Quest: Mountain Gorillas: Discovery Channel

Another Snare

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.

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 in Nyakagezi Group,
Uganda, has wire wrapped around his right hand.

Gorillas can sometimes pull 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 can't 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. Although 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 vet, 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 6 and 7 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.

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.

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 OK. It wasn't. She kept the wound clean until the damaged tissue fell off (See Magayane Performs Her Own Surgery). 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.

[Rwanda, April 20, 2008. Pictures: Dr. Lucy Spelman/MGVP]

New Simple Tests for Humans Could Help Gorillas

Kwitonda silverback eats a stalk of bamboo.

A few months ago, I received an e-mail 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 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 and from there to Rwanda. Jackie invited me to check out her company's Web site (http://www.doctorsdirect.md/Disease-Testing.html) 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! But we often wait weeks to months for other types of tests while permits are processed.

Various instant result 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 a 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 a 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 can't 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.

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

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 on 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.

The saliva recovery study is not a new idea and it may not work in gorillas. It's been successful in chimpanzees, but that 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 forage at the Interim Quarantine Facility.

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.

An adult female mountain gorilla in Shinda Group
chews on a leaf she later dropped.

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 to 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 OK, 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.

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.

[Rwanda, April 8, 2008. Pictures: Dr. Lucy Spelman/MGVP]

Chimpanzee Park

Angolan colobus monkey, Nyungwe, Rwanda

Magda and I recently returned from a 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

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

Bill Weber of the Wildlife Conservation Society organized the workshop. 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 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

During the workshop, Magda and I discussed the findings of a newly published scientific paper. 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 (averaging 92.2 percent). In several outbreaks as many as eight individuals from one community died (18 percent).

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

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

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.

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.

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

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

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

On the second day, we spent the morning crisscrossing 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.

[Rwanda, March 12, 2008. Pictures: Dr. Lucy Spelman/MGVP]

Checking on the Injured and Missing

WARNING: POTENTIALLY UPSETTING IMAGES AHEAD.

Nzeli walks on her injured left foot but not her right, one week after receiving antibiotics.

After I darted Nzeli with antibiotics we kept a close eye out for recurrent swelling or discharge from her wounds. The long-acting penicillin we use for darting is formulated to remain in the body's tissues for several days. We often repeat the treatment three to five days later to ensure we've knocked out any bad bacteria.

We dislike using antibiotics unless they're absolutely necessary. Nzeli improved so dramatically after that first dose — which also upset her intestinal flora enough to give her diarrhea — that we decided not to treat her again.

I checked on Nzeli again this past weekend, two weeks after the penicillin dart. She was with Bwenge and the rest of his group on the side of Karisimbi volcano at about 3,200 meters (10,499 feet), surrounded by dense vegetation full of berries and brambles.

Scraping our way through sharp thorns, the trackers and I followed Nzeli as she foraged. She was moving quickly, as evidenced by the scrapes on my forehead (I'd forgotten my hat), and I saw her use her right foot gingerly a few times. When she took a rest, the wounds looked clean. If she has a broken bone in that right foot, it appears to be healing, too.

Karisoke Research Center tracker Faustin Barabwiriza helps examine the carcass of a dead gorilla.

When I had first seen Nzeli injured and not moving, I worried she might disappear later. I've had a few patients vanish since I've been here —gorillas we knew weren't feeling 100 percent, others who disappeared for no reason we could discern.

It didn't help that I'd been called to examine the carcass of a dead female gorilla a few weeks earlier. With one of the Karisoke Research Center's most experienced trackers, Faustin Barabwiriza, I went to examine the body to see if we could learn anything about why she died and to identify her, if possible.

The decomposed carcass of a female mountain gorilla in Rwanda.
This is a nasty looking photo, but it shows an important part of life and work here.

We turned the body over and found very little left to examine. I asked Barabwiriza if he thought it was Papoose, a 40-plus-year-old gorilla from the Titus research group who hadn't been seen in weeks. He nodded yes.

Using a stick, he stretched the skin over the gorilla's skull to re-create her nose print, as if that would convince me! But I didn't think her teeth looked old enough. She could be an unhabituated wild gorilla or maybe a female from Pablo group, Gitebe, who disappeared months ago after we treated her for a presumptive uterine infection.

We may never establish identity in this case, but I did collect some tissue for DNA testing. Karisoke Research Center has Papoose in their genetic database, so we may be able to rule her out . . . or in.

Grauer's gorilla orphan Mapendo with a gradually resolving case of ringworm

Jacques presented Mapendo's case at rounds last week. The orphaned Grauer's gorilla continues to eat well and gain weight, but she remains very timid — and solitary as we've had to quarantine her. Unfortunately, this situation will not change any time soon.

First, she has ringworm. Second, we're not certain where to move her. At rounds we compared photographs of Mapendo's skin condition now to four weeks ago when she was first confiscated [see Two New Orphans]. Overall, she has responded well to topical treatment. But these infections take time to resolve. We’ll need to keep her in quarantine until the fungus disappears completely.

Gorilla doctors get a lesson on emergency medicine from ER doctor, Dr. Denise Baskind.

I'm still amazed that Eddy managed initially to revive Mapendo's companion Vumilia after the sickly gorilla collapsed in the middle of the night. Though it will be months before we have final results on why the animal went down a second time and died, Vumilia's case prompted me to set up a review of emergency medicine procedures.

This month proved to be perfect timing for that project, as we have a volunteer ER doctor visiting from Texas — Dr. Denise Baskind. Denise came to help review our employee health program. Little did she know she'd be helping us practice how to do CPR on a gorilla!

Newly hired ORTPN Akagera Park (Rwanda) vet Noel Arinteireho learns how to
place an intraosseous catheter from ER doctor, Denise Baskind.

