The man who did the counting
Epidemiologist Les Roberts was hired by the International Rescue Committee to tally up the casualties of war in Congo
Les Roberts' personal account of his mission in the Congo
EDITOR'S NOTE: Les Roberts, an epidemiologist who teaches at Johns Hopkins University, went to the Democratic Republic of the Congo this spring to oversee a series of surveys for the International Rescue Committee aimed at quantifying the level of civilian death in the war-torn country.
After two grueling months, of being "on" all of my waking hours, the peers,
friends and press folks I speak with never want to ask the tough introspective
They never ask, "How can it be; where almost every family has lost someone from
this war, where they see and fear armed combatants on a daily basis, that small
children will run up with smiles, and crowd around you just hoping to catch
your eye, or better yet, hold your hand, with absolutely no fear in their
hearts? Yet, in my safe country, saying more than hello to a child on the
street will send them running for their mother who in turn will call the
No one ever asks, "How can you leave your wife and 'cush' life in exchange for
two months of continuous dealings with illiterate 17-year-olds carrying
Kalashnikovs?" (Perhaps that is lucky, because I don't know the answers.)
Instead they want to know, "How can you possibly measure mortality amidst the
chaos of what is now the eastern Democratic Republic of the Congo (DRC)?" I
usually interpret that to mean, "Can the number of deaths you claim have
happened possibly be right -- or are you completely wacko?" The other thing
they want to know is, "How bad were the risks?" The answer to all three is
that everything is relative.
Many years ago, the U.S. military established a network of satellites to guide
projectiles and aid in a variety of types of navigation across the earth's
surface. Since that time, the Global Positioning System (GPS) has become an
important navigational tool for campers, boaters, fliers, surveyors, and a host
of other folks for whom the military is usually not in the business of
supporting. Among those are public health workers. In recent years, GPS
technology has become part and parcel of public health research and service. I
have used GPS units in rural Uzbekistan to record the position of households we
were enrolling in a study so that they could be re-interviewed at a later date.
The nongovernmental organization (NGO) for whom I often work, the International
Rescue Committee (IRC), uses these units to quickly measure the distance
between water sources and the populations for whom they would like to supply
water. This takes perhaps 2 percent of the time needed to measure a distance
with a tape measure and one of those devices on a tripod you often see
surveyors use at construction sites. That's the way the IRC did it just three
years ago. I spent last winter teaching IRC workers in Central Africa how to
estimate water consumption in a population with a survey technique that depends
on sampling places evenly over space, something made possible with the advent
of GPS technology.
A mother and child who fled violence wait in Bukavu, Congo. The woman told interviewers that lack of food would likely force her family to return home to an uncertain fate
The eastern DRC is now in a level of disarray which is ALMOST incomprehensible.
Up until 1996, it was the neglected backwater of the former Zaire. Given that
it was the food basket and held the main stores of diamonds and gold for the
country, former President Mobutu was certainly not going to let it go. But
when it came to supporting universities, or infrastructure projects, those in
the eastern provinces often felt neglected. But, neglect turned to destruction
in 1996 when a coalition of forces, led by Laurent Kabila and backed by Rwanda
and Uganda, took over in the east, and then steadily marched westward with the
Mobutu regime crumbling before it.
Unfortunately for the Congolese, after only 15 months in power, President
Kabila had a falling-out with his former backers and Rwanda and Uganda were
back trying again to over-throw the Kinshasa-based government. This second
round of war has drawn on for almost two years. A rebel government (the RCD)
backed by Rwanda, Uganda, and Burundi has run things in the east, and
anti-rebel groups have sprung up and aligned themselves with Laurent Kabila.
In most areas, it is not safe for NGO workers or civil authorities to travel.
Thus, the roads have disintegrated, the clinics are often not stocked or are
unmanned. The limited economy related to food exchange, lumber, and mineral
harvesting has come to a screeching halt. Into this transportation and
communication nightmare, enters the role for GPS technology.
