It's been busy here as usual. I try to carve out quiet time to review, crop, label and shrink our project photos down to a Web-friendly or Word-doc-friendly size. They're part of our medical records, as well as a great way to share. There's also the time involved in trying to get them to upload to the Internet. No matter how small I make the files, it doesn't work until now, 4:30 a.m.

Infant mountain gorillas Ndakasi and Ndeze in Goma, Oct 24, 2008

Infant mountain gorilla Ndeze plays with a new toy.

Infant mountain gorilla Ndakasi plays with a new toy.

Juvenile Grauer's gorilla Mapendo plays with a new toy.

Andre Bauma with Ndeze and Ndakasi

Mapendo with Babo, one of her caretakers

Ndakasi playing on her climbing structure.

The chaos in Goma also causes countless delays. With our slow Internet and unreliable cell phone connections, it can take all day to get an update from Jacques and Eddy. To add to the tension and worry about orphan gorillas, as if we needed more, lightning struck our electric fence at the facility in Kinigi, Rwanda, 10 days ago. We've been scrambling to gather the right parts and finish the repairs ever since. Ntabwoba, Itebero and Maisha know when the electricity to their fence is off, and if their caretakers aren't watching, they'll get out — not all the way out, but into the rear area or the kitchen, far enough to cause havoc.

Several of the orphan gorillas at the Kinigi facility in Rwanda watch their fence being repaired.

The box that supplies electricity for the Kinigi fence had not only burned up, but part of the wire and insulators had disintegrated. There was a hole in the cement wall big enough for a gorilla hand. We needed to get new parts quickly. Thank goodness for our friends, Ged Caddick, who runs Terra Incognita Tours, and Doug Braum, Magda's husband. Both happened to be here when we needed them.

Doug and Glenn set up the new electric fence box with no problems.

Ged stopped by our office to say hello just as our local electrician was telling me he could fix the box, which consisted of a few bits of plastic and burned-up electrical parts. I couldn't imagine that anyone could put it back together, especially someone with no tools. No way, I said, there's nothing to fix. We needed a new system, which I knew we couldn't buy in Rwanda.

Ged came to the rescue. He made a few phone calls to his friend Carol at Volcanoes Safaris in Uganda, got someone on the phone at a store in Kampala, talked back and forth with me about what we needed, made a decision, put all the expenses on his credit card, and arranged for two new electrical boxes to arrive by Sunday morning — one for now — and one for the next time lightning strikes. A week later, back in his Tampa office, Ged wired our project even more money as a donation. We cannot thank him enough!

Doug then spent the better part of a week putting the electric fence system at Kinigi back together while either Magda or Jean Felix did their best to distract the gorillas with attention, toys and peanuts. Glenn Bush, another helpful husband, also lent a hand. Glen is married to Katie Fawcett, director of the Karisoke Research Center; he'd dealt with the fence once before and I think he was happy to have Doug's help! I'm sure neither planned to become experts at gorilla containment. They are now.

Ndakasi and Ndeze play in Goma.

But these weren't the real reasons I'd delayed viewing the orphans' photos. The truth was that given all the subsequent chaos in Goma, I couldn't bear to see happy gorillas and relaxed caretakers. Finally, I realized that looking at the photos might cheer us all up a bit.

Andre Bauma with Ndeze

Mapendo

Jacques and Eddy assure us that nothing has changed for the orphans so far. They're the same playful, well-fed creatures they were two weeks ago. As for the caretakers, Andre and the rest of the team are determined to stay put, though I doubt they're sharing as many smiles or looking as relaxed as they were during Magda's visit. For now, we're taking things one day at a time.

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

The road to Kinigi is always crowded just after dawn and before dusk, especially when the rain has just stopped, so I left a bit early, anticipating the congestion. In relative terms, the traffic was nothing like my recent adventure in Los Angeles, where it took me two-and-a-half-hours to drive 30 miles in rush-hour traffic to a book signing. I was a nervous wreck when I arrived, after wasting more precious minutes looking for parking.

A view of the Virunga mountain range after a rain.

I took a deep breath and tried to enjoy the drive. In contrast to the colors of urban Southern California — gray roads, glassy buildings and hazy skies — the landscape around me glowed with greens and blues. The late afternoon light created a series of gorgeous shadows high up along the forested ridges of Sabinyo Volcano. The gorillas might be grabbing one more meal now after hunkering down during the rain, before what I guessed would be a cold, clear night. Fields of corn and potatoes covered the lower slopes of the Virungas. It was clear enough to see Mikeno, too, one of the still-active volcanoes in DR Congo. A puff of clouds encircled its squared-off top. That was where today's fighting was taking place.

A map of the mountain gorilla's habitat includes Rwanda DR Congo and Unganda.

As I drove up to the lodge, enjoying the peaceful greenery, the events of the day swirled in my head. Just a week ago I'd listened to the start of the presidential debate during my nightmare drive across L.A., checked the traffic on my iPhone, and even glanced at the New York Times or my email when the traffic slowed to a crawl.

Here, the main driving hazard was a sheep that nearly ran into my truck. For most of the day, my cell phone had no signal and the Internet had been down. The radio in the truck doesn't work, either, not that I can understand the garbled French voices. The political scenery was different, too. I had the news of the day, only secondhand. Tensions in Goma were building as rebels took over Rumangabo, the ranger station on the Mikeno side of the gorilla park, and headed toward the border city.

Clouds obscure the Virunga range.

My job, of course, is to ensure the safety of our staff first and foremost, and secondly do all I can for the gorillas. We (MGVP Inc.) have three staff living in Goma, DR Congo — and three orphaned gorillas. We've all been wary of the fighting in and around the park. Our Congolese field vets, Jacques and Eddy, haven't been able to check the mountain gorillas with the park rangers on any sort of regular basis for years. Our Congolese lab manager, Jean Paul, had been able to monitor employee health for park staff last year, but we'd had to suspend the program for 2008. I haven't felt very safe in Goma, but then, I'm a white ex-pat woman. The guys haven't worried until now.

Ndeze, one of the orphaned gorillas living in Goma, DR Congo.

From what I understood from my conversations today, Goma may soon be overrun with looters as well as with refugees running away from their camps. All I can do to help is make sure the guys have some cash on hand. That way, if someone breaks in, they'll have money to give. As for the orphans, all we can do is support their caretakers. If the situation deteriorates, human safety comes first. We'll of course try to take care of the gorillas, but there's not much point in making any grand plan right now. Plans don't work in a chaotic place.

The dinner party proved a good distraction. I met some wonderfully supportive people who promised to help our project with donated funds. They quickly understood my message about "one-health" and the importance of taking care of the people who live near the gorillas, as well as the animals themselves. The big challenge is that the three countries, Uganda, Congo and Rwanda, need to work together to ensure the survival of the mountain gorillas and to improve human lives. That's not happening now, at least not today.

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

Uganda has very few habituated groups — one had just disappeared into D.R. Congo — so these visits are carefully arranged. Unlike Rwanda, where visitors gather at one location and are dispatched into the forest from there, tourists in Uganda are assigned to a particular group, with no possibility of switching at the last minute.

