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.
Nyiramurema carries Umoja one year ago.
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.
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 his 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?
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; however, 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, Feb. 2007.
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 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, two days post-op, riding on his mother's back as they leave their night nest.
The next day I did the Umoja re-check. 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 farther inside the forest): Umoja riding on Nyiramurema's back, bright-eyed and alert.
Kwitonda silverback, 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 farther.
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 had been that the sutured tissue would break down, or dehisce. Since we expect some inflammation at 48 hours post-op, 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 the incision looked OK. 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.
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
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 4 meters. She moved uphill, 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.
[Rwanda, May 4, 2008. Pictures: Dr. Lucy Spelman/MGVP]
THANK YOU THANK YOU THANK YOU!!!!!! I have been on pins and needles waiting for an update on little Umoja. Thank you for every single thing you do out there for the beloved mountain gorillas! I worry about what the world would be like without people like you all at the MGVP!
Posted by: Megan | May 20, 2008 at 02:37 PM