Dr. Denise is a fine and experienced teacher — she routinely instructs ER nurses. Magda and I have been soaking up as much knowledge as everyone else during rounds. We've just finished a streamlined and up-to-date protocol for emergency procedures, drugs and dosages.

Also, we have a new tool in our medical field kit: a special drill and attachments for inserting an IO (intraosseous, meaning "into bone") catheter. Denise realized from talking with us that we sometimes have difficulty securing a "line" to our patients, so she called a friend at a medical company (http://www.vidacare.com) who sent us the necessary equipment, along with a plastic bone to practice on.

Female mountain gorilla, Icyi, suffering from exposure, needed an
IV line for fluid therapy while under anesthesia.

Getting a line into a patient can be life-saving. Via fluids and emergency drugs, it's what allows us to support circulation, the "C" of the ABCs of CPR ("A" airway, "B" breathing). A fluid line is standard procedure for anesthesia, too. Unfortunately, the anesthetic combination we use for the mountain gorillas causes veins to constrict, and given the cold and rainy conditions in which we usually work, getting an IV catheter in can be difficult, even for those of us with years of experience. It also takes time. Now, we can get IO access quickly. I think this technique will be a huge help to all of us and our patients.

Ntobo's infant acts healthy, despite strands of hair constricting his fingers on both hands.

Unfortunately, our newest potential patient may be too tiny even for the smallest IO catheter. He's just 6 weeks old, the baby of Ntobo, another female in Bwenge group. This infant has multiple strands of hair encircling several fingers on both hands, partially cutting off circulation and making them swell. He's active and playful and appears normal otherwise. He may be creating the problem by twirling his mother's hair in his hands while he nurses. It doesn't help that Ntobo seems to have particularly long hair.

The problem is not life-threatening for this baby now, so we won't intervene, but it could become a larger issue. If the tissue becomes infected, he could sicken and die quickly. If his hands become too painful, he may not be able to hold onto his mother to nurse.

The best outcome is that the hair will break down soon, ideally with Ntobo helping to clear it away. It's also possible that the constriction from the hair will act like a snare, causing the eventual loss of the ends of his fingers — something we know he can live with as long as infection does not set in. We'll be up and down the mountain checking on him this week.

[Rwanda, Feb. 18, 2008. Pictures: Dr. Lucy Spelman/MGVP]

Nzeli Injured

Nzeli injured and resting before receiving treatment in Bwenge Group, Rwanda

I jumped out of my chair when my cell phone rang … so much for a quiet Sunday morning. First an earthquake — which had sent me running outside for fear that the roof of my little house would collapse — and now the phone. I glanced at my watch. It was 10:51 a.m. and the caller was Veronica, the field coordinator for the Karisoke Research Center in Rwanda. The combination could mean only one thing: emergency in the field. We typically hear of problems in mid-morning. Sure enough, Nzeli, an adult female had been found down, unable to move.

Nzeli picks up her injured left foot to inspect and clean the wound.

I quizzed Veronica while grabbing my field clothes, filling a baggie with raisins and slapping Band-Aids on my toes (a routine precaution). Hadn't Nzeli left Bwenge Group with a young silverback, Twizere? Yes, but she had just reappeared. It seemed she preferred to be with Bwenge. Were the injuries new? The trackers described a bad injury to one foot, with whitish tissue exposed. There had been several aggressive interactions between Twizere and Bwenge — maybe Nzeli had got caught in the middle. It sounded to me as if the injuries could be several days old.

Nzeli, alert but depressed, not eating and unwilling to move on the day her injuries were reported

I was the only gorilla doctor in town, but I knew Elisabeth (the vet tech who works for the park service, ORTPN) was in her office, working on a report. Bwenge Group wasn't far away. Elisabeth could join me quickly if needed. Nzeli's condition could be serious enough to warrant intervention with anesthesia, which we'd plan for first thing the following morning unless I found the gorilla in dire straits. I loaded our three medical bags into the truck and got halfway through our gate before I realized I'd nearly forgotten the penicillin.

At 1 p.m., I had my first look at Nzeli. She sat in a hunched position, occasionally picking at wounds on her hands and feet. When she got up to reposition herself, she used her knees instead of her feet. I could see a deep triangular gash across the bottom of her right foot and her toes were very swollen. She had a similar nasty wound on the heel of her left foot. Gorillas normally recover from fight injuries, but these appeared several days old and possibly infected. No wonder Nzeli hadn’t moved since the trackers arrived five hours ago.

Nzeli's injured feet the day after penicillin treatment

I called Elisabeth to discuss the options. We could intervene with anesthesia or antibiotics today, or wait until tomorrow and see if the gorilla's condition worsened — but we risked losing Nzeli. Twizere could challenge again; Bwenge could move quickly. She couldn't keep up. If we anesthetized her, our main goal would be to give antibiotics and clean the wounds We'd also be able to collect samples and prove or disprove infection. But the results take time. I chose to dart Nzeli with penicillin and recheck tomorrow.

Nzeli crawling away, walking on hands and knees, after receiving a dart of antibiotics

While I was preparing the penicillin dart, the group moved away to feed and Nzeli followed, crawling on her knees. We found her easily. She stopped to eat a few bits of vegetation — a good sign that she hadn't entirely lost her appetite. With the rest of the group far ahead, I knelt and waited for Nzeli to turn her head away from me. In just a few minutes, the opportunity came. She grunted when the dart hit, turned back to pull it out of her thigh and glance in my direction, then continued her slow crawl.

Nzeli examining her wounds

Elisabeth joined me early the next morning. I brought the full medical kit again, just in case. But I felt optimistic. Antibiotics are often highly effective, especially in our setting, where we use them sparingly. Unless Nzeli was much worse, we'd give her time to respond.