The Nkuringo Group of gorillas live in Uganda's Bwindi Impenetrable Forest.

Park officials with the Uganda Wildlife Authority (UWA) generally prefer that tourists visit the gorillas first, with vets doing any necessary work afterward. This is mainly because an intervention can disrupt the group and thus the visit. It’s a system I find hard to accept, as I’m always anxious to get to the patient.

Fortunately, Benard had convinced the Nkuringo warden that in this particular case we could get our work done before the guests arrived — assuming we found our patient promptly. If there's such a thing as an easy intervention, it's with a blackback or lone silverback. Since these males usually roam on the edge of the group, we can often intervene without the leader knowing that anything out of the ordinary has happened. (Of course, this is impossible when the patient is a breeding female or infant.)

The snare around Kirungyi's right leg, the fourth in 2008 in Uganda.

Benard and I arrived at the ranger station on schedule at 7:30 a.m. and were disappointed to find that neither our tracker nor the porters had arrived. We had no choice but to wait. At least the advance tracking team had already left, we were told.

I paced, glancing anxiously at the cloudy sky and trying to keep a polite distance from the one tourist who'd already arrived, someone I'd met at dinner the night before. It helped to know I could run down this trail faster than people who'd never done it before. The route to Nkuringo Group was down, not up — hard on the knees, rocky and slippery, but quicker than climbing. Our intervention team could gain a good chunk of time before the tourists' arrival if we ran it — and we did.

Though we reached the bottom of the ravine swiftly, I was dismayed to hear one of the porters coughing repeatedly. Our lead tracker, who mostly works as a UWA guide, said nothing. Why hadn't we encountered the tracking team yet? I asked. He told me not to worry. It was he who'd seen the gorillas yesterday and reported the snare.

There was nothing I could do now about lack of coordination among the trackers, but I could and did send the porter home. I reminded everyone that a cough means you may be carrying an infection. One of the other porters nodded in agreement and picked up the extra bag.

Blackback gorilla Kirungyi climbed a tree easily despite the wire snare around his leg.

Thirty minutes later we found the group and our patient, a full-sized blackback gorilla named Kirungyi. Despite the wire snare wrapped around his leg, he easily climbed a tree and sat eating amidst the vegetation. As we approached to get a closer look, he got up to move. A long piece of bicycle-brake cable wire trailed behind him. It encircled his lower right leg, which was swarming with flies. I caught a whiff of dead tissue, a sour smell.

Seemingly out of nowhere, the rest of the trackers arrived. Benard and I resolved to have a serious discussion later with the park warden about their performance. But for the moment we had work to do. At least the gorilla appeared strong, so much so that he promptly climbed into another tree just as Benard was ready with his dart.

I took some video of the gorilla in the tree (if I can figure out how to download it, I'll post it online). Kirungyi looked as if he wanted to find a comfortable place to rest and put his feet up, literally. But his sore leg kept hampering him, and he couldn't get comfortable. The trackers slapped the tree trunk with a stick until the gorilla returned to the ground to look for a more peaceful place to rest. Benard got the dart in a few minutes later.

Lucy and Benard work on Kirungyi.

We calculate our anesthetic dose by estimating the weight of the patient. We use its age class as an overall guide; the choices include infant, juvenile, sub-adult, adult female, blackback and silverback. If the gorilla is on the small side (infant up to small adult female), we can weigh him or her during the procedure using our meat scale and find out how accurate our guess was. This patient was too big for that, and although he fell asleep readily enough under the effects of the drug, it took him eight minutes to go down rather than the six we'd predicted. I guessed he'd need more anesthetic.

Once we had our hands on him, we decided he weighed closer to 150 than 130 kilograms. When we tried to reposition our sizeable patient by pulling on his arms to roll him onto his back, he moved his powerful head — but we were ready for that. Benard gave him another injection, and we were set to begin work.

While Benard removed the snare, I silently wished that gorillas could
somehow learn how to use wire cutters themselves.

The snare injury could have been much worse, and would have been after a few more days. The wire was embedded in the gorilla's leg and there was a lot of swelling, but there was no evidence of dead (or necrotic) tissue beneath a few centimeters where the wire dug into his skin. His swollen toes were warm, a sign that blood was still circulating.

Having just seen the gorilla moving about and eating, we knew the damage couldn't be too severe unless he had an infection brewing. We'd give him antibiotics to play it safe. As I watched Benard cut off the snare, I silently wished that gorillas could somehow learn how to use wire cutters themselves.

We collect blood on every patient as soon as the snare is off;
Kirungyi had a high white blood cell count.

Time flies during these procedures. We didn't want to inject the gorilla again with more anesthetic, so Benard and I worked as quickly as possible. He collected blood while I monitored anesthesia and did a general physical. Next I cleaned the snare wound while Benard administered the antibiotics, then took nose and throat swabs.

As time began to run short — we have a window of about 40 minutes once the animal is stable — we moved all of our equipment out of the way, hoping to accomplish a few more things. Benard started body measurements while I prepared a second antibiotic for an intravenous limb perfusion. It wouldn't hurt and the medicine would find its way into the swollen foot tissue more quickly than via the intramuscular injection.

Lucy cleans Kirungyi's snare wound.

Unfortunately, Kirungyi took a deep breath, moved an arm, and suddenly rolled over on his stomach. He clasped the mask we’d put on his face to protect his eyes and pulled it off.

Once again, we were ready. I grabbed the mask out of his hand and yanked the tarp out from under him, tumbling back on my rear end as Benard gave the reversal drug. The gorilla got up and walked away. Fifteen minutes later, we watched him eat. The fast recovery from anesthesia (medetomidine combined with ketamine) never ceases to amaze me.

Although Kirungyi's foot was very swollen, his toes were
warm to the touch, a sign of good circulation.

We packed up our kits and encountered the tourist group just minutes later. They'd only just arrived. I briefly explained what we'd been up to and wished them a good visit. Unfortunately for them, and for us, it started to rain.

The rain felt good at first — I'd worn too many layers during the procedure, fearing I'd be cold as usual, but soon I was uncomfortably hot under my rain gear. I packed it away and hurried back up the hill faster than most of the group, made possible by the fact that I don't carry a bag.

The gloomy weather helped propel me, as the rain was soon accompanied by thunder and lightning. I told myself I should be able to generate enough beads of warm sweat to counteract the icy drops pelting my arms and face. The rain won, but I kept walking. As the climb steepened, I stopped thinking about Kirungyi (he would recover) or the poor performance of the trackers (we'd definitely point it out) or the rain (nothing I could do about it) and concentrated on just one thing: putting one foot in front of the other.

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

I wondered why Bernard hadn't called, until I remembered the poor cell phone reception around the parks in Uganda. He must have gotten the message from the park warden and decided the best way to relay it quickly was via the nearest Internet café. I wrote back asking him to call me as soon as possible to confirm the bad news. This case sounded a lot like the last three snares in Uganda: no chance that it would resolve on its own.

