UN Chronicle: Issue 2, 2001: The Ebola Virus ...

went down, everything changed.

We then realized the chaos could come even to our door. This is not to say that we had no concern, no fear, prior to Dr. Matthew's death. Every day, the slightest hint of a headache or fever would cause health care workers and citizens alike to seek us out. "Doctor, I think you better test me", they would request, sticking out an arm as if I had a needle and syringe ready. Nor were we immune to these fears. Most of us, expert or not, would have to admit to days when sweating in a plastic wrap of protective gowns, gloves, aprons, masks and goggles, we wondered if it was just particularly hot that day or maybe we were especially tired, or was this the first day of a fever? One usually kept his mind from thinking too seriously, too far ahead. But that, again, was before Dr. Matthew.

Guinea Institute for Research and Applied Biology (IRBAG) in Kindia, Guinea.

An Ebola outbreak in a community causes complete upheaval to virtually all facets of society. It is an event that divides time into a "before" and an "after". After, whether you personally were infected or not, nothing can ever again be the same-no person is left unaffected, no emotion unturned. The individual agony of those stricken with Ebola is readily apparent, but the losses run much deeper. Scared neighbours, sometimes even family members, refuse to let convalescent patients back into their homes, sometimes burning their belongings or their entire hut. Deep-rooted African customs regarding burial of the dead are disrupted. Traditional funerals, which often entail ritual washing and touching of the corpse, are suddenly forbidden. Reactions are mixed. Initially, family members may resist the change.

In the West African country of Guinea, researchers mill about the worn walls of the Guinean Institute for Research and Applied Biology, known by its French acronym of IRBAG. Most people still call it by its old colonial name, "Pastoria", belying its beginnings as one of the many Pasteur institutes the French peppered around the globe. Pastoria tells a familiar story of colonial powers that come and go, bringing with them, for a time, scientific technologies that would seem to benefit the populace. Under the French, Pastoria was a top-notch facility engaged in a wide array of research disciplines, studying malaria and sleeping sickness, producing snake anti-venoms and the Yellow Fever vaccine, even studying primate behaviour in semi-natural habitats. But with Guinean independence in 1958 came the equally independent spirit of President Sekou Touré, breaking definitively and acrimoniously with the French. Charles DeGaulle returned in kind, suspending support and dismantling infrastructure virtually overnight. Pastoria, left to fend for itself in a poor nation, fell into disrepair and virtual disuse.

During the cold war, Guinea leaned toward the Soviets, who rejuvenated the Institute. At its height in the mid-1980s, Soviet researchers and their families at the Institute numbered over 70 people. Buildings were erected, equipment imported, studies put in place. Scores of Guineans were sent to train in the Soviet Union or Cuba. Even today, two former classmates will chance across each other in a small Guinean village, breaking into Russian, laughing about the snow, about the challenges they faced as black Africans in the white world of Soviet Russia.

But what they rarely have occasion to do is discuss research collaborations. The fall of the Soviet Empire again brought a precipitous withdrawal of a superpower from Guinea, again leaving Pastoria on its own. Most days now, you find researchers waiting to see what comes next, suspended in history, educated ghosts haunting the old offices and laboratories, one sign on a door in Pasteur-era French, another in dusty Cyrillic lettering, complete with hammer and sickle. They can still recount the scientific details of their disciplines and research, but most often the story ends with the fall of the Berlin Wall. Nor is the story of Pastoria necessarily an unusual one. Across the continent, there are laboratories and programmes started in good faith, now the domain of historians.

But like the proverbial phoenix, IRBAG is again showing signs of life. In 1996, the Institute and CDC started the Guinea Lassa Fever Research Project to study viral haemorrhagic fevers in that country. Unlike the old colonial days, the Project represents more of a collaboration between equal partners. CDC provides most of the infrastructure support, but most of the scientific work is undertaken by West Africans. IRBAG has been seeking other similar collaborations to bring the research back to the level of the old days, yet this time as a partner, not a subordinate.

Later, as the destruction wears on, fear takes over. Working on the ward, I would have letters handed to me, such as the one that stated: "Our brother reported sick this a.m., but passed away before being brought to hospital from unknown sickness which started only last night. People have run away from home. Let the burial team come collect the body and bury." Burials, traditionally done around the home, now take place in graves designated for those with Ebola, a life turned into a white plastic body bag, in seven days time.

Augustine Goba at the IRBAG/CDC Lassa Fever Research Station in N Zerekore, Guinea.

Back in Atlanta, the Ebola outbreak behind me, I readopt the plans I had when I left, catching up on work, sleep and exercise. But for me too, Gulu represents a before and an after. I slowly try to make some room in my brain, amidst data to be analyzed and phone calls to return, to understand what it all means to me. It's a slow process that can come to you only at an angle, like how you can see a faint star only by looking out of the corner of your eye. The image in my eye has not yet completely formed, but I think it's mostly a simple but graphic reminder of our mortality, a timeless message about the fleetingness of life, a nudge to call your family more often.

Paradoxically, more pragmatic questions are often more difficult to

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