When we were about halfway up the mountain, the advance trackers radioed good news: Nzeli was with the group. We walked that much faster until we caught up to the gorillas. Nzeli looked remarkably better, still crawling, but her toes were less swollen and she was eating.

Nzeli four days after therapy, wounds healing

In appearance, Nzeli's wounds, while still very severe, looked healthier and more manageable, the kind that will heal on their own with plenty of cleaning and grooming — by the gorillas, of course.

The fact that Nzeli had regained her appetite also gave us confidence that she could keep up with the group. I was glad we'd made the decision to try penicillin and that it had worked. The pain wasn't gone, but the antibiotics had reduced her risk of developing a life-threatening infection and being left behind.

I was equally relieved that Bwenge and his group seemed so calm. Any time we intervene, there's the risk that the gorillas will become wary of visitors, especially of those who carry dart guns. I knew that neither Nzeli nor the others had seen me fire the dart — and that's the key to working with them as a vet: Hide the equipment. Yet they must smell the medicine at the puncture mark where the dart hit. I often wonder what sort of communication goes on after one of our very rare interventions.

Nzeli cleans her wounds

On the second day after the penicillin dart, Veronica reported that Nzeli had an even better appetite and could move more quickly, though still on her hands and knees. The gorilla had a bit of diarrhea, which we attributed to the antibiotic.

When I checked her on day three, Nzeli had begun to walk gingerly on her left foot while continuing to drag the right one. She cleaned her wounds, resting on her back and holding her damaged feet up in the air, exposing them to air and sunlight. Was my intervention with antibiotics necessary, given that our mandate is to intervene only when the problem is life-threatening or human-induced? I'll never know for sure. One thing is clear: she's better.

[Rwanda, Feb. 6, 2008. Pictures: Dr. Lucy Spelman/MGVP]

People Who Care

Susa Group mountain gorilla tracking and monitoring team, ORTPN, Rwanda

I smile when people say, "You're so lucky to be able to work with animals all day."

In fact, vets spend more time working with people than they do with their patients. Obviously, a sick or injured animal cannot speak, so we rely heavily on information that flows to us from those who work in the field as well as on outside experts. This is a good thing! The enthusiasm and compassion park staff and scientists show for the gorillas — the connections that develop between people and animals — are what fuel my batteries for work each day.

Kanama, a female mountain gorilla in Shinda Group, Rwanda

When the field staff describes a minor problem among the gorillas, we initially follow up with questions. I heard last week that two females in Rwanda's Shinda Group had watery diarrhea, and my first question was answered before I asked it: the gorillas weren't acting sick.

I asked if anyone had seen them eating unusual plants or feasting on a particular one, such as bamboo shoots, which can result in watery stool. No, not that anyone saw. Of course, they could have eaten something different before trackers arrived that day.

Pasika, a female mountain gorilla, with silverback Shinda, Rwanda

Fortunately, the Shinda females were perfectly fine the next day. If the problem had persisted, one of us would have made a monitoring visit to observe the animals and collect fecal samples. Our assessment in this case: mild, one-time diarrhea, two individuals affected, probable diet-related intestinal upset. Now we need to follow up and ask the trackers if there were any bamboo shoots around, though it's not currently the season for them in the Virungas.

Information-gathering is one reason we do routine health checks. We tend to hear more about the gorillas from colleagues and observers when we're in the field. And we usually find something we didn't know about or learn something new that might be important.

A small, seemingly minor problem can signal a bigger one; moreover, we're always on the lookout for communicable diseases — infections that can spread. These visits give us a chance to talk with park staff as well as an opportunity to observe the animals when they're healthy.

Blackback mountain gorilla, Gahinga, in Amahoro Group has minor wounds

I went on a routine health check visit to Amahoro Group the other day and noted that a blackback, Gahinga, had numerous scrapes on his face. He'd challenged the chief, Ubumwe, and quickly lost.

We don't typically intervene in cases of male-to-male aggression because this is natural behavior. In this case, the silverback was simply asserting his dominance, as long-time tracker Jean Baptiste confirmed. But it's helpful to know that this is a group where similar and potentially more serious encounters may become more frequent.

ICCN guide for Grauer's gorillas at Kahuzi-Biega National Park, DR Congo

Unfortunately, the situation in DR Congo has not yet stabilized. We cannot make any kind of vet check, let alone a routine one, to the habituated mountain gorillas on the Congo side of the gorilla park. Nor can we travel easily to the Kahuzi-Biega National Park to monitor the Grauer's gorillas there; the road outside Goma is unsafe.

We do continue to talk about their situation, hoping to become partners in the effort to establish a home for them in DR Congo, a sanctuary where MGVP would provide the health care. But until the security situation improves, we're not likely to make much progress.

Kwitonda Group tracker Jean with friends near the park
boundary with Art of Conservation banners in the background, Rwanda

The effort to save the mountain gorillas involves people who live and work outside the national parks, too. Here again, communication is vital. Our partner in art, Julie Ghrist, has printed banners with drawings and paintings created by Rwandans who took her free Art of Conservation classes. Now she's putting them up in the community — at local hotels as well as in the villages.

An Art of Conservation-MGVP banner shows destruction and protection
of the environment; artwork courtesy of Julie Ghrist and AoC team.

The artists combine scenes from nature with those that show the struggle of daily life, sending the message that although basic needs must come first people here do want to feel connected with the landscape and its animals. Unfortunately, this is a place where people suffer preventable disease and illness as well as poverty and war.

Is a healthy ecosystem possible in this setting? I don't know, but I do know that there are many people here determined to achieve it.

[Rwanda, Jan. 27, 2008. Pictures: Dr. Lucy Spelman/MGVP]

Death of an Orphan

WARNING: Graphic images ahead.