From the bit of information I had, I suspected that this was not a new snare. It takes a few days for lameness to occur, and that could explain why the gorilla was lagging behind his family. Much depends on how tight the snare is and on whether it is indeed made of wire. I think it's been years since we had a case of a rope snare in Uganda. What was going on? This would be the fourth wire snare in Uganda in six months, the sixth in the past 13 months.

First 2008 Uganda snare in February.

Various questions collided in my mind. The most obvious and important one was: Where are the snares coming from? As I've explained before, the snares are set to catch game for food, especially small antelope, or duiker. Are more being set, or are the gorillas moving through snare-laden areas more often?

If there are more snares in the parks in Rwanda and Uganda — we have no idea what's going on in DR Congo — is it because there are more hungry people these days? Whatever the answer, many illegal hunters are still getting into the park. Is this because of the leaky and insecure border with Congo? Maybe the poaching patrols have simply not been doing their jobs, or maybe they lack the equipment to do them effectively.

When a wire snare isn't too tight, the wounds are minor
like this one (snare No. 1 2008 Uganda).

I'd raised these questions during a recent community conservation meeting held by the chief park warden of the Volcanoes National Park in Rwanda. I asked them again after little Icyerecyezo's snare injury. A month earlier, I'd also spoken with the chief park warden in Uganda's Bwindi and Mgahinga parks and directed Benard to check with the patrols there.

Each time the reply has been the same: the wardens have more rangers patrolling more of the parks than ever, and believe they've become more proficient at finding snares. That may be so, but given how many snared gorillas we’ve seen recently, there may also be an increased number of snares in the park.

Second 2008 Uganda snare in April.

Another possible explanation is that the gorillas have become lax at watching for snares and traces of human activity. The trackers say the gorillas know where the poachers set snares, along paths used by antelope. What would send them into these potential minefields? Maybe the gorillas' preference for a particular food is leading them astray. When I was checking on the Kwitonda Group gorillas for respiratory disease, they were intensely focused on Drombere tree flowers for the entire month.

There's also the fact that many of the gorilla groups routinely leave the park to forage for crops in Uganda; in Rwanda, they leave to eat the bark of eucalyptus trees. It could be that these trips out of the park and closer to the human population around the border is the source of the problem. Or maybe they're encountering snares because their movements are affected in some way by the war in DR Congo.

Third 2008 Uganda snare in August.

Alternatively, weather might have something to do with it. There are supposed to be both a short and long rainy and dry season, weather patterns that confuse me to no end. As I understand it, the short rainy season was late this year, and even shorter than normal. Now it's almost time for the long wet season.

Unfortunately, if the snare is tight and made of wire, it can do irreparable
damage even if we get it off within 24 hours, as in Magayane’s case (Rwanda, Aug. 2007).

While I waited for Bernard's reply that morning, I tabled plans to meet with Magda to go over administrative stuff. Oh, well. At least there was enough time for me to pack up and get to the border crossing before it closed. Instead of tackling the pile of paperwork on my desk, I piled it back up into a neat-looking stack and closed down my email. Not only was it my turn to go to Uganda, but Magda had just returned to Africa from a holiday in Poland and was still in quarantine.

Magayane nursed her sore finger after we removed the snare, and
she healed well, though minus the end of her middle finger (Rwanda, Sept. 2007).

I texted Benard a second message repeating my request to call as soon as he had a signal and saying I'd be on my way once the case was confirmed. It's a long way to go only to find out the snare is off, something that's happened before. Usually, we prefer to document the presence of a snare by sending out a field vet to check it one day, then readying a team to remove it the next. These reports are often a series of relayed messages, and they can change from one person to the next, as well as from one language to another.

Benard answered my text immediately: yes, the snare was confirmed. The information came from the most experienced guide for the Nkuringo Group. A few minutes later, I managed to reach him on the cell phone. He was on the road from Kampala, the capital city of Uganda. Despite terrible reception, he was able to give me some additional information. The snare must indeed be several days old, as the gorilla's leg was reportedly swollen and he'd been dragging it. We wouldn't know how bad the damage was until we got there. I started packing.

The newly reported snare around the leg of a blackback in
Nkuringo Group sounded a lot like this case from Uganda in 2004.

To be continued . . .

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

We did indeed have an emergency. One of the infant gorillas in Sabinyo Group was caught in a snare, and the silverback, Guhonda, had bitten one of the trackers. We made a quick plan: Jean Felix and Elisabeth would try to check on the infant, knowing they might not be able to get very close; I would rush back to the office to grab my kit, and then check on the injured tracker.

Recent snare: wire wrapped around the arm of a young
female in Nyakagezi Group, Uganda (April 2008).

I thought through possible next steps and outcomes as we hiked down out of the forest. Either Guhonda was already in a rage, or the tracker tried to take the snare off and the silverback saw him. There was a good chance no one would even see the Sabinyo gorillas for the rest of the day.

Often our first opportunity to remove a snare is not until the next morning, once the group has calmed down. Even then we may decide not to intervene if we think the gorilla or one of its family members can get the snare off. As I've mentioned before, the snares are not set for gorillas. They're for antelope.

Dushishoze, an infant in Pablo Group, was the last
young gorilla to get caught in a rope snare (July 2007).

Dushishoze, a 3-year old in Pablo Group, was our last infant stuck in a snare, in July 2007. She had a long rope wound around her upper arm; though they tried, the other gorillas could not figure out how to remove it.

We’ve had four more snares since then, all metal, all involving juveniles or adults. In Rwanda, we removed a bicycle brake-cable wire snare from the middle finger of an adult female, Magayane, in Kwitonda Group. She lost the end of the digit (link to blog). The other three cases occurred earlier this year in Uganda. Two were wires wrapped around a hand and one around an arm.

The most recent snare in Uganda, in Rusheguro Group (August 2008).

I didn't see Jean Felix until the very end of the day. He, Elisabeth and the trackers had made three unsuccessful tries to approach the Sabinyo gorillas. They'd waited a full hour between attempts, but no way would Guhonda let them see his family. He kept charging.

Meanwhile, I checked on the injured tracker, Jean Claude, on his way to the hospital for a complete evaluation. Fortunately, he had only a few surprisingly superficial scrapes and bruises on his left shoulder back.

Guhonda, the silverback in Sabinyo Group, has removed snares
more than a few times from the arms and legs of his family members.

Jean Claude told what he remembered from that morning. The trackers were doing their morning check when they heard a cry and a scuffle. Jean Claude saw one of the young gorillas with a rope snare around its arm. He wasn't sure if it was the 4-year-old or the 3-year-old.

He approached the infant to check it and was bending down just as Guhonda charged from out of nowhere, flattening Jean Claude to the ground, beating and biting at his back but stopping before he did serious damage. Maybe the silverback initially mistook the tracker for a poacher.

Then Guhonda broke the snare with his teeth, sending the bamboo it had been anchored to flying behind the infant gorilla. The whole group went running.

Icyerecyezo in Sabinyo Group is recovering from injuries
sustained when his father, Guhonda (left), removed a snare from his left arm the day before.