Using satellites where no roads exist
The difficult part about sampling is finding a way so that everyone has the
same chance of being visited. When the Gallup Poll folks or the students at
your local research university want to sample, they dial random telephone
numbers or choose from resident lists. In DRC, local officials often know how
many people are in a village or an area, but there are no lists, or addresses,
or even roads in most cases. Thus, these GPS units allowed us to sample random
points in space. We would drive, or ride a motorbike, or walk to one edge of a
village or clinic area, store that point in our GPS unit, and then go to the
opposite side of the area and use the GPS to measure the distance across. If
we had measured the area east to west, we might also measure the distance north
to south or just ask a local nurse how far the north to south was compared to
east to west. While they could rarely say in kilometers, they always knew
quite precisely how long it took to walk to any edge of their area.
Thus, we had with some effort, a crude estimate of the area of the village or
clinic zone, with one or two points on the periphery stored in the memory of
the GPS. The GPS unit guided us over hills and through rivers until we arrived
at the chosen spot.
In most of the five different areas we surveyed, we visited 40 different
"random spots" and interviewed the families IN five houses closest to that
spot. Because spatial sampling "over-samples" rural folks and "under-samples"
folks in crowded areas, we recorded the distance we had to go from the original
spot to encounter five houses. This way, after the fact, we could determine if
death in this rural setting was or was not related to crowding. On average, we
had to walk about two kilometers, for each cluster interviewed. Over the
course of five surveys, I walked between two and three hundred kilometers over
hills and through swamps, and two of us each rode motorcycles over 200
kilometers on roads and paths which were mostly impassable to cars.
At each of the households, we asked an adult just three questions: How many
people are in your household? (and we would record the age and gender of
each); Has anyone in your household died since last Christmas? (if so, we
recorded the age of the person, the month of death, and what the family thought
they died from); and, Did anyone in your family die last year, 1999?
Being a skeptical scientist, I was prepared to discard this last question since
remembering if a death was during December 1998 or January 1999 seemed to me,
beyond the capacity of these calendar-less households. That was just one of
many of my under-estimations of the Congolese. Not only did they know, but
most of the mothers remembered the exact day. These deaths were so vivid and
painful for these people. While some reported deaths in a manner like one
might report rainfall, many others, especially those recalling violent deaths,
would cry or talk about how the fabric of the family was torn. In the areas
with the most violence, many households had lost several people.
One teenage girl described how her village was overrun by the Interahamwe, the
Rwandan Hutu militia, who were largely responsible for the genocide against
Tutsis in Rwanda in 1994. This girl told us that she and her family fled to
the forest with no food, no blankets, and no water containers. They stayed
hidden as much as possible, foraging a little for food with little success.
Within a month, five of her eight family members had died of malaria. In the
beginning, I kept asking my interviewers, "Can this be true? Are you sure they
are not telling us sad stories because they want our help?"
My interviewers were incredulous. They would assure me that the mothers cannot
lie about this, that people here do not fake tears.
So, how can one measure mortality in the chaos of the Congo? The answer is
walk and walk and walk, and go ask. The families have not forgotten.
Kisangani: Home to diamonds and warring factions
As far as, "How bad are the risks?" -- they were huge, but everywhere I went
others seemed to be taking larger risks in order for us to get our work done.
The first really tense spot was in the city of Kisangani, DRC's second largest
city in the north-east of the country. It is where the first rapids on the
Congo River occur, beyond which boats traveling up-stream can not pass.
Doctors without Borders (MSF) Holland works in Kisangani and acted as our host
and co-investigators while we were there. Things had been tense in the city
between the Rwandan and Ugandan forces over the past year, and in August 1999,
fighting had broken out between these two "allies."
Non-Governmental Organization workers in Kisangani and locals felt these
tensions were over control of the lucrative diamond and gold trade. A
prestigious think tank in Washington attributes these tensions to differences
in philosophical approaches. Given the fact that the only people I saw
frequenting the diamond shops were soldiers, and that the Middle Eastern
diamond dealers were often driving around with soldiers, and that the only two
well-dressed businessmen with whom I had long conversations eventually
acknowledged being Ugandan officers, my vote goes with the local gossip.