The orphaned Grauer's gorillas, Mapendo and Vumilia, in Mutsora, DRC,
on Jan. 10, 2008. Photo: Dr. Eddy Kambale

After 10 days of caring for the two orphaned Grauer's gorillas in Mutsora, we thought both would live. Vumilia was weak, but he regularly drank plenty of water and ate fairly well, especially fresh fruit.

We continued preparations to move him and Mapendo to Goma. Workers rushed to construct a temporary home at the Dian Fossey Gorilla Fund International (DFGFI) office there. The staff of the NGO WildlifeDirect arranged for a plane flight. Soon, we'd have all four orphans in one city.

Dr. Eddy Kambale and Dr. Magdalena Braum weigh the corpse of Vumilia. Photo: LHS

Thirty-six hours before the planned move, Eddy called me in the middle of the night. Vumilia had suddenly cried out and collapsed. Using CPR, Eddy managed to revive the young gorilla. I called Dr. Magdalena Braum, our new regional field vet who lives near me in Ruhengeri. We traded phone calls with Eddy, offering ideas and advice, hoping the problem wouldn't recur. But it did and Vumilia died. We'd be meeting a plane carrying one live gorilla — and one dead one.

Andre with Mapendo just after arrival in Goma on Jan. 14, 2008. Photo: LHS

Early on the day of the flight, Magda and I drove to Goma, stopping at the DFGFI office to check that everything was ready. Unfortunately, the walls of the outdoor gorilla enclosure still reeked of fresh paint and the newly poured cement floor in Mapendo's night house needed another day to dry. I decided that our part-time office space was the better — indeed the only — option.

Out went the desks and bookshelves and in went a mattress. When we let Mapendo out of her transport crate, she looked around calmly and walked straight into Andre's waiting arms.

MGVP vets Jacques, Magda and Eddy perform the postmortem on Vumilia
in a makeshift necropsy tent. Photo: LHS

With Mapendo settled, we began the postmortem on Vumilia. As with any complicated procedure, each of us had an assigned task. Magda and Eddy collected samples; I photographed; and Jacques recorded the findings and helped weigh or measure the various internal organs. The staff of DFGFI-Goma provided us with a makeshift tent; two of its sides open to the fresh air and a table. The flies found us quickly, however, making for a long afternoon. At least the weather was cloudy.

Vumilia had enlarged, deformed joints, evidence of severe metabolic bone disease. Photo: LHS

The little gorilla was emaciated and stunted. Though he'd been eating while under our care, he had no fat stores and his muscles were severely atrophied. His knees and elbows were abnormally large, the result of bony swellings characteristic of metabolic bone disease. Known as rickets in humans, this problem results when a young, growing animal is fed a diet too low in calcium or too high in phosphorus. Without access to sunlight, it develops more quickly. This condition, along with the scars around his wrists, suggested that Vumilia had been captive for many months.

Dissection of abnormal knee joints found during the postmortem exam on the
orphaned Grauer's gorilla, Vumilia. Photo: LHS

The gorilla's internal organs were pale in color with tiny pinpoint hemorrhages in some areas. We did not find any evidence of a communicable infection — good news for Mapendo and all who worked with Vumilia, though these findings are only preliminary.

Next we apply for permits, ship the samples to the University of California, Davis, and wait for the tissues to be analyzed by the expert veterinary pathologists. Only then will we be able to determine the cause of death. Sometimes, we never find out for certain what happened.

Clearly, Vumilia suffered from months of malnutrition, rickets and severe stress, all of which contributed to his death and may have been enough to kill him. We found a small amount of food – partly digested fruit – lodged in the gorilla's larynx, right at the opening to the trachea or windpipe. This could explain what happened at the very end. If the gorilla vomited a mouthful of food and choked on it, he may simply have been too weak to cough it out on his own. Eddy's CPR cleared the airway, but only temporarily. This is only speculation, but it's also our best guess until the final report comes in.

Mapendo eats ficus leaves; she has a probable fungal skin infection with patchy
and itchy areas of hair loss on her hands and body. Photo: Dr. Magda Braum

Three days after the postmortem, Magda returned to Goma to check on Mapendo as well as Ndeze and Ndakasi. Earlier, we'd noticed patchy hair loss on Mapendo; by the time of Magda's visit, the condition had worsened and the little gorilla was itchy. The problem looks like ringworm, so Magda started Mapendo on the appropriate medication. She and Jacques hope to confirm the diagnosis with analysis of hair samples.

Fortunately, the new orphan is taking her bottle quite well and shows no overt signs of rickets. Milk, sunlight and plenty of fresh browse will ensure that Mapendo does not suffer the same fate as Vumilia.

Jean Paul holds Mapendo; he and at least one other ICCN ranger have
joined the gorilla caretaker team in Goma. Photo: Dr. Magda Braum

Mapendo has two new caretakers, Jean Paul and Babo. Like Andre and the group caring for the mountain gorilla orphans, both are ICCN staff who have helped care for orphaned gorillas in the past — namely Pinga and Serufuli, two of the eight orphans who live at the Kinigi facility in Rwanda.

The rangers have been stuck in the city since last summer anyway. The situation in the Virungas section of the park is chaotic and the forest border is being destroyed by illegal charcoal manufacture. We have no news of the gorillas that live in the area.

Mountain gorillas Ndeze and Ndakasi are thriving in Goma. Photo: Dr. Magda Braum

I'm happy to report, though, that Ndeze and Ndakasi are doing fine, gaining weight slowly and playing most of the time. And the best news of all: both orphans have normal stool, formed and brown in color, rather than runny and white, and neither has had to be treated with antibiotics for several weeks — acidophilus did the trick. Now that they’re healthy, it was time to give them their vaccines. Magda and Eddy had the honor. Neither gorilla seemed to notice the needle stick. Apparently, Ndeze thought Eddy was just playing a game!