The next morning, we found the females in the group resting calmly in a bamboo thicket. Guhonda too was resting nearby, but out of sight. The 3-year old in the group, Big Ben, hung from tree limbs looking fine. The youngest infant, only a few months old, crawled in and out of her mother's lap. Her older brother, 4-year old Icyerecyezo (i-cherry-che-zoo), sat huddled next to them, motionless. It took over an hour to get a good luck at him.

When he finally sat up, we could see that his face and arms were swollen, but there was no snare. Had there been one, we'd probably missed our opportunity to get a dart off; Guhonda would be up soon. Intervening in this case would have been a huge challenge, given the protective father and mother. Whew!

Despite the trauma of getting caught temporarily in a
snare on the prior day, Icyerecyezo is eating well and keeping up with his group.

One of the trackers called headquarters on the radio to say that the snare was gone, and the other called Jean Claude. They were all smiles.

Meanwhile, I was focused on Icyerecyezo's right eye and hand. I could see swelling over the metacarpal bones. He could have a fracture there, but that would heal. He had a scrape over his brow that could have been caused by the bamboo as it snapped free and trailed behind him.

Because he kept his right eye closed, I worried that he might have an injury to its surface, or cornea. He'd probably heal without our help, but he could lose his vision. We agreed to leave the group alone and return the next day.

Two days after the snare incident, Icyerecyezo managed to keep up
with his family in Sabinyo Group, though he favored both arms.

When we returned, Guhonda was leading his group around the edge of a large crater. Maybe he knew that poachers wouldn't bother to set snares on such a steep slope. Then again, maybe he was just moving through his home range as he normally would.

Icyerecyezo looked much brighter. I watched him eating hungrily as he followed Guhonda. He didn't use either arm fully, but the swelling in his right hand had decreased. When Big Ben tumbled over toward him to play, he backed off, but looked interested. I guessed he’d be back in the game soon, even if he couldn't yet see very well.

Two days after the snare incident, Icyerecyezo's face appeared less
swollen in some areas and more in others, including his right upper eyelid.

The infant's right eye remained closed, and on this day I could see a bit of white discharge. That could be a normal reaction to the trauma, or it could signify a bigger problem. The swollen eyelid didn't worry me. It serves as nature's best Band-Aid for a corneal scratch. What I couldn't rule out, however, was the possibility that a foreign body — like a splinter of bamboo — might begin poking through the lid.

Of course, the gorilla would let us know. He'd either have more discharge from the eye the next day, or the condition would begin to resolve on its own. For now he was eating well and keeping up with the group.

Kampanga, one of the other adult females in Sabinyo Group,
carried her 1-yr-old infant, Salcola, high into this tree to eat.

Later that day, the trackers called to say that the infant had opened his eye and the cornea looked okay. Elisabeth visited the next day and reported the same, adding that there was very little discharge. I'd planned to go check him one more time, until the cell phone rang again.

This time, it was Benard relaying a report of a snared gorilla in Uganda. We made a quick plan to meet in Kisoro, Uganda, and look for our patient the next day. I'd cross the border to Uganda that night. I had a feeling the next snare scare would not be as easy.

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

Kwitonda's home range overlaps with two of the other three groups, Hirwa and Group 13, so it made sense that the disease had spread again, either gorilla to gorilla or people visiting gorillas to gorillas. Those people, by the way, include all of us who visit the park — vets, trackers, guides, researchers and tourists.

Eilsabeth added, "It's not bad. All the gorillas are moving, eating, and the babies are playing."

Kwitonda Group's Ndimubanzi

After I hung up the phone, the long list of unanswered questions about the origin and spread of respiratory disease in mountain gorillas ran through my head. We've also recently discussed these same questions here in Rwanda with park (ORTPN) and researcher (Karisoke) staff in various meetings.

Are we reintroducing these viruses each year, or are they just moving around? (All evidence suggests that viruses cause the disease, but we cannot entirely rule out bacteria.)

How did they get into the gorillas — was it someone visiting from another country or living locally? Was it a one-hour visit (i.e., a tourist or park guide or vet) or a long close-up encounter (i.e., a researcher or park tracker)?

Have the weather patterns been different, with cooler drier nights that favor the spread of most respiratory viruses? Could one infection have spread from the Susa gorillas, which live on Karisimbe volcano, all the way over to the Hiwra, Group 13 and Kwitonda gorillas, which live on Sabinyo?

And how would it have spread — via gorilla movements (there are wild gorillas in the region) or people? Or, is it being reintroduced in each place as the result of a bad "flu" or "grippe" season that is spreading among the local community?

Kwitonda Group's Umoja

In the last instance, the source of the infection would be people living close to the park, but where did those people get the disease? They could have picked up the infection from a visiting tourist, but most people who come to see the gorillas stay in the region for only a day or two. These folks are not likely to be spreading the disease.

Respiratory disease and pneumonia among the poor and malnourished are well-documented problems in developing countries. Are they the source of the illness in the gorillas, given that park staff live in the local community? This question feels as if it's been burning a hole in my head these days. We need to better understand the health of the people around the park, both for their sake and the gorillas'.

Kwitonda Group's Karibu

The other confusing thing about respiratory disease in habituated mountain gorillas (there have been cases in Uganda, too, so it's not just Rwanda) is that there are some differences when compared to habituated chimpanzees.

Outbreaks of illness with runny noses, coughs, fever, secondary pneumonia and deaths have been recently documented in chimps. Chimps get sicker and die more quickly than mountain gorillas, which means there are a lot more samples to analyze.

It's hard to make conclusions from lots of gorillas that are sick but recovering, and hard to say we should be intervening more often to get samples when the mortality of respiratory disease is low, and, equally important, is not new. This may be a bad year, but the historical record shows gorillas have had similar outbreaks for two decades.

Ururabo's baby has recovered from a severe bout
with respiratory illness.

For example, it's difficult to make any sort of definitive diagnosis or to isolate a virus from nose and throat swabs taken from one or two individual mountain gorillas. Though we have samples from Ururabo and her infant in Susa Group, and from Muninya in Hirwa Group, and we're trying to identify the source of the illness, we don't have any clear answers yet.

Similarly, a single blood sample from a sick gorilla — or human — may show a high antibody level, or titer, to a particular virus, such as influenza, but that result proves only that the individual has been exposed recently. We need a second blood sample two to three weeks later to document active infection. These sampling challenges are the reason we’re pursuing noninvasive sampling methods, such as the saliva study.

Urungwuko's baby rides on her back during a bout with respiratory illness.

There are also other differences between chimpanzee and mountain gorilla respiratory disease. The outcome differs as I've mentioned: more chimps sicken and die of secondary bacterial infection than gorillas.

Among the four groups recently affected, all of the individuals in each group showed signs of illness. That's a total of 80 mountain gorillas affected! Fortunately, only two required treatment, and they lived.

The origin of the infection also seems to be a bit different. When the really bad outbreaks of respiratory disease occurred in chimps, it was before visitation rules were in place. Now that chimp researchers and tourists maintain a greater distance from the chimps and are more aware of their personal hygiene, the number of respiratory disease outbreaks has gone down.