Nonetheless, tensions had risen and eased repeatedly over the preceding year
causing MSF to evacuate its staff by airplane on two occasions.
During all of my travels, I was accompanied by a jovial Congolese nutritionist
named Charles Hail. Like so many of my Congolese counterparts, he was very
hard working, and very smart. Although he seemed to me, at first, particularly
un-enthused about the possibility of being killed. On April 30th, day 3 of our
planned eight-day stay, rumors spread about building tensions between the
Rwandan and Ugandan forces. On May 1st, a reported 12,000 Ugandan soldiers
arrived in town by foot. My MSF counterpart, an American nurse and old hand in
Africa named Karen Kasen, took this all very coolly with an analytical approach
-- if fighting begins, we will call for a plane and depart within three hours;
if the airport is taken, first we will congregate at the MSF Holland house
where we have emergency stocks....and until that time, let's stop talking and
get the work done. Our 10 interviewers, who happened to comprise a statistics
class at the local university, were convinced fighting was going to break out
but took this very light-heartedly and were primarily concerned that their rare
opportunity for paid work might get cut short. Charles just looked sick.
On the night of May 1st, the streets were deserted after dark. Bicycle taxis
(tolikas) usually swarm the flat and crumbled streets of Kisangani. Last round
of fighting, hundreds of these tolika drivers were grabbed by soldiers and used
at transport slaves, sometimes for days on end. Having learned their lesson,
these guys were nowhere to be
seen. Kisangani had the empty look of Manhattan without cars. Groups of
soldiers were far more numerous in town. I called IRC's director in Bukavu,
Michael Despines, and explained to him that tensions were rising. He agreed to
check in with Airserve, the NGO which flew us in to Kisangani, to see if we
could move the return up a day or so.
Tuesday, May 2nd, things were really tense. Most of the shops were closed.
There was the feeling one occasionally experienced in high school when an
unknown someone had done something to really upset the teacher. The teacher
confronted the class demanding that the culprit come forward, and the request
was met with a long, tense silence. That tense silence seemed to grip the
entire city of 600,000.
Interviewing in the shadow of violence
Karen from MSF, per usual, took this calmly and in stride. She said something
to the effect of, "I would like us to stay here at the office for an hour or so
until we see what the morning will bring. If at 9, there are still no
problems, we will make sure each car has a radio and get out to work." We went
to work, the tension remained but no fighting broke out. In the hour wait, the
MSF director pulled me aside and said that if MSF is evacuated by air, there
would be a seat on the plane for me, but that Charles would have to stay
behind because he was Congolese, and thus not neutral in this conflict. MSF
policy was that only expatriate personnel from countries not involved in the
conflict could be included in an evacuation of humanitarian personnel. That
was it: I called IRC in Bukavu and said we wanted to get out NOW! Michael said
he would work on it, but if I get the chance to leave on an MSF plane, I should
give all of my cash to Charles and get out. He would be fine, this was his
country. Needless to say, this gave me quite a sick feeling. ... Charles was
the most lovely and trusting of companions and to abandon him ... was a
repulsive thought. On the other hand, he does not stand out (like I do) should
any looting and uncontrolled violence break-out and he had friends and family
in the city to stay with.
When I told Charles of the MSF policy and what Michael had said, his already
demoralized spirit virtually shriveled-up. I suggested that if fighting breaks
out, we ignore the plane option and just take a canoe down the Congo River,
which has a swift current at Kisangani and could carry us 60 kilometers to the
next major town in just 4 or 5 hours. He could not swim and was terrified of
water. This was certainly the least appealing plan he had heard thus far. I
tried to comfort him by telling him that we would have to assume that Michael
would get us a plane, in spite of my knowledge of just how booked that plane
usually was mid-week.
Both teams worked frantically until late that day and completed the last two
days of interviewing in one day. We were finished. Charles and I packed up
from our insecure hotel, where the doors had recently been kicked in and where
staff and soldiers always looked at our sat-phone longingly, and we moved to
the MSF house. This house of four
expatriates graciously allowed us to slip in and feel as safe as was possible,
given the state of Kisangani. On the phone that night, Michael had talked the
Airserve folks into getting us at 1 p.m. the next day. I worked on a draft of
our report until 2 a.m., slept a bit, and started again at 6 a.m., ecstatic and
energized by the fact that I could still not hear any fighting.