Ndakasi and Ndeze with their dedicated caretakers in Goma. Photo: Dr. Magda Braum

We've also started Ndeze and Ndakasi on a new milk formula, one I brought back from the U.S. that is supplemented with both fatty acids and probiotics. It seems crazy to pay extra baggage fees to transport tins of milk powder such a great distance, but the supply and selection of milk formula vary widely here. Thanks to the donations many people have made recently to MGVP, we can afford it. The caretakers are following a schedule, mixing the new with the old powder and gradually increasing the concentration. So far so good.

[Rwanda, Jan. 21, 2008. Pictures: Dr. Eddy Kambale, Dr. Magda Braum and Lucy Spelman/MGVP]

The Gorilla Doctors

MGVP staff, from left: Jospin Mbonekube, Jean Paul Lukusa,
Dr. Jean Felix Kinani and Dr. Eddy Kambale.

MGVP's veterinary staff — collectively, the gorilla doctors — is a unique, diverse and interesting group of people. We differ in terms of our nationality, training and experience, as well as in the territory we cover. The in-country field vets are stationed in their home countries, either Rwanda, Uganda, or the DRC, while the regional vets and project director move about.

MGVP's regional headquarters is located in Ruhengeri (Musanze), Rwanda for two main reasons: Most of the world's habituated mountain gorillas live in Rwanda, and Ruhengeri itself is about halfway between the border with Uganda to the east and Congo to the west.

Dr. Lucy Spelman leads an MGVP team helping a wild giraffe at
Akagera National Park with an infected snare wound.

Though a subset of the six field vets will sometimes work together on a mountain gorilla when veterinary intervention is required, this happens only a few times a year. Typically, we are out and about alone or in pairs.

As regional director, I initiated monthly regional vet rounds so that the vets could get to know each other by sharing experiences and exchanging information. I also make the most of every opportunity to augment their training whether we're in the field or the office. The reality is that veterinary training in Africa falls considerably short of what we receive in the U.S. and Europe. When opportunities arise for mobilizing the entire team I go for it, as in the case of the giraffe in Akagera National Park (Rwanda) needing treatment for a snare wound [Mission Giraffe].

MGVP director Dr. Mike Cranfield also enjoys photography.

MGVP director Dr. Mike Cranfield was one of the first veterinarians to embrace the concept of "one health" (integrated medical coverage) and apply it on behalf of great ape conservation. Mike has led the project since 1999 and is always on the lookout for ways to build local capacity. MGVP has trained a number of in-country vets, helping several to obtain masters and PhD degrees.

Mike has also expanded MGVP programs to include employee and domestic animal health. His greatest challenge these days is raising the funds to sustain all of this important work. A Canadian, Mike currently lives near the Baltimore Zoo in Maryland, where he works as a research veterinarian studying avian malaria in South African penguins. His hobbies include competitive sailboat racing, ice hockey and squash.

Dr. Lucy Spelman, MGVP regional veterinary manager,
and ORTPN vet tech Elisabeth Nyirakaragire prepare for the field. Photo by Julie Ghrist.

I am the one American on the team, having grown up on an old dairy farm in Connecticut with a menagerie of animals. Even before I understood that such jobs actually existed, I wanted to be a doctor helping wild animals.

After college at Brown University, veterinary school at the University of California Davis, internship training in private practice and zoological residency training at North Carolina State University, I worked for the National Zoo in Washington, D.C. for nearly 10 years, first as a clinician and then as director.

But after 16 years as a vet, I'd still never treated patients in their natural habitat. That’s when I decided to apply for a job with MGVP as regional vet manager, a post I took up a little over a year ago. Aside from my work, I love to write, walk and read.

Dr. Jean Felix Kinani, MGVP Rwandan field vet, preparing to dart a
mountain gorilla with ORTPN vet tech Elisabeth Nyirakaragire.

Dr. Jean-Felix Kinani is MGVP's Rwandan in-country field veterinarian. Jean Felix received his veterinary degree from Check Anta University in Dakar, Senegal. He joined MGVP in 2004 and especially enjoys fieldwork with the gorillas. He is also interested in domestic animal health and recently started an annual rabies vaccination program for domestic dogs in the region. Near the Virungas there have been several recent cases of rabies in jackals and feral dogs; humans too have died of this disease.

Jean Felix is the project's great communicator. He speaks many languages, knows many people and has by far the highest cell-phone bill. His hobbies include playing and watching soccer, or football as it is known here. He and his veterinarian wife have just started a family.

Jean-Paul Lukusa, MGVP regional laboratory manager, teaches basic
hygiene at Art of Conservation class. Photo by Julie Ghrist.

Jean-Paul Lukusa is MGVP's regional laboratory manager. He received his degree in microbiology from L'Institute Superior Médicale in the Democratic Republic of Congo and then worked as a professor at a medical school in Rwanda before joining MGVP in 2003. Jean Paul lives in Goma, DRC, but commutes regularly to MGVP's main office in Rwanda. His duties range from running fecal parasite checks and bacterial cultures on mountain gorilla samples to administering the MGVP employee health program. The latter job involves coordinating doctor visits and laboratory samples for hundreds of park rangers, guides and patrols each year.

Jean Paul is MGVP's most gifted teacher and public speaker. And, as we learned when he participated in Julie Ghrist's Art of Conservation class (www.art-of-conservation.com), he can make even brushing one's teeth exciting!

Dr. John Bosco Nizeyi, MGVP research veterinarian and professor, at
Makerere University in Uganda.

Dr. John Bosco Nizeyi is MGVP's research veterinarian and a professor in the wild animal resource management department of Makerere University in Uganda. JBN (he's known by his initials) received his veterinary degree at Makerere, his masters of science in recreational resources from Colorado State University and his PhD in veterinary medicine at Makerere University in 2005. He has worked for MGVP since 1993, when he started as a field vet. His research interests include the use of fecal cortisol testing to monitor stress levels in wild animals.