Susa Group's Ururabo and her infant

In Rwanda and Uganda, the situation is different. Gorilla researchers and the field vets follow a self-imposed quarantine as needed (we wait at least two weeks after travel on buses or airplanes to make sure we haven't come down with a respiratory illness). We follow the same distance and personal health and hygiene rules established for all park visitors, including tourists.

Is it that, on the whole, we're not following these rules well enough? Or is the disease simply better established among the gorillas and circulating now no matter what we do? Or, again, is there more of it in the local community?

The other factor is, of course, the Democratic Republic of Congo, where no rules are being followed whatsoever when it comes to visiting mountain gorillas and there are many people living illegally inside the park.

Getting back to my phone conversation with Elisabeth, I knew Kwitonda and his group had suffered through a severe outbreak of respiratory illness just last year in April (2007), so my next thought was that maybe this one wouldn't be so bad. The group should have some immunity to the infectious organism, most likely a virus, if it's the same or related to the one that affected them last year.

I remember because a tiny baby, the 3-month-old infant of Mugeni, had died suddenly. The mother had shown only mild signs and her baby none, until it died — presumably of an overwhelming viral respiratory infection. The incident cemented in my mind the importance of preventing these outbreaks to begin with if we can, because once they hit, there’s nothing we can do for the very youngest of the group. The babies and infants are, of course, the future of the population.

Okapi, one of the juveniles in Kwitonda Group, is eating fine despite a mild cough.

I heard a cough even before we reached the group — just one. As usual, the sound, a loud short burst of expelled air, took me by surprise. It came from somewhere down and to the right of where we'd been climbing. The tracker, Jerome, and I scoured the trees to find the source. We could see branches moving in the distance.

Then I saw a young gorilla, probably Ndimubanzi (nee mu ban zee) crossing a stream. Seconds later, we reached the group resting at the base of a clump of trees. One of the females, Mbimbilibili (mim bili bili), coughed softly three times. I craned my neck to see her face. She gazed back at me bright-eyed with no nasal discharge, a good sign. One of her offspring, Chiri, picked her nose but then tumbled around in play. Ndimubanzi appeared minutes later in a closer tree and coughed twice, confirming our earlier guess.

Mugeni , one of the adult females in Kwitonda Group, showed no
signs of illness during the 2008 respiratory outbreak.

On my way out of the forest, I called Elisabeth on the cell phone and suggested that I become the vet assigned to the Kwitonda Group respiratory illness — in case it turned out to be a severe one. That way, she and Jean Felix could continue to check other groups as needed. As an extra precaution, I also asked that the park service assign the same guide to visit the group, and that no trackers move from one group to the other.

The vets have limited their movements during these illnesses, but we haven't asked the park staff to do the same. Though these may sound like obvious and easy preventive measures, tracking and visiting the gorillas on a daily basis involves a complex set of logistics. As I've stressed during our meetings, the key is that no one sick goes to work. Unless you're coughing or sneezing, you're not likely to spread a disease. So while we can, and have, limited where staff go, it's how we're feeling each day that matters.

Mugeni's infant played and played, showing no signs of
illness during this year's (2008) outbreak of respiratory disease in Kwitonda Group.

On my next several visits, the Kwitonda gorillas were feeding high up in the Drombere trees, eating flowers. I'd hear a cough and then wait and wait until I could see exactly who produced it. The trackers did a terrific job keeping notes, too. Their understanding of this disease and why we worry about it has increased greatly.

The outbreak was indeed very mild, though it steadily spread through the group with one or two new individuals affected each day. Mugeni, who has a new infant, coughed only a few times on one day. Thankfully, her new baby never showed signs of any illness. He played and played.

Silverback Kwitonda, on the day after he fought with one of his group's blackbacks.

The silverback, Kwitonda, was the only gorilla to cough for more than two days in a row. He ate well and moved about normally, until we found him one morning unwilling to get up from his nest. When he finally sat up, I could see he had a swollen lip and bruised forehead. I felt relieved that all he'd had was a fight with one of the young males in the group.

In fact, on that day and the next, Kwitonda's cough was the least of his worries. Had the situation been different and we hadn't just been through such severe outbreaks in two other groups, I'm not sure we would have placed much significance on this mild Kwitonda Group cough. As they say, context is everything.

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

I've been back in Rwanda for several weeks. As always, I spent two of them in self-imposed quarantine. Any time one of the vets travels on an airplane, we risk exposure to infectious diseases carried by fellow travelers. Though I wash my hands often and stay away from people who appear sick, it's impossible to eliminate the risk.

Since most viral and bacterial infectious have a week to 10-day incubation period, we spend at least two weeks office-bound. It's a time to focus on administrative tasks and deal with paperwork.

Kabatwa and her infant Urwunguko rest in the sun;
both are recovering from respiratory disease.

While I worked at my desk, Magda, Jean Felix and Elisabeth kept me updated on the field situation in Rwanda. They continued to check on two family groups of gorillas sick with respiratory disease. Group 13 had an easier time of it, with milder symptoms — some nasal discharge and a few coughs.

Muninya, the Hirwa Group silverback, is fully recovered two weeks
after treatment for a severe bout of respiratory illnes

The outbreak in Hirwa Group was more serious. The silverback Muninya recovered quickly after treatment with antibiotics, but the illness continued to spread slowly among the others. The sickest gorillas included four females, all with offspring ranging in age from 1 to 1 1/2 years old. So far, only one infant, Urwunguko, had shown any real signs of illness, and at last report he was recovering.

I visited Hirwa Group on my first day back in the forest. Magda had just left for Nwyungwe National Park, where she'd been invited to work with the trackers there on chimpanzee identification and health monitoring, Jean Felix needed a day in the office and Elisabeth was on vacation.

Hirwa Group gorillas, recovering from respiratory illness, rest during a brief period of sunshine.

I knew to expect lethargy, runny noses and loud coughs. Even so, when I first heard a series of low-pitched grunting sounds, it took me a few seconds to recognize the noise as a coughing gorilla.

When we found the group still hunkered in their night nests, I shouldn't have been surprised. Respiratory disease makes tracking the gorillas easy. You can hear them coughing from quite a distance, and they rarely move far from one day to the next.

Sabana, an adult female in Hirwa Group, regained her
appetite after several days of lethargy and cough.

I watched and listened as one of the adult females, Sabana, coughed repeatedly. She lay curled on her side, still in her night nest. Her infant, Umuranga, sat next to her, playing with a few leaves, waiting for his mother to move. The lead tracker for the day, Majoro, told me that Sabana had just started eating again yesterday.

Four other gorillas coughed somewhere in the surrounding vegetation. We later identified them as the females Mararo, Ntamehezu, Ikerezi and Magayane. Sabana's cough sounded the worst, so much so that I found myself stopping in my tracks to look in her direction each time she started up.

It's an awful feeling to know these rare animals might be sick from a disease we humans unknowingly passed on to them. Definitive proof of such transmission still lies ahead in the analysis of the data we're slowly collecting. But we know from recent studies in habituated, free-living chimpanzees that human respiratory viruses can infect wild great apes, making them sicker than their own naturally circulating viruses.

