Group. The trackers reported that she had swollen eyes and couldn’t see, but was eating normally. I ran through the possibilities in my mind as we hiked up to see her. Injury was the most likely. Though eye injuries can be serious, they rarely fall into the category of human-induced or life-threatening, so it was unlikely that we’d end up treating her. But I wanted to be sure Muntu didn’t have some sort of communicable infectious disease.

Muntu closes her eyes, a sign of pain or blepharospasm.

My first glimpse of Muntu made me worry that she had a serious problem. She sat in the shade with both eyes closed tightly, a sign of pain, or blepharospasm. Then she got up and began to forage, moving around with her left eye fully open and her right mostly open. Once we caught up with her in sunlight, I could see the problem. She had a cloudy circular area covering about half of the surface of her right eye, a sign of a healing corneal ulcer. Over the next hour, she squinted at times but mostly held both eyes open.

Muntu has a cloudy right eye, the result of a healing ulcer.

The eyelid acts as a natural Band-Aid for damage to the cornea, so squinting protects the eye and helps it heal. The cloudiness results from the healing process. Muntu may have scratched her cornea in a scuffle with another gorilla, or simply by brushing her eye against a nettle. I did notice that Muntu had a pale scar on the right side of her face, a lesion that looked herpes-like, and considered briefly that the problem could be infectious. We haven’t seen this combination before but will look out for it from now on.

Inziza, adult female mountain gorilla in Shinda Group, Rwanda.

The second case of the month was another adult female, Inziza, in Shinda Group, also reported to have a swelling on her eye. The gorillas were foraging on a steep slope covered with nettles, which made it very difficult to see them. We were lucky to come across Inziza soon, sitting calmly while she ate. At first, both of her eyes looked normal. Then she turned her head to the left. I could see an odd, blister-like swelling on the upper edge of her left eye and a small amount of white discharge.

The swelling on Inziza’s left eye is evident even with her eyes closed.

Inziza sat perfectly still while I peered at her left eye through my binoculars and then took a series of photographs. The lesion seemed to arise from the surface of the eye, or cornea. Most of the time, she held the eye wide open and showed no sign of pain, which surprised me. When she closed her eyes, the swelling created a slight bulge in her eyelid. Maybe she’d been poked in the eye by a stick or thorn. It could be eye cancer, but this hasn’t been described in mountain gorillas and Inziza is only 14-years old.

Imvune, a female mountain gorilla in Shinda Group, Rwanda.

After observing Inziza for some time, I went on to check the rest of the gorillas in the group. I wanted to make absolutely certain that Inziza’s was the only case of its kind among them. Given the dense vegetation, eyes and faces were about all I could see anyway. We found one individual, a young female, Imvune, with a different sort of eye problem, a tiny scratch below her lower right eyelid, which was lined with a film of white discharge. It seemed a very minor injury, but I took photos just in case.

Inziza in Shinda Group with an eye injury.

I reviewed Inziza’s photos later that day with regional field vet Dr. Magdalena Braum, using the computer to enlarge the images. With magnification, we could see more easily that her left pupil was abnormally shaped, narrow and slit-like. The iris, the muscle that controls the size of the pupil, may even be attached to the inner surface of the cornea. Magda wondered if Inziza could see out of this eye. Imvune’s photos confirmed the scratch along the lower eyelid of her right eye. I emailed the images to my friend Dr. Seth Koch, a veterinary ophthalmologist in Washington D.C. for his opinion; Magda planned to return to Shinda Group in a few days.

Nyakalima, a lone silverback in Rwanda with a chronic eye problem, Rwanda.

Given my rule of threes, it’s possible I’ve already seen the third eye case. (Imvune’s eyelid scratch doesn’t count because no one called us to check her.) A few months ago, I was called to check on a lone silverback, Nyakalima, who lost his left eye in a fight with another male and has a chronic infection. Aggression among silverbacks is natural and normal, so we haven’t intervened. He’s a magnificent-looking animal aside from his damaged eye. With any luck, we won’t see any new eye problems for a while. Then again, we might.

Angolan colobus monkey, Nyungwe, RW

Magda and I recently returned from whirlwind three-day road trip to Nyungwe forest, Rwanda’s newest national park, where we participated in a workshop designed to establish protocols for chimpanzee ecotourism. Magda is a chimp expert, having worked previously at two national parks in Tanzania, Gombe and Mahale. She brought all of her experience and knowledge to share at this meeting. My role was to share the health protocols we currently have in place for the mountain gorillas, as a starting point for Nyungwe.

Forest caterpillar, Nyungwe National Park, RW

During our long drive, I asked Magda dozens of questions. I wanted to know more about how things work at the research and tourist camps in Tanzania, where tracking habituated chimps has been going on for many years. In Nyungwe, the process is beginning with two small chimp communities and one large one. Whereas gorillas live together in stable groups, chimps live in communities of grouped individuals whose composition changes frequently. Like mountain gorillas, chimps are susceptible to human diseases, so the risk of transmission will increase as they become habituated to people.