Because JBN lives in Kampala, a long way from mountain gorilla habitat, and his days are full of teaching and guiding students, we don’t see him often. But when we do get together for an all-staff meeting in Kisoro, Uganda, everyone looks to JBN for his historical knowledge and experience.

Dr. Benard Ssebide, MGVP Ugandan in-country field vet, on a routine
health check in Bwindi Impenetrable Forest, Uganda.

Dr. Benard Ssebide is MGVP's Ugandan in-country field veterinarian and the team’s newest staff member. Benard (yes, this is the correct spelling) received his veterinary degree and masters of Science in wildlife health and management from Makerere University in Uganda. For six years, he worked for the Ugandan Wildlife Authority as veterinarian and chief park warden, based in Bwindi Impenetrable Forest. During that time he became a collaborator and friend of MGVP.

He joined the project early in 2007 to concentrate on field vet work rather than administration. Benard has a keen interest in wildlife diseases and will begin work on his PhD soon. With a home in Kampala and his patients spread out among dense jungle, Benard travels more miles over rough terrain than the rest of MGVP staff combined.

Dr. Jacques Iyanya, MGVP DRC field vet, monitoring
gorillas in Kahuzi Biega National Park.

Dr. Jacques Iyanya is one of MGVP's two in-country field veterinarians based in the Democratic Republic of the Congo. He received his veterinary degree from the University of Lubumbashi in the DRC then worked for the Department of Agriculture and Development in the eastern part of the country before joining MGVP in 2004. His duties include monitoring mountain gorillas on the DRC side of the Virungas and Grauer's gorillas in the Kahuzi-Biega National Park. He and his colleague, Dr. Eddy Kambale, also take care of the two newest infant mountain gorillas in Goma, DRC.

Jacques speaks perfect French, is exceptionally well connected and diplomatic and understands DRC's complicated political system. As a result, he often accepts the role of MGVP political adviser. He is rapidly learning English, and will soon be correcting me in my native language as well as in French!

Dr. Eddy Kambale, MGVP DRC field vet, helps care for
the orphaned mountain gorillas in addition to his field work.

Dr. Eddy Kambale is the other MGVP in-country field veterinarian based in the DRC. Eddy received his veterinary degree at the Catholic University of Graben, Butembo, in the DRC. Before joining the MGVP in 2004, he was a scholar at the Technical Institute for Agriculture and Veterinary Science in Butembo, DRC. In cooperation with Dr. Jacques Iyanya, Eddy’s duties include monitoring Grauer’s gorillas as well as mountain gorillas — and caring for the orphans.

He enjoys every aspect of clinical medicine, including pathology, or the study of disease after an animal has died. Eddy performed field necropsies on the gorillas shot in the DRC last July, hoping to learn something from this tragedy. Among MGVP staff, Eddy has a wry sense of humor and can make people laugh in any number of languages. At work, however, he’s seriously quiet.

Jospin Mbonekube is MGVP’s regional administrator
who helps coordinate the project in three countries.

Jospin Mbonekube is MGVP's regional administrator. He has worked for the project since 1999 and has managed to continue his university studies while working full-time. Jospin's workload has expanded significantly in recent years, perhaps especially since my arrival! His job includes just about anything — calling a plumber, inputting accounting data, arranging staff schedules. I often joke that we all work for Jospin, because he knows better than any of us where everyone and everything is at any one time. For every question he asks me, I ask another one back.

Jospin works in an environment where administrative headaches abound. Most of the time, however, he takes it all in stride. He is fiercely loyal to MGVP and stresses the importance of working as a team, even if it's easier at times to act alone. On some days, he is also MGVP's best dressed staff member.

MGVP's support staff, including Leon Ntahobavukira, the house
manager (left), eagerly help put the new truck's roof rack together.

MGVP's support staff includes long-time employee, Leon Ntahobavukira, the house manager. Felicien Mulinda, Faustin Nemeye and Samuel Nshimiyimana work as guards/grounds staff at the headquarters in Ruhengeri. Jean-Claude Rusengamihigo, Michel Mwemezi and Innocent Barimenshi perform a similar function at the interim quarantine facility (IQF) for orphaned gorillas in Kinigi, Rwanda.

MGVP employs five of the seven caretakers who work at the IQF: Amiel Bapfakwita, Dieu Donne Muyambabazi, Jean Baptise Bisenigamana, Innocent Kabendera and Fabian Bahati. The project also pays part of the salary for Simon Childs, IQF manager.

[Rwanda, Nov. 28, 2007. Pictures: Lucy Spelman/MGVP]

A Visit to Uganda

A new camp for refugees from the D.R.C. in Kisoro, Uganda, Nov. 10, 2007.

I continued my travels in Uganda last week, first on safari with friends, then back to work with gorillas (more about them in a moment).

Early on, in Kisoro, we drove past a refugee camp set up by M.O.N.U.C., the U.N. mission in the Democratic Republic of Congo. The camp is just off the main road connecting the Virunga Mountains with Bwindi Impenetrable Forest, the only two places in the world where mountain gorillas live. Though the refugees have access to basic health care and vaccinations, any number of diseases could whip through this camp, putting people, as well as the nearby mountain gorillas, at risk.

Our next encounter with M.O.N.U.C. was a good deal less positive. We were in Queen Elizabeth Park on a game drive. Our amazing guide, Francis Kiwanuka, had spotted several lions after hours of searching. The male lion had a swollen muzzle, so of course I was trying to get a better look at him.

Suddenly, two U.N. trucks drove up and parked behind us, engines running. Dozens of people got out and continued talking. The lions moved away and so did we.

A male African lion in Queen Elizabeth Park, Uganda, Nov. 13, 2007.

