Congo Kinshasa: Worms

We spent our evenings playing Canasta – it’s a card game, played in pairs, and we were four.

Fr. Kees de Lange, Fr. Ben Jorna, Brother Gerritt Gerrittson, and myself. The year was 1993, and I was working with Mill Hill Missionaries in Zaire (now called the Democratic Republic of Congo).

After a day’s work and our evening meal, we would sit for a couple of hours, until around a quarter past 9 in the evening playing cards, chatting and enjoying a glass of beer.

Drinking coffee at the table where we played cards. [(l - r) Gerritt, Kees, me- Ben is taking the photo] 

We played cards Monday, Wednesday and Friday evenings, as well as Tuesdays and Thursdays – oh, and at the weekend, too! In fact, every evening.

We sat outside on our veranda at a stout octagonal table, each player sitting opposite his partner. I played with Ben; Kees played with Gerritt – every night. Fr. Kees kept the score and measured out the beer – one bottle for three people, twice during the evening. Ben didn’t drink.

With the sound of crickets chirping from the dark, moon-lit cow-pastures in front of our house, sprinkled with the star-like flashes of fireflies settled on the grass, and the occasional deep “Rivvit!” from a few frogs, warning us of rain, we each took our turn. The days events would be commented on, then the next person would play their hand, a little sip of coolish beer, and the next person would lay down another ‘trick’ … and so on. 

The weekend games were special. Two or three times each year, Fr. Kees received a several metal oil-drums, welded shut to protect their contents. They were from a Dutch couple known as Oma and Opa – Grandma and Grandpa. Oma and Opa filled the barrels with clothes; the clothes could then be sold to add a little cash to the parish’s coffers – and had the added advantage of bringing good quality clothes for the local population in the village of Baringa. Kees also oversaw the maintenance of our three cow-pastures , which tended to get overgrown by a creeping weed. The teenage girls he invited to tease out the weeds were paid with a smart new outfit – a nice top, a skirt and a belt, or whatever the choice was each time.

Inside each barrel, hidden within the clothes we would also find some hidden treasure. Packet soup was a little taste of Europe, but the real gem would be a bottle of whiskey! It varied each time: Johnny Walker, Balantyne’s, Clarke’s, or Jack Daniels. Occasionally, it rendered only Dutch gin – but seeing as the other three were all Dutch, I had to accept it.

So, one Saturday evening, we sat there – each taking our turn, each making a comment or two, and each taking a sip of our beer and then a sip of our whiskey. A peaceful evening after a tiring day.

I started to drift into a dream. I didn’t feel as though I was really there. I felt heavy, nauseous. The cards were laid, each taking his turn. “Surely, at least one of them can see that I’m ill,” I thought. I made an effort and took my turn. Then I sipped my whiskey. I started to take deeper breaths. I felt like I would faint. 

Suddenly, I jumped up from my seat – I was going to be sick! My room, which was right next to us, didn’t have a toilet, so I had to run from the front of the house and around the side of it, to a separate building behind, which housed two toilets and a shower. 

As I made the final approach, I realised I was too late. With a slide tackle on the grass, I tried to yank down my trousers – but a little too late as I exploded at both ends. I lay in a pool of diarrhoea and vomit as a fresh evening breeze wafted over me. Rivvit – said the frog. Stangely enough, I felt a lot better. 

I hurried myself into the bare concrete shower room and washed away the evidence, as gheckos scrurried up the wall. In the pitch black of the African night, I timidly walked, naked, back to my room, holding my clothes in front of me, for modesty. I emerged as quickly as I could, now wearing clean clothes, and resumed my place at the card table.

Nobody seemed concerned. Nobody said anything. The game continued. 

Eventually, Fr. Kees, poker faced, said, “Ah, you weren’t here for your turn, so Brother Gerritt took it for you. But now it’s your turn again.” I took my turn, and then Kees took his. “but we noticed that perhaps the whiskey didn’t agree with you, so I’ve moved your glass over to Brother Gerritt,” he continued. I noticed Gerritt had two whisky tumblers next to him. Gerritt raised his eye-brows briefly and gave a little smile.

My turn came round again and Kees said, “Perhaps tomorrow you should go down to the hospital with a sample and get checked out.” I agreed – there was certainly something wrong.

After the game, we each retired for the evening and the generator was turned off.

The next morning, after breakfast, I walked the 2 km into Baringa village, to the hospital, and gave them my precious sample. The hospital is a pretty basic building, but in the reception area was someone with a large microscope. After sitting for a while they half carried a young man in and propped him up facing the wall. They then proceeded to do a lumbar-puncture on him. As he writhed around in agony, the man with the microscope started to beckon people towards him. One by one, they took turns to look into the microscope and then to stare at me. “Oh, no,” I thought, “I’ve got some terrible tropical disease and I’ll going to die!” The man with the microscope knocked on an office door. Our recently arrived, Congolese doctor came out and they exchanged a few hushed words. The doctor turned to me and smiled. 

“Don’t worry, Francis,” he said, “it’s only worms. You’ll take some pills and it’ll soon be gone.”

“But why did everyone take such an interest?” I asked.

“They were amazed that the white man can suffer from something we get all the time,” he laughed. “But, actually, they only saw a very few eggs. Your infestation is very light, but because you’ve never had worms before, you had a strong reaction. That’s good, because when your body gets used to these parasites – and you don’t react anymore – that’s when it can kill you, through shock.”

The worms are called ascaris. Ascaris looks like spaghetti and can grow to 35 cm. If you have one worm in your intestines, it’ll lay 50,000 microscopic eggs each day. The eggs then move through your intestine wall and enter your blood supply. They whizz around your body through your veins and emerge in your lungs. Causing a slight irritation, your lungs produce some mucus, which causes you to cough a little, but persistently, until the mucus is in your throat. This contains thousands of eggs. Then you swallow them and they hatch into new, spaghetti-like worms. Your dinner becomes their dinner (it seems they don’t like whiskey!) Each day, each of the new worms will produce 50,000 eggs … and the process will repeat, until you are completely packed with worms. This causes a blockage in your intestines. You go into shock, resulting in death.

The treatment is very simple. A single dose treatment in a chewable, orange flavoured tablet will kill ascaris within minutes. It’s advisable to take the treatment over three days to include all the different types of worms that could cause such an infection. To make sure there are no active eggs left, it’s a good idea to take the pill again after a couple of weeks.

Ascaris in all its glory!
Photo: James Gathany/CDC