ORTPN staff Dr. Julius Nziza (veterinarian) in Nyungwe National Park, RW

The workshop was organized by Bill Weber of the Wildlife Conservation Society. He and his wife, Amy Vedder, helped establish ecotourism for mountain gorillas in the late 1980s. Bill understands that establishing protocols for human visitors can go a long way toward preventing problems, so he’d organized a series of meetings to address all aspects of park management, including health. Magda and I were happy to find that Dr. Julius Nziza had just arrived at Nyungwe as the on-site vet. We’ve invited him to several sessions of our MGVP training rounds and he’s keen to learn more. His participation will be key.

Male chimpanzee, Nyungwe National Park, RW

During the workshop, Magda and I discussed the findings of a newly-published scientific paper http://linkinghub.elsevier.com/retrieve/pii/S0960982208000171. Chimp researchers in the Tai forest (Ivory Coast, Africa) observed multiple outbreaks of respiratory illness in their subject animals. The morbidity rate, or the percent of the animals affected in each chimp community, was high (average 92.2%.) In several outbreaks, as many as eight individuals from one community died (18%.) Respiratory outbreaks also occurred among people living in the research camp. Though her own findings have not been published, Magda has treated chimps suffering from bacterial pneumonia thought to be secondary to a viral respiratory infection—introduced by humans.

Male chimpanzee, Nyungwe National Park, RW

The Tai forest paper examined the source of the respiratory viruses. Though samples were available for only a handful of outbreaks, the results clearly showed that the chimps were infected with one of two types of human-origin Paramyxovirus. The virus strains matched epidemics circulating in people elsewhere in the world, including Asia and North America. This data proves what scientists have long suspected, a suspicion strong enough to serve as the basis for our current gorilla ecotourism guidelines: that humans have introduced novel pathogens into populations of free-living great apes.

Three male chimpanzees, Nyungwe National Park, RW

Tourists and researchers are not the only risk to the chimps (or gorillas.) Disease outbreaks that occur in villages bordering parks like Nyungwe also pose a huge threat. Anyone who lives in the community can pick up an infection and bring it to the park, including staff members. An outbreak of meningitis, for example, could spread quickly. Humans can be vaccinated against these and other diseases, but vaccination is logistically a very difficult procedure with free-living apes—and chimps can move faster and farther than gorillas. Clearly, prevention of disease transmission is the key.

Three male chimpanzees, Nyungwe National Park, RW

With respect to health protocols for ecotourism, we cannot know for certain if a visitor has just been exposed to a nasty virus. Obviously, keeping a safe distance from the chimps or gorillas reduces the risk of disease transmission—and it’s also important in terms of minimizing stress to the animals But under favorable conditions of temperature, moisture, and wind, aerosolized droplets containing diseases can survive longer and float farther than most of us can imagine. Face masks can greatly reduce the spread of disease, but only if used properly.

Drs. Julius Nziza (ORTPN) and Magdalena Braum (MGVP) examine the carcass of a dead monkey in Nyungwe National Park, RW

Throughout our formal and informal discussions at Nyungwe, I stressed the importance of practicing good basic hygiene—on the part of both staff and tourists. Frequent hand-washing with soap and water and wearing only clean clothes in and out of the forest are relatively easy precautions to note and remember. Guide and tracker health is equally important. We recommended that Nyungwe adopt an employee health program similar to the one MGVP supports in the Virungas.

Tea plantation near Nyungwe National Park, RW

In addition, Julius plans to become acquainted with the local health officials so that if there is an outbreak of illness in the community, he’ll know about it. In such a case, the wisest move may be to stop chimp visits until the illness has been identified and contained. Finally, all of these preventive measures must be communicated to tourists, researchers, and park staff effectively and regularly. If people don’t understand the risks, they’re less likely to follow the hygiene and distance protocols that are in place.

Male chimpanzee feasting on ripe figs, Nyungwe National Park, RW

As Magda and I learned for ourselves during the two days we tracked chimps at Nyungwe, distance is less of a problem while the chimps are not yet habituated to humans. On our first day, we found three males feasting on figs. They hooted several times. Magda explained they were calling the females, who weren’t likely to show up with all of us around. I’d never seen any animal fill his mouth as full as one chimp did with figs. Had I not seen him put the fruit in his mouth, I would have thought something was wrong with his face!

Fresh chimpanzee track, Nyungwe National Forest, RW

On the second day, we spent the morning criss-crossing a patch of forest with the trackers, looking for the same chimp community we’d visited the day before. Though we could hear the chimps—their voices echoed from at least two locations—and found fresh tracks, we made little progress for several hours. Finally, we tracked a group of chimps making their way to the familiar fig tree. Three males climbed up to feed, though not the same trio as the day before. Once again, they called to the females; once again, none appeared. Magda and I left Nyungwe worrying less about disease for the time being. But when the chimps do become fully habituated, the risks will increase exponentially.