Only about 100 lions remain in the entire park, a decline in population caused by the poisoning of lions by cattle farmers who prefer to protect their herds in this way rather than wait for compensation for their losses from the Uganda Wildlife Authority (U.W.A.).

Evidently, M.O.N.U.C. staff visit the park weekly during their breaks. Our safari group was disappointed and disheartened by their behavior. I don't think it can be good for these few lions to have people visiting the park who don't observe common safari etiquette, which calls for visitors to turn off their vehicles, stay inside and remain quiet around the animals.

A female leopard in Queen Elizabeth Park, Uganda, Nov. 13, 2007.

Francis quickly put some distance between our truck and the U.N. group. We continued on our game drive, passing a huge herd of elephants, one of many we glimpsed during our three-day safari.

Suddenly, Francis stopped, turned off the engine and pointed upward. A leopard! She too had a minor medical problem — a cloudy right eye with a bit of discharge. She noticed us but then went back to sleep . . . until the U.N. trucks showed up. She was long gone before they all got out and walked around her tree.

Francis Kiwanuka, nature guide and expert driver.

Francis himself was as impressive as the animals we saw on our Ugandan safari. He works for Volcanoes Safaris, a company that manages several eco-lodges in Central Africa. We'd hired him through Terra Incognita Ecotours, a company that donates to M.G.V.P. when guests visit our project in Rwanda.

These tour companies, as personified by Francis, offer proof that people and wildlife can live in balance with mutual respect for one another's boundaries. As for the U.N., maybe the Queen of England can ask them to mind their manners — this week she is due to visit the park named in her honor.

M.G.V.P.'s new field office in Buhoma, Uganda, adjacent to Bwindi Impenetrable Forest.

On my own I traveled next to Buhoma, Uganda, near the boundary of the Bwindi Impenetrable Forest. Bwindi is not far from the Virungas, but the drive on winding often muddy mountain roads with a stop at the border crossing from Rwanda takes about eight hours.

M.G.V.P.'s Ugandan field vet, Dr. Benard Ssebide, is based in the Buhoma area and we planned to do a few routine health checks together. Benard also wanted to give me an update on the new M.G.V.P. field vet office, still under construction.

A mother and her infant in the Nkuringo Group, Bwindi Impenetrable Forest, Uganda.

Bwindi is home to half the world's 720 mountain gorillas, though only about a quarter of these have been habituated to people. The percentage is much higher (75 percent) for the gorillas that live in the Virunga Massif of Rwanda, D.R.C. and Uganda.

Most scientists say that the two populations separated about 500 years ago — the result of logging and agriculture. Compared with the Virunga gorillas, Bwindi gorillas live at lower elevations in tree-covered peaks and valleys, eat a greater variety of plants, and have shorter hair.

Dr. Benard Ssebide stands inside M.G.V.P.'s newly constructed Buhoma field office.

To make a cell phone call, Benard must drive to a particular spot on the road where he can get decent reception. His office is wherever he finds a spot to land.

Recently, though, M.G.V.P. has co-funded the construction of a small building. One side houses M.G.V.P.'s new Uganda field office and it's almost ready. The other side was funded by a small business owner who planned to open an Internet cafe. Now we're hearing that this may never happen. So for now, sending email or talking by SKYPE in this area remains a dream.

Buzinza's infant in Bwindi’s Rushegura Group acts fine,
despite multiple small white lesions on the face.

I trekked with Benard and U.W.A. rangers to see Bwindi's Rushegura Group of mountain gorillas. Benard has been monitoring a 10-month-old in the group. It shows no signs of ill health except for multiple whitish-gray, plaque-like lesions on its chin, nostrils and lips. These lesions appear viral — possibly herpes or pox or papilloma (warts) — and have been observed on other infant gorillas. Indeed, during this visit, we noticed another infant, an 8-month-old, with similar facial lesions.

Kyirinvi's infant in Bwindi's Rushegura Group also has some small white lesions on the face.

Since the skin condition doesn't make the infants sick, we have not intervened and thus have been unable to make a precise diagnosis. It's definitely not mange, which has been documented once before in Bwindi. But it does last for weeks. To track this problem, Benard and I took dozens of photographs of the Rushegura Group infants, hoping that one of us would capture a decent image. I learned that it can be very dark in the Bwindi Forest, even on a clear day.

A view of Bwindi Impenetrable Forest from Nkuringo, Uganda.

After visiting the Rushegura Group, our plan was to visit another Buhoma-based family of mountain gorillas: Mabale Group. But the U.W.A. rangers reported that a black back (a young adult male gorilla) in the Nkuringo Group had been coughing. This group lives on the other side of Bwindi near the town of Nkuringo, a 15-kilometer (9-mile) forest walk from Buhoma. Unfortunately, the gorillas were another five kilometers away — too far to walk and do a health check on the same day. We got back in the car, drove five hours, spent the night in Kisoro, and drove another hour-and-a-half the next morning to Nkuringo.

To reach Nkuringo Group, we hiked down into a deep valley. Because of the dense vegetation, I found it difficult to fully observe each individual. But we did succeed in getting a clear view of the coughing black back, Kisoro. He rested most of the time, ate a bit and intermittently sounded a loud, dry cough. We were relieved to find that none of the other gorillas was coughing. Benard will go back to check in a few days. After a challenging hike out of the valley, I left with a new appreciation for the word "impenetrable."

[Uganda, Nov. 17, 2007. Pictures: Lucy Spelman/MGVP]

The Good, the Bad and the Very Very Sad

Ndakasi, an orphaned female mountain gorilla infant, chews on wild celery.

For the past several weeks, the Goma orphans have been our only active cases — and I'm glad to say they're both in good health at the moment. But everything changed a few days ago. I've been called to the forest urgently nearly every day this week. So far, we haven't had to provide medical treatment, but the week isn't over yet.