Urwunguko clings to his mother, breathing with his mouth
open to compensate for a stuffy nose

We found Kabatwa and her 13-month-old infant, Urwunguko (pronounced Urunn gu gwu kwo), foraging apart from the group. Kabatwa coughed lightly a few times, picked her nose with one hand and continued feeding with the other. She appeared unfazed by her illness.

Urwunguko clung to her quietly, his nose running. He held his mouth open, breathing through it rather than through his congested nostrils. Magda, Jean Felix and Elisabeth later confirmed that this infant had had a nasal discharge for more than a week. The color — white — was a good sign. Yellow to green snot is a sign of serious bacterial infection. Even so, Urwunguko's history put him in the category of at-risk-for-pneumonia and I planned to return the next day.

Urwunguko and his mother, Kabatwa, rest together.

Early the next morning, we found three Hirwa Group females and their infants still in their nests, Mararo, Sabana and Kabatwa. All were coughing — Sabana again louder than the others. White mucous streamed from Kabatwa's nostrils. She licked her nose and picked at the discharge with one hand, while grooming Urwunguko with the other.

The infant sat motionless, eyes droopy, nose runny with a yellowish-white discharge. He seemed less alert than the day before. Uh-oh, I thought, wondering if the infection — which we generally believe to be viral at first and bacterial later on — was going down into his lungs. We agreed the trackers would watch him closely all day.

As I left, I tried not to overthink this case. I thought back to Ururabo and her baby during the Susa Group respiratory disease outbreak in May. The day Ururabo felt too sick to hold and groom her infant had been the day it weakened and had trouble breathing. It was also the day we intervened.

In this case, not only is Kabatwa taking good care of Urwunguko, but he's a full year older than Ururabo's baby. If he continues to nurse and she continues to keep him warm and dry, he'll probably be OK.

Ntamuhezu, recovering from respiratory disease, and
her still healthy infant, Agasaro, wake up early one morning

We know the gorillas feel better and improve more rapidly after antibiotic therapy, but we don't treat them unless absolutely necessary. We certainly don't want to risk creating resistant bacteria, among other things. The decision to intervene is always a judgment call. Our goal, which is also our mandate, is to intervene on Urwunguko's behalf only if his condition becomes life-threatening.

The trouble is that young apes — or humans — with signs of upper respiratory disease can suddenly develop a life-threatening infection deep down in the lungs. Urwunguko is also just small enough that darting him with medicine might be too much of a challenge, meaning we'd have to anesthetize the mother as well. The good thing is that we can check him each day. That's our job.

Urwunguko resting on his mother's back, breathing rapidly.

The next morning as we headed into the forest, Majoro told me he'd seen the infant nursing well yesterday afternoon. But when we reached the group, the situation appeared to have worsened.

Urwunguko had a runny nose, and his eyelids were swollen and wrinkled. He seemed to want to do nothing except sleep. Moreover, he was tachypneic — his breathing rate was elevated to 100 or more breaths per minute. (Normal is 30-40 breaths per minute for a gorilla of his size.)

After the sun came out and the other infants began to play, he hung on to his mother and continued to sleep. When Kabatwa got up to eat, though, he climbed on her back and looked more alert. I left thinking I'd better bring the medical kit the next day.

Kabatwa grooms her infant, Urwunguko.

The report that afternoon was encouraging. Majoro again observed the infant nursing and spending a few minutes sitting next to his mother, rather than clinging to her. Given how quickly pneumonia can kill young primates — humans included — I decided to bring the kit the next morning anyway.

Once again we found Kabatwa still in her nest. Majoro and I watched anxiously for several minutes as Urwunguko slept in her arms. His breathing rate was better, down in the 60-70 breaths per minute range, but his upper lip was covered with crusty, yellowish, dry nasal discharge.

Finally, he woke up, stretched, opened his eyes wide, picked his nose and then coughed several times — a wet-sounding cough. Kabatwa grunted as if to tell him not to make that noise. Despite the cough, my worry level went down, at least for this day. As Kabatwa groomed her infant, he fiddled in her lap, a normal behavior. Urwunguko's tiny leg and arm muscles were definitely small targets for a dart of antibiotics. Were we to intervene, we'd have to anesthetize the mother, too.

Urwunguko, a 13-month old mountain gorilla, is improving after two weeks of illness.

I brought the kit one more time the next day, anticipating that the infant would either be much better or in big trouble. To our relief, we found him nibbling on bits of plant material and sitting several feet away from his mother. Though he coughed several times, his eyes and nose were clear.

Kabatwa looked at me sideways, tolerating my presence, as usual. I don't really believe she has a clue about who I am; still, I found myself saying to Majoro, as if he could understand my English, "She's probably wondering why the doctor keeps showing up and what in the world I've been so worried about."

A female bushbuck feeds among the vegetation near the Hirwa Group of gorillas

As we left the gorillas, a surprisingly docile female bushbuck stared at me, again as if to say, What do you think you’re doing here?

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

For the past two months, we've been working out ways to collect and store saliva from gorillas. In the future, we plan to test these samples for diseases, especially the viruses that cause respiratory illness. This study has been a good idea in our heads for some time. Thanks to veterinary student Tierra Wilson, it's finally under way. Tierra not only designed the research project, she found her own funding to come to Rwanda and run it!

Wild celery is often fed to the orphaned Grauer's gorillas.

We're always looking for new ideas for screening the gorillas for various pathogens, such as herpes virus or influenza. The outbreak of respiratory disease in the Susa group, for example, reminded all of us how difficult it is to diagnose a problem without intervening. Yet when gorillas cough, they must, like humans, be swallowing some of the phlegm that builds up in their nasal and airway passages — and a recent study in chimpanzees showed that respiratory viruses could indeed be found in fecal material. That made us wonder if we could find the pathogens in saliva. Tierra's research project is the first step.

Tierra Wilson, a third-year veterinary student at Tufts University in Boston.

We agreed on a basic approach: the field vets would follow the gorillas, collect unfinished bits of chewed-on plant material and bring it back to the lab for Tierra to test for saliva. If she found any, she'd store the samples for future testing.

Tierra also proposed an alternative, more direct method of sample collection: straight from the gorilla's throat. She'd researched various ways of testing for saliva, including the use of a special colorimetric test kit for the enzyme alpha-amylase. She hoped to try the test on saliva samples collected from anesthetized gorillas to verify that it worked.

MGVP vets perform an annual health exam on one of the orphaned gorillas,
from left, project director Dr. Mike Cranfield, Dr. Jean Felix Kinani,
soon- to-be Dr. Tierra Wilson and Dr. Magdalena Braum.

Before she came to Rwanda, Tierra had asked for help from vets at Zoo New England, who were preparing to do some exams on their lowland gorillas. The zoo staff agreed to collect saliva using special absorbent sponges developed to collect saliva from humans. Unfortunately, these swabs yielded very little saliva. They tested positive with the color kit, but there was no sample left to store.

We repeated this part of the study here on the orphaned gorillas at Kinigi when it was time for their annual exams. The results were the same. The conclusion: there’s not a whole lot of saliva in the mouth of an anesthetized gorilla.

