had thought about and responded to the outbreak. Many local people told him, using a term from their Bakola language, that this Ebola thing was ezanga, meaning some sort of vampirism or evil spirit. Asked to elaborate, one villager explained that ezanga are “bad human-like spirits that cause illness in people” as retribution for accumulating material goods and not sharing. (This wouldn’t seem to apply to that man on the upper Ivindo, in 1994, who reportedly shared his tainted gorilla meat before he died.) Ezanga could even be summoned and targeted at a victim, like casting a hex. Neighbors or acquaintances, envious of the wealth or power someone has amassed, could send ezanga to gnaw at the person’s internal organs, making him sick unto death. That’s why gold miners and timber-company employees suffered such high risk of Ebola, Hewlett was told. They were envied and they didn’t share.
Barry Hewlett had investigated the Mékouka outbreak in retrospect, months after the events occurred. Still fascinated by the subject, and concerned that an important dimension was being omitted by the more clinical methods of research and response, he got himself to the scene in Gulu, Uganda, in late 2000, while that outbreak was still going on. He found that the predominant ethnic group there, the Acholi, were also inclined to attribute Ebola virus disease to supernatural forces. They believed in a form of malign spirit, called gemo, that sometimes swept in like the wind to cause waves of sickness and death. Ebola wasn’t their first gemo. The Acholi previously suffered epidemics of measles and smallpox, Hewlett learned, and those were likewise explained. Several elders told Hewlett that disrespect for the spirits of nature could bring on a gemo.
Once a true gemo was recognized, as distinct from a lesser spate of illness in the community, Acholi cultural knowledge dictated a program of special behaviors, some of which were quite appropriate for controlling infectious disease, whether you believed it was caused by spirits or by a virus. These behaviors included quarantining each patient in a house apart from other houses; relying on a survivor of the epidemic (if there were any) to provide care to each patient; limiting movement of people between the affected village and others; abstaining from sexual relations; not eating rotten or smoked meat; and suspending the ordinary burial practices, which would involve an open casket and a final “love touch” of the deceased by each mourner, filing up for that purpose. Dancing was also prohibited. Such traditional Acholi strictures (along with intervention by the Uganda Ministry of Health and support from the CDC, Médecins Sans Frontières, and WHO) may have helped suppress the Gulu outbreak.
“We have a lot to learn from these people,” Barry Hewlett told me, one day in Gabon, “as to how they’ve responded to these epidemics over time.” Modern society has lost that sort of ancient, painfully acquired accumulation of cultural knowledge, he said. Instead we depend on the disease scientists. Molecular biology and epidemiology are useful, but other traditions of knowledge are useful too. “Let’s listen to what people are saying here. Let’s find out what’s going on. They’ve been living with epidemics for a long time.”
Hewlett is a gentle-spirited man with a professorship at Washington State University and two decades of field experience in Central Africa. By the time I met him, at an international ebolavirus conference in Libreville, we had each visited one other village famed for suffering the disease—a place called Mbomo, in the Republic of the Congo, along the western edge of Odzala National Park. Mbomo lies not far from the Mambili River and the Moba Bai complex, where I had watched Billy Karesh trying to dart gorillas. The outbreak around Mbomo began in December 2002, probably among hunters who handled infected gorillas or duikers, and spread throughout an area that encompassed at least two other villages. A large difference between Hewlett’s experience in Mbomo and mine was that he arrived during the outbreak. The grease was still flaming in the pan when he made his inquiries.
One early patient, Hewlett learned, was pulled out of the village clinic because his family disbelieved the Ebola diagnosis and preferred relying on a traditional healer. After that patient died at home, unattended by medical personnel and uncured by the healer, things got testy. The healer pronounced that this man had been poisoned by sorcery and that the perpetrator was his older brother, a successful man working in a nearby village. The older brother was a teacher