By 10 a.m., I had a draft report finished, which later I found to contain a
couple of minor but glaring mistakes. Charles was also energized, less because
the fighting had not begun than because he was getting out of Kisangani. On
that day when the streets were empty and transport was not available, he
managed to find and pay all 10
interviewers by 11 a.m.
As the plane departed, I was feeling a bit like I may have overreacted. There
had been no fighting yet. The U.N. official who jumped on our plane to Goma
assured me that talks had begun and there would not be any violence. MSF was
not ready to call for their plane and they lived here and knew the risks. As I
contemplated my level of cowardice, Charles turned to me and said, "I am so
happy to get out. If any soldier had stopped me
on the street and I spoke, they would know I was from South Kivu and think I
was Mayi-Mayi and ... " He gestured that his throat would be cut.
Suddenly, I felt vindicated. The risks Charles held the day before probably
far out-weighed mine. That evening, fighting broke-out between the Rwandans
and Ugandans, a couple hundred people were killed, almost none of them
soldiers. The MSF office received major damage and a mortar hit
the MSF house causing a minor fire. The MSF folks put out the fire and no one
was hurt. Before it was over, the entire dozen expatriates in the Kisangani
humanitarian community spent 12 days crowded into the MSF Holland house. They
had experienced far more risks than I. Charles had probably experienced more
risk than I. Every Kisangani resident who did not have the option of
scooting-out before the fighting began probably experienced more risks than I.
The risks had been bad, but the question was for whom?
Most of the hazards encountered were a little more mundane than the major
fighting in Kisangani. One of the most acute dangers was Charles on a
motorcycle, a realization I made during the last of our five surveys, in the
port city of Moba. Moba is on Lake Tanganyika, near the southern border with
Zambia. In this dusty fishing town of 15,000, there was only one privately
owned truck, and because the roads were impassable just a few kilometers
outside of the port, the truck was of little use to us. Thus, when Airserve
flew us down in their nine-seat Cessna Caravan, they took out the back seats
and we flew in with two motorbikes.
I had owned and ridden motorcycles when I was in my twenties, but that was 15
years ago. Charles had paid his way through college by venturing into
the interior and buying gold on behalf of a dealer in Bukavu. He was great on a
motorbike. Riding from the airport to the Catholic Mission (whom we imposed
upon for the week) with 60 liters of fuel and all of our baggage, it was nearly
impossible to stay up with Charles. The next couple of days, with a locally
hired interviewer on the back of each bike, we went our separate ways. This was
primarily because a string of villages running 18 kilometers south of Moba
along the lake shore were best reached by canoe, and Charles was not going to
go in a canoe! In the end, the canoes were not operating on the day of our
southern jaunt, so we rode the motorbikes as far as we could and then walked
the last 12 kilometers down and back. When we finally started a major trek to
the west on the third day of interviewing, I and the interviewers were pretty
comfortable on a motorcycle.
The town of Kala was 35 kilometers west of the mission. There reportedly had
been a Mayi-Mayi attack on a village in between the night before. The priests
said that there should not be trouble in the daylight hours but to look at the
military check point after 18 kilometers. If the post was manned, there is no
trouble because as soon as the Mayi-Mayi showed up, the Burundian and RCD
soldiers would always run away. Charles and I decided to ride about 200 meters
apart so that if one of us ran into trouble, the other might be able to escape.
Also, we agreed to move at a steady clip. Charles started out ahead.
This was a bad mistake. About 10 kilometers into the journey we bounced down a
road of cobbles ranging in size from that of softballs to the size of
basketballs. As we crashed down a slope, I looked up to see a bridge ahead, and
that I was too close to Charles. The bridge consisted of a log, 20 feet long,
a foot in diameter with a flat surface planes on the top. At 30 kilometers per
hour, Charles just zipped across it as if he was a circus act. My brain was
not responding properly due to all of the jarring. I meant to brake, I thought
about braking, but for some reason I opened up the throttle.