Tierra tested saliva collected from various methods for the enzyme alpha-amylase;
a yellow color indicated a positive result.

Tierra's findings make sense. Since the salivary glands are stimulated by the presence of food and the act of chewing, it's no surprise that anesthetized gorillas don’t produce saliva. As noted above, our original plan had been to follow the gorillas while they foraged and to pick up discarded mouthfuls of plant material — but we didn’t want to go forward until Tierra could establish the gold-standard test for the presence of saliva. Ideally, we'd be able to store extra samples for future testing for viruses as well as stress hormones and gorilla DNA.

Saliva samples from gorillas stored on special filter paper that preserves genetic material.

Fortunately, our star student researcher had designed her study to explore all possibilities. She'd brought some novel supplies with her that at first puzzled the rest of us.

In a scientific paper describing saliva collection in chimpanzees, she'd read that chimps often chew their food into big wads and then spit out the residue, creating a perfect saliva-packed sample that can be retrieved and taken to a lab. A few minutes in a centrifuge, and the wad breaks down into food and saliva.

Tierra came up with the idea of a saliva-harvesting chew toy for gorillas. She asked if we could try it out on the orphans.

The orphaned gorillas chewed on the mesh bags for five to 10 minutes,
long enough to soak the rope inside with saliva.

We were a bit sceptical, especially because gorillas tend to destroy their toys. Tierra tried out two versions of the saliva chew toy. Each used thick (.5-inch) dental rope soaked in juice. One was a plastic container with holes drilled in the lid. Tierra plugged these holes with several short bits of rope, but the gorillas promptly pulled them out.

The other, a mesh bag large enough to contain a longer piece of juice-soaked rope, worked beautifully. The gorillas put the bags in their mouths and chewed on the rope, trying to extract every bit of juice. When Tierra later centrifuged the chewed-on rope, she recovered lots of alpha-amylase-positive fluid.

Tierra harvested saliva samples by swabbing the bite marks made by the
gorillas as they chewed on the celery.

Next, I collected a few samples from wild gorillas as a test, picking bits of chewed-on celery and bamboo from the ground and putting them in a vial. We were ecstatic when Tierra tested these for alpha-amylase and they came up positive!

While she continued to work out the best method for harvesting the saliva from the plant material, we all began collecting more samples. In the end, Tierra's recovery method proved to be fairly low-tech: she'd rub a Q-tip in the tooth marks, then use a tiny amount of a storage reagent to save the sample in a plastic vial or on a piece of special filter paper.

Tierra also worked in the field, collecting samples of celery
and other plants eaten by mountain gorillas.

Once we knew the saliva collection and storage methods were working, we requested permission from the park authorities for Tierra to visit several gorilla families in order to collect her own samples. She not only collected bits of discarded plant material with care and precision, she had a chance to watch her study subjects chewing — and producing saliva — firsthand.

After comparing different species of plants, she concluded that wild celery works best for harvesting saliva. Now, that's not something we would have predicted, even though it's the most common plant species eaten by the mountain gorillas.

Elisabeth Nyirakaragire, ORTPN vet tech, monitors the anesthetized Muninya, the silverback of Rwanda's Hirwa group.

Before long, Tierra's saliva study took on added significance when both the Hirwa and Group 13 gorilla groups came down with respiratory disease. We continued collecting food samples, this time storing saliva from coughing gorillas.

Since these two gorilla groups often interact, we think the same virus or bacteria may have affected both. One group became much sicker than the other, however. When Muninya, the Hirwa group silverback, suddenly fell very ill, the vet team went on high alert.

The Hirwa family consists of females, babies and only one male, the silverback. If the chief is incapacitated for any reason, the family, particularly the infants, are at high risk when the group encounters another male.

When Muninya failed to leave his nest and his family wandered away, we decided to intervene. Magda anesthetized Muninya with the help of Jean Felix and Elisabeth, who treated him with antibiotics and collected a full set of samples, including saliva.

Fortunately, he improved dramatically the next day and continues to recover, though the rest of his family continues to cough. We hope the combination of samples will one day shed light on the diagnosis. The next step is to secure the permits needed to ship them out for analysis.

Wild celery is not only a favorite food of gorillas, Tierra found
out that it's also best for collecting saliva.

Meanwhile, Tierra completed her stay in Rwanda. She emailed me from an airport on her way back home to thank everyone again — and to make certain I had her final list of samples, formatted exactly as needed for the shipping permits.

Next she'll pursue all options for testing the stored saliva samples for the presence of various viruses, cortisol and gorilla DNA. I know she'd like to analyze them before school starts, but that's not likely given the permitting process.

Before she left, we took Tierra out for dinner at a local restaurant. I asked her what she'd remember most about us. Her answer: Celery … and the gorillas, of course!

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]

We continue to help take care of the three orphaned gorillas in Goma, Democratic Republic of the Congo (DRC). They include the two infant mountain gorillas, Ndeze and Ndakasi, whose mothers were shot and killed one year ago, and Mapendo, a juvenile Grauer's gorilla confiscated from poachers six months ago. Here's a brief update about each one.

We continue to help take care of the three orphaned gorillas in Goma, Democratic Republic of the Congo (DRC). They include the two infant mountain gorillas, Ndeze and Ndakasi, whose mothers were shot and killed one year ago, and Mapendo, a juvenile Grauer's gorilla confiscated from poachers six months ago. Here's a brief update about each one.

Ndeze climbs a tree and rope ladder.

NDEZE
Age: approximately 1 year, 5 months
Weight: 11.9 kg
Milk intake per day, divided in 4-5 bottle feedings: 1.3 liters
Favorite forest plant foods: Rimex, Urera
Favorite toys: anything and everything
Favorite games: climbing, running and tumbling

Ndakasi

NDAKASI
Age: approximately 1 year, 3 months
Weight: 10.1 kg
Milk intake per day, divided in 4-5 bottle feedings: 1.1 liters
Favorite forest plant foods: Rimex, Urera
Favorite toys: plastic chair and sticks
Favorite games: climbing, tumbling on tripod

Mapendo

MAPENDO
Age: approximately 3 years, 6 months
Weight: 17 kg
Milk intake: has been off milk for several weeks and is eating only solid foods
Favorite forest plant foods: Rimex, Ficus
Favorite toys: sticks and ball
Favorite game: climbing

Ndeze (left) playing with Ndkasi (right) on their climbing structure
in the backyard of the house where they live in Goma.

The two mountain gorilla orphans, Ndeze and Ndakasi, are thriving. They live together with their human caretakers in a small house located near the DRC/Rwanda border. The infants have a fairly big yard with climbing structures and toys. Mapendo lives a short distance away, also in Goma, in an enclosure built especially for her, right next to the offices of DFGFI (Diane Fossey Gorilla Fund International). She, too, has a grassy yard, climbing structure and small house, where she sleeps at night with her caretaker.

MGVP's Dr. Eddy Kambale coordinates regular trips to the Virunga forest to collect natural foods — all green plants — for the Goma orphans.

Ndeze eats Rimex, a plant collected from the Virunga forest.