We heard late yesterday that a lone silverback had been injured badly during an interaction. If the trackers can find him, we'll be back up the mountain.

Silverback Guhonda in Sabinyo Group eats a huge root; his left hand was injured by a snare years ago.

The string of unexpected calls began on Monday, the day I was supposed to have an interview with correspondent Anderson Cooper for a CBS 60 Minutes story. I'd met with his production team over the weekend to provide background information and film the orphan gorillas at the Kinigi facility.

Our Rwandan field vet, Dr. Jean Felix Kinani and I were scheduled to talk to Anderson on Sunday afternoon about the role of veterinarians in gorilla conservation and we were looking forward it. At the last minute our interviews were rescheduled for Monday. I had a premonition that something would undo the plan. I was right.

In October and November, the Virungas tend to be misty
and wet during each day, but with clear and cold nights.

Back at the office, we had a quick staff meeting before my interview. Just as I prepared to leave, Elisabeth, the ORTPN vet tech, rushed in to say that trackers had reported a 2-month-old infant in Kuryama Group to be very weak. Our cell phones weren't working, so she'd come straight to the office.

With sick infants there isn't much time. Pneumonia is always on our differential list and it can kill them very quickly. It was already midday and by the time we reached the group we'd barely have time to intervene if that proved necessary. I grabbed an extra flashlight, remembering more than one very dark descent after a field emergency.

Segasira, a 2-year-old in Kuryama Group, had an episode
of choke several months ago that resolved quickly.

The trackers and vet team often chat as we hike up the mountain. We mix bits of English and French, and I try to learn a few new Kinyarwanda words. But when we know there's a potential patient up there, no one says very much.

My brain starts to churn and my pace quickens. I'll run through a mental checklist of questions: What is the most likely outcome based on what I know so far? When is the last time I saw this individual gorilla? Do we have everything we need with us? Should we have brought a thermos of hot water to warm the patient, even though it adds to the weight of our heavy bags? Will radios and cell phones work where we are going?

Umusatsi's infant appeared strong and active the next day.

After a brisk and anxious hike up to 3,000 meters (9,843 feet), Elisabeth and I had less than a quarter of an hour to observe the patient. The skies had begun to darken and Umusatsi, the infant's mother, had settled into a hole at the base of a tree, probably for the night.

I'd asked one of the Karisoke Research Center scientists, Winnie Eckardt, to observe the infant while we hiked. Although it had been reported earlier as limp and not nursing, Winnie saw it nursing twice in one hour. This news dialed our worry level way down, as did my first glimpse of the infant: it was wide-eyed, clinging to its mother's neck. Five minutes later, it fell fast asleep.

I hiked up the mountain again early the next morning with the Kuryama Group trackers for another look at Umusatsi and her infant. It had been a cold night, and if pneumonia was brewing, the baby could be in bad shape. On the other hand, if it had simply suffered a bout of colic the day before, it could be just fine today — and indeed, we found Umusatsi resting in warm sunshine while her infant made soft chirping noises and climbed all over her, nursing hungrily. This was the best news of the day, despite my frustration at having missed the Anderson Cooper interview (Simon Childs, who manages the orphan facility but is not a vet, did it in my place.)

Nzeli in Bwenge Group carries her dead infant on her back the day
after trackers found her with a new but lifeless baby.

Next day, after a morning of catch-up desk work, I learned of a new, sad case. Nzeli, a female in the Bwenge Group, had given birth on Wednesday morning. But the baby was dead when the trackers found her.

Theo Ngabo, who collects data for the Karisoke Research Center, had found some of the placental tissue. He rushed to our office with the sample and described what he'd seen in the field: Nzeli was weak, with a bloody vaginal discharge that left a trail of red spots on the ground as she moved. This is normal right after birth, but not if it persists. He didn't get a close look at the infant and was uncertain if it was full-term or premature. From Theo's description, it was clear we needed to check Nzeli and recover the dead baby if possible.

Nzeli continues to groom her dead infant, and may do so for up to three weeks.

When we reached Nzeli the next morning (after trekking up a different mountain), she was resting, holding a lifeless infant that appeared otherwise normal. This wasn't the first baby that Nzeli had lost. She and two other females had transferred from Pablo Group to Bwenge's new group last January after their infants died in the midst of a severe outbreak of respiratory disease. It seemed they'd left their old group for a chance at a new family. That was exactly nine months ago. So this new infant could be Bwenge's (gestation in gorillas is the same as in humans) — or not.

Over the next two hours Nzeli groomed the infant as she would if it were alive, then picked it up and carried it about as she foraged for food. When I returned to the lab, our microbiologist, Jean Paul Lukasa, gave me an update on the bacterial cultures from the placental tissue. He is growing a pure colony of a type of streptococcus; meanwhile we will also preserve the tissue for future analysis (histopathology).

These tests, plus a review of the cause of death of Nzeli's prior infants, might yield important information. There are also other female gorillas who have lost infants unexpectedly at an early age. Maybe there is a common factor.

Umusatsi's infant — strong and active.

At the end of the day, I discussed Nzeli's case with Jean Felix and Elisabeth and sent an update via e-mail to key partners at ORTPN and Karisoke. While it would be helpful to recover the carcass of the dead infant to do a necropsy, intervention to take it forcibly is not warranted. There's no evidence that the group is sick with something communicable. And since there are at least two other pregnant females in Bwenge Group, we don't want to risk causing them undue stress by anesthetizing Nzeli. Sometime in the future, however, we might recommend a full examination to evaluate her more fully.

Though we did hear good news at the end of the day — Umusatsi's infant continues to do well — there is now the fresh challenge of the injured silverback. We are waiting to hear from the trackers.

[Rwanda, Nov. 2, 2007. Pictures: Lucy Spelman/MGVP]