Suddenly, I was six feet above a rocky riverbed with a 150-pound, trusting
mother of three on the back of this machine which I clearly was not
controlling. I let go of the throttle, the bike lurched forward, and before I
knew what had happened we were across the log. I slammed on the brakes,
thinking of how I had almost killed my interviewer, and stopped to find out if
I was going to throw up or not. Charles stopped up ahead, pulled up his face
shield to reveal a big smile, and gave me thumbs-up. I suddenly realized that
on this journey, Charles was far more likely to kill me than the Mayi-Mayi.
Friendly villagers, jeering soldiers
Kala turned out to be the most depressing place we visited. Like everywhere
else, the people were lovely and trusting. (Over our five surveys which
included more than 1,000 households, barely half a dozen refused to answer our
questions.) But, the military were paranoid and drunk, a common and bad
combination. We could see the entire town as we reached the edge. We started
our routine of quickly guessing the dimensions of the village, chose four pairs
of random numbers to correspond to the four cluster locations we needed to
visit in Kala. It often took us longer to explain to the local officials or
military why we were in their village than it did for an interviewer to visit
five households. Thus, we dropped each of the interviewers at a different
cluster location and then went to visit the military commander.
It was 10 a.m., and a large fraction of the soldiers in Kala were drunk. As we
rode up, dozens of the soldiers cheered and jeered at the sight of a white guy
on a motorbike. The commander was found after what seemed an eternity, but was
probably two minutes, and he invited us into his hut. It was a mud brick
structure with a thatched roof and a floor which was dug down about two feet
below grade. There must have been 50 of the rockets which are used in mortars
spread around on the floor. One of the drunk soldiers who wandered in behind us
kicked one of the rockets, which gave a bonk as it hit another. I clenched, but
none of the 10 other people in this shack seemed to notice. We showed him our
permission letters, our questionnaire, and went through the usual routine. He
wanted to know half-heartedly if we could spare any money. We laughed that one
off. In the end, he said we could work but that we must take his Captain with
us for our protection. Onto the back of my bike the 5'6", 250-pound Captain
went, and off we drove.
The interviewers had finished with the first two clusters so we moved on to the
next spot and I applied myself to entertaining the Captain so that the
interviewers could work without a soldier making the interviewees nervous. The
Captain's name was Roberto. My last name, Roberts, seemed to him to have an
uncanny similarity. He was drunk out of his mind. He kept saying, "Roberto,
Roberts. Roberts, Roberto." I gave him my card; he kept kissing it. Between my
bad French and his intoxication, our conversation stayed at a pretty basic
level for about an hour until he mentioned that he had a 10-year-old son in
school in France. This short, fat, former soldier in Mobutu's army did not
conjure up an image of the proud parent at the graduation ceremony of a French
boarding school. I said, "Isn't that expensive? How do you pay for this?" He
said that it was not a problem, that he had lots of diamonds, and he puts his
money in a bank account and it is transferred to the school directly.
I was dumb-founded. He was so drunk, and clearly being very honest. For all of
the moments of fear on a motorbike and trepidation at check points, Roberto's
revelation was one of the worst moments I had experienced. I knew that all of
the civilians complained that the RCD forces would never engage the Interahamwe
and Mayi-Mayi even when they knew where they were. I knew that the foreign
soldiers were looting Congo's natural resources. Yet, only when I looked at
Roberto's drunk, happy face did I realize how disastrous an end to this war
would be for so many of these mid-level soldiers. He could never support a
child in France and a wife in Kinshasa on a soldier's salary.
I recently read a book called "King Leopold's Ghost" about the Belgian rape of
the Congo. In it, the author describes how the pursuit of ivory and rubber led
to inconceivable abuse of the civilian population, in some large areas causing
a dramatic de-population. In Moba, history is repeating itself. The commodities
are now diamonds and gold, the invaders are now Africans, but the result is
much the same.