Mapendo is more relaxed and playful than when she first arrived, but we're all very aware that she should be living with other gorillas. We have not recommended that the three orphans live together, mostly because the mountain gorilla infants are much younger and more susceptible to introduced infections. But Mapendo, a Grauer's gorilla, is also a different subspecies.

Ndakasi eats Urera, a plant collected from the Virunga forest.

The future of the orphans remains uncertain. When will they return to their natural habitat? We don't know. Maybe never. Minimally, it will be quite some time because their home is unsafe. All 11 orphans, the three Goma orphans plus eight others that live in Kinigi, Rwanda, are from DRC. Until this region is secure, we cannot even consider releasing them back to their homes. There are other complications as well.

Ndakasi eating Urera and playing.

First, their families are gone. Second, all were young when they were brought into captivity, requiring near constant human care and contact. As a result, they are very habituated to people, a situation that is unavoidable when hand-raising orphaned gorillas.

Finally, we're concerned about disease transmission and introduction of diseases to free-ranging gorillas. The eight Kinigi orphans have grown up in a mixed subspecies group that includes two mountain gorillas and five Grauer's gorillas. This housing strategy was necessary to offer a proper social environment for each individual gorilla, but we don't know for certain that it's a harmless mix.

Ndeze likes to climb in the mango tree, though this plant is
not a species found in the Virungas.

Unfortunately, Goma is dry and dusty and at a much lower altitude than the Virungas. We continue to work with the various government and nongovernmental partners on a better long-term home for the orphans in DRC, as well as those in Rwanda. We hope the scientific committee that was originally created to make recommendations about their future will convene again soon. Meanwhile, we are pleased with the overall progress and health status of the Goma orphans.

[Photos courtesy of Dr. Eddy Kambale, MGVP Field Veterinarian, DR Congo]

Elisabeth and I trekked up to Susa Group again the morning after the intervention for Ururabo and her sick baby. Magda and Jean Felix had gone to Kigali for an important meeting on the topic of gorilla visitation rules, a timely subject. My job today was not only to check on our patient but to send regular updates by phone text to all those who'd helped yesterday. Everyone wanted and deserved to know the outcome.

We'd been on the trail for more than an hour before the radio call came in from the second tracking team. I caught the gist of it, even in Kinyarwanda: They'd found a fresh trail. Elisabeth translated the details: the trackers were following the trail of a single gorilla who was moving quickly. Ten minutes later, the news was repeated. The trail was heading up in the general direction of Susa Group's location yesterday. We all believed that Ururabo could easily find her group if she kept moving. She wasn't more than a kilometer away. But until she made it, we'd worry.

Susa Group gorillas nervous of people the day after Ururabo's intervention.

The next radio update brought really good news. The trackers had seen Ururabo at a distance. She was carrying the baby. Their plan was to stay well behind — several hundred meters — and quietly follow the mother, prepared to block her way if she chose a mistaken direction.

I asked if they could hear Ururabo coughing, a near constant indicator of her location the day before. No, they answered. Ten minutes later, they reported again on her location, adding that the baby was riding on her back, eyes wide open. Elisabeth and I shared a big smile. He'd made it. The rest would be up to his mother.

When we reached Susa Group, Igisha was among the first gorillas to notice our group of four — Elisabeth, myself, Fidel and Antoine. We were the same people who'd yelled at him the day before. Nevertheless, the silverback sat down near us to eat bamboo shoots, ignoring our presence. Since he wasn't showing dangerous aggression, we moved slowly into the group to monitor any sick gorillas. Though we spotted Rwandarushya nearby, we couldn't see her infant. Rain poured down a few minutes later. We backed out of the group and stood under the trees, waiting.

Ururabo eats ravenously after returning to Susa Group the day after intervention.

About an hour later, the downpour stopped, but dark skies threatened more rain. We decided to proceed with our visit until the skies opened up again. As we approached Rwandarushya — she hadn't moved during the rain — a radio call brought the best news of the day: Ururabo had reached the group.

We turned and looked back at where we'd left Igisha, in time to see mother and baby appear on the trail. He walked right over to her, put one hand on her back then disappeared into the bamboo. She sat down and began eating, despite the misty weather. We backed away, figuring other gorillas would soon come to check out Ururabo.

Poppy with Igisha, who bared his teeth in an aggressive yawn
directed at the intervention team the day after the procedure.

What happened next took me completely by surprise. All five silverbacks appeared in the clearing, while Ururabo began to mix with the other members of the group. The reunion was quiet — no problem ("ntakibazo" in Kinyarwanda.)

Slowly, but almost in unison, the big males turned their heads in our direction, mouths open and teeth bared. We backed up even more. The trackers cautioned that it would be impossible for us to enter the group now. Some sort of communication had occurred when Ururabo re-entered the group. To the gorillas, the four of us meant trouble.

Silverback Getty glares at the intervention team the day after the procedure.

Worried about the remaining sick gorillas, we agreed to wait and let the group settle. Two hours later, we'd made little progress. As long as we remained 20 meters from the group, the gorillas didn't mind our presence. But even one tracker approaching to get a closer look triggered aggressive looks in our direction.

Finally, I was able to see that Ruvumu's infant had a thick nasal discharge; he appeared very lethargic. Rwandarushya's baby was alert and more active. As for Ururabo, she stayed mostly out of sight. We never heard her or the baby cough.

Ruvumu's 11-month-old infant recovering from a repeated cough and nasal discharge.

By the next day, the gorillas had calmed down considerably. Magda, Elisabeth and I returned with the kit one more time, thinking we might need to get antibiotics into Ruvumu's baby. At almost a year old, he was big enough to dart. Fortunately, he'd improved. He might not be out of the woods yet, but he certainly seemed strong enough to go another day without our help.

Ururabo reacts to Drs. Spelman and Braum two days after the intervention.

Next we checked on Ururabo. She coughed just once during the hour, and her baby showed absolutely no signs of illness. He slept, nursed and later rode hanging from her chest, wide-eyed and alert. Ururabo did take notice of us when we first entered the group, but her response was muted. She stared at me then at Magda — then pursed her lips, walked away and sat down near the chief.

Ururabo's baby is bright, with a clear nose and no cough, five days after treatment.

But we couldn't help second-guessing our clinical success, even three and four days after the procedure. It was the first time we'd used that particular antibiotic for respiratory disease, and it's not formulated to be long-acting. It's just highly effective — in humans as well as gorillas. How long would it remain effective? We also knew that any of the other infants who'd been through the cough and runny nose phase could suddenly become ill.

Five days later, I made another Susa Group check. Ururabo's baby finally convinced me not to worry about him! He nursed and played in his mother's arms. He also stared in my direction for what seemed like a long time. His case has given us the confidence to use the same antibiotic in the future for respiratory tract infections.

Our intervention on his behalf also yielded valuable samples. Someday we'll be able to draw conclusions about what caused the outbreak; we hope we'll also know whether or not those common facial lesions are indeed herpes. As for Ururabo, she already seems to have forgotten who I am.

[Rwanda, 2008. Pictures: Dr. Lucy Spelman/MGVP]