In Bukavu, the capital of South Kivu in the Democratic Republic of Congo (DRC), everyone knows Kamituga, 160 kilometers away, on the edge of the great equatorial forest. This is where students become diggers in order to pay their school fees, where former child soldiers try to retrain or where young girls offer to wash stones in the hope of finding gold flakes.
In 1923, the Minière des Grands Lacs (MGL) was founded by Belgian investors, including Baron Empain, a close friend of Belgian King Leopold II. The company, which would later be called Sominki (Société minière du Kivu), hired workers from all over the region. The European engineers lived on the hill, in villas surrounded by wire fences, while the employees and underground miners living in carefully demarcated perimeters called themselves “sawa sawa” (“same as whites”) and sent their children to school so that they would one day become “evolutés”…
Who remembers this industrious past, this relative prosperity due to gold and tin? In the mid-1990s, as the Mobutu regime was ending, Sominki retreated to its headquarters in Mwenga (still in South Kivu). The rebels of the Alliance of Democratic Forces for Liberation (AFDL) led by Laurent-Désiré Kabila on their way to Kinshasa passed through the site, which was looted. Some of the equipment was transferred to neighboring Rwanda, which had begun its reconstruction after the 1994 Tutsi genocide. The Canadian company Banro bought what was left of Sominki and mechanised the exploitation of many sites, digging ever deeper into the red earth of the hills.
Informal and organized system
In Kamituga, however, the diggers continued to dig tunnels by hand, shoring them up with makeshift means, defying the risk of landslides. The Congolese workers had been joined by many Rwandan Hutu refugees who, after the 1994 genocide, were afraid to return to their country. They in turn settled in Kamituga to try their luck. Over time, having secured the protection or complicity of the military, groups of armed men took control of certain sites. In exchange for financial contributions, they granted access cards, controlled production and imposed taxes on the miners. Riding small Chinese motorcycles, purchased for less than $1,000, young men took charge of transporting the production to neighbouring countries.
Despite the investments made by Banro, the Kamituga site has completely shifted to a system that is both informal and highly organized: teams of diggers enter the tunnels, women wash the stones in the river and spot golden sparkles, children carry the baskets, and “sex workers,” or “free women,” offer their services, helping the men spend the little money they have earned. Other women, called “Twangaise mothers,” pulverize the stones all day long and sift the dust where glitter shines.
In this small world, there are bars that are called “ambiance à gogo”, stalls selling goat skewers, huts that welcome couples in a hurry to get married. Kamituga is a summary of the entire region: traders come from Bukavu and compete with the bikers; the diggers come from all the neighboring countries, Rwanda, Burundi and even Tanzania; some “free women” have come up from the shores of the Indian Ocean; and a few multi-storey buildings have appeared in this Congolese far west.
The end of the smallpox vaccine
Around Kamituga, the natural environment has been seriously devastated: the hills are dug with poorly shored tunnels, the springs and watercourses are polluted by the mercury used to produce gold, the Kahuzi-Biega natural park, which is home to lowland gorillas, is haunted by poachers and armed groups.
As early as the 1970s, epidemiologists had identified sporadic cases of monkeypox transmission to humans in neighboring regions of the Central African Republic, and in 2023, the first cases were discovered in South Kivu, mainly affecting “sex workers.” An epidemiologist at the University of Lubumbashi and trained at the Pasteur Institute in France, Dr. Ekwalanga points out that the decline in herd immunity is due to the suppression of the smallpox vaccine in the 1970s, when the scourge was considered defeated: “The vacated ecological niche was then filled by another pathogen while other factors such as malnutrition and lack of hygiene reduced herd immunity. The cross-protection provided by the smallpox vaccine was gone.”
Dr. Mamadou Kaba Barry, who coordinates the activities of the NGO Médecins du Monde (MDM) from Bukavu, remembers that in March 2024 he warned the National Institute for Biomedical Research of the appearance of what looked like a new epidemic:
It was a zoonosis, the transmission to humans of a disease that until then only affected monkeys. In other parts of the country, such as the Equateur province near the Central African Republic, the consumption of bushmeat contributed to the transmission of what was called “clade 1a” (a mutation of monkeypox). Here in Kamituga, in the mining areas, prostitution remains the primary cause of contamination. In March, when 350 sex workers were affected by what was called “clade 1b,” we began community outreach. We reached 70,000 people, including 36,500 women, 350 of whom were prostitutes. Sounding the alarm, we tried to share our statistical data. For three and a half months, we received very little help. A local NGO, Alima, did what it could with American funding, but we lost the race against time.
Cities hit by the epidemic
The epidemic spread without hindrance, the doctor continues: “Of the 34 health zones in the region, 29 are affected by the scourge, which has spread far beyond the perimeter of Kamituga. The “hot spot”, the main contamination zone, is now Miti Murhesa, near Bukavu, where the hospital is overwhelmed. Nine children have died in one month. The scourge has also reached the cities, spreading to the most populated and poorest neighborhoods of Bukavu, Kadutu, Ibanda, where for years populations driven out of the forest by armed groups have been flocking.”
Present throughout South Kivu, Médecins du Monde teams have noted that the epidemic, declared an international public health emergency by the World Health Organization (WHO) in August, is now approaching the borders of the DR Congo. From the site of Kamanyola, where the future Marshal Mobutu won a memorable victory over rebels in 19641on the other bank of the Ruzizi River, we can see the tin roofs of the first Rwandan villages. Further south, 500 cases have been counted in the town of Uvira, neighboring Burundi.
The war is not helping matters: all along the Great Lakes chain, from Lake Albert to Lake Tanganyika, and more particularly on the Congolese shores of Lake Kivu, populations are on the move, and humanitarian agencies cite the figure of 3 million displaced people: from North Kivu where the M23 rebel movement, supported by Rwanda, is constantly expanding its territory, the displaced are retreating south and camping on the shores of Lake Kivu, in Minova or Kalehe. Others, leaving Goma, are heading towards what is called the “Great North”, the very commercial city of Butembo, neighbouring Uganda, or are taking refuge in the green hills of Masisi. The risks of contamination are thus spreading to the Ugandan border.
Covid barrier gestures forgotten
The gold trade is accelerating the epidemic: from Kamituga or other mining sites, motorcyclists transport the precious ore to Burundi or Tanzania and promote the circulation of the virus. Doctors are also worried about the start of the school year, because mpox, another name for monkeypox, attacks the weakest, especially children under 15, who in turn contaminate adults.
MDM coordinates its interventions with the authorities of South Kivu but notes that “There are many aggravating factors: malnutrition, anorexia (loss of appetite), mouth sores, lack of hygiene”explains Dr. Barry. He remembers that, “A few years ago, faced with the Covid epidemic, the population had understood the importance of barrier gestures: handshakes and effusions had disappeared, people had gotten into the habit of washing their hands and basins of clean water were circulating everywhere.” “These good reflexes no longer exist, regrets the doctor, Community relays are weakened, prevention has declined.
So far, the disease is not yet fatal, but it could get worse because the virus is mutating and becoming more virulent, no longer limited to spots, fever and general fatigue. In Kinshasa, the first 200,000 vaccines sent by the European Union and produced in Denmark have just arrived and are due to be sent back to the contaminated areas. But is it reasonable to want mass vaccination? Medical circles do not hide their skepticism: “In the city it would be possible, but in the countryside, how can we transport vaccines while preserving the cold chain? We even lack freezers…”deplores Dr. Barry. There remain the basic gestures, which have proven their worth against Covid: washing your hands with soap and avoiding direct contact.
