This week, Ndakasi was on my list for a follow-up health check. All reports were that the orphaned mountain gorilla had been doing well, taking a full bottle at each feeding and steadily gaining weight. According to Eddy, her primary vet, she'd even begun to resist her daily physical exams — a great sign that she was getting stronger..

It was hard for me to imagine her as a feisty little gorilla. The first time I met her she was very ill and weak. The second time, she was just barely able to take her bottle and needed oxygen around the clock.

I was excited during my drive to Goma and looking forward to seeing Ndakasi feeling well rather than at death's door. We'd set up an intensive-care-style schedule of health checks and Eddy had been sending us the results of her physical exams. But those were reports on paper. Today was my chance to see her recovery for myself and there were a few things I wanted to check carefully.

My main goal was to get a follow-up blood sample. It had been three-and-a-half weeks since we first diagnosed Ndakasi's pneumonia. I'd gotten a tiny amount of blood then and saved it; by taking a second sample now, I'd have what we'd need to run paired titers. This special set of lab tests might ultimately reveal which virus or other microorganism had caused the baby's illness.

She had been anemic last time I visited and I hoped we'd see her red blood cell numbers go up today. I also had concerns about her body weight -- at about nine pounds, she's small for a four-month-old mountain gorilla. She had been drinking full-strength formula for only a week before she became ill, and was underweight even then. It takes a lot of calories for a healthy infant, let alone a sick one, to maintain its body temperature, and her metabolic rate had probably doubled during the illness. This is one baby who can't afford to get sick again any time soon.

The weather made me worry about Ndakasi's hydration. It's very dry in Goma — the town is at a lower altitude than the Virungas —and now it's the dry season. Instead of a wet and misty drive, my trip to the Rwanda/DRC border was dusty. The difference was striking, almost as if I'd gone to a different country. My hair is always a good measure of humidity. Curly in the wet season, it's now almost straight. Instead of slightly frizzy, moderately short hair, I have long straight hair that keeps falling in my face.

Infants lose body fluids as easily as they burn calories. The humidified air produced by the oxygenator machine and the nebulizer definitely helped Ndakasi stay hydrated. But she wouldn't tolerate the treatment anymore. She'd learned quickly how to push the hosing away from her face with her tiny hands, diverting the moist vapor. Now that we'd gotten her through the illness, my sense was that her entire system would be better off in a natural environment. I thought I'd suggest to Eddy that he attempt the homemade eucalyptus leaf humidifier therapy only once in a while.

Lastly, I wanted to be certain that the variable blood oxygen level readings Eddy was recording were due to the baby's movements (the sensor doesn't work well with any type of motion) and not residual problems with her lungs.

Eddy had reported that Ndakasi wouldn't hold still for anything these days. It was taking him as long as 30 minutes just to complete a single "TPR" (temperature, pulse and respiration) without stressing her. When the gorilla was weak, she allowed Eddy to do these brief exams in just a few minutes. He could wrap the pulse oximeter sensor around her thumb and she’d ignore it; now she pulled it right off.

I hardly recognized Ndakasi when I walked into the room. She was bright-eyed and she'd grown noticeably since my last visit. I think Andres (one of her caretakers) could tell I was smiling, though my mask hid most of my face. Like all baby animals, she gazed back at me with an endearing expression.

The calm didn't last long, however. Ndakasi wanted nothing to do with my stethoscope or the oximeter — just as Eddy had reported. When it was time for the blood sample, she let me know exactly how well she was feeling: she squeaked, chirped, struggled and even tried to bite Andres! She was such a strong, moving target that it took me three sticks to get the complete sample.

She recovered quickly once back in Andres' arms, though she may very well remember me next time as the not-very-nice white ape with the needle.

Back in the lab, we found that her anemia had resolved. Now we just needed to get permits from the various governments to send mountain gorilla blood samples out for analysis. That's a whole separate project, but it could add valuable information to what we know about respiratory illnesses in mountain gorillas. At least we can take Ndakasi off the active patient list.

Sadly, I've just learned that there's been a tragic incident in the DRC like the one that orphaned Ndakasi. Wild mountain gorillas have again been shot to death and at least one infant left motherless — Ndakasi now has company.

To be continued. . .

Mission Giraffe
July 19, 2007

I came to live in Central Africa because of the wild mountain gorillas. But they aren't the only animals that need health care around here.

When it comes to wildlife medicine, we (MGVP) are the major resource in Rwanda and the adjacent areas of Uganda and the DRC. There are district veterinarians who take care of farm animals, a handful of small-animal veterinarians who work in the cities and a few government-salaried vets, but overall, we're the only professionals in the region whose job it is to look after sick or injured wild animals. So we do what can when we're not in the field with the gorillas.

In the past six months, we've treated or collected samples from a variety of species: a chimp with meningitis, a baboon with a snare injury, two golden monkeys caught by farmers for stealing potatoes, a half-dozen parrots, numerous wild forest buffalo (several of which were killed by the local community for meat), and several dozen dogs whose owners requested a spay or neuter. I even paid a call to check on a downed cow belonging to the chief park warden of the Parc Nationaux des Volcans in Rwanda. Just as I was deciding she must be suffering from low calcium or magnesium, the district vet appeared and administered the treatment for both problems. She was up in an hour.

So when my cell phone rang the other day about a new non-gorilla problem, I took a deep breath. Luckily, we had no active wild gorilla patients because this case was going to be a big one — a giraffe with a snare around its leg in Rwanda's southernmost park, Akagera, a four-hour drive from here.

The park system vet, Dr. Tony Mudakikwa, was calling to ask if I had a particular type of anesthetic and if so, could he get a supply from me? My answer was no, but I had something similar. I wanted to help, but reminded him — and myself — that giraffe anesthesia is very risky and should be attempted only if absolutely necessary. I'd have to call or e-mail for advice from my zoo and wildlife vet friends about the dosage. Meanwhile, could he find out more about the giraffe, or maybe even go see it?

I'd anesthetized several giraffes in a zoo setting years earlier and knew how difficult it was to do this procedure safely — for the people and the animal. But I also felt we should try if the problem was confirmed and there were no other options, like flying in experts from South Africa who do this sort of thing routinely. I called each of our field vets and our director, Mike. All agreed: we should help and we’d work together as a team.

The subject line in my e-mail query read, "It's a giraffe with a snare, not a gorilla!" I figured they might wonder why I was asking them about giraffe anesthesia when they know I work in the mountains and not the savanna. The word "snare" would explain. This is an awful injury no matter what the species — all the more distressing to a vet because it's caused by human hunters.

Two days later, armed with expert advice and all of the equipment we could think of to bring, our entire MGVP field vet team gathered in Ruhengeri at 4 a.m. — myself, David, Jacques and Eddy from the DRC, Benard from Uganda and Jean Felix from Rwanda. We picked up Tony, the park system vet, in Kigali — he hadn't yet managed to get to the park to see the patient — and arrived at Akagera National Park by 7:45 a.m.

Akagera's warden, Robert, and one of the lead rangers, Roger, were happy to see us. They explained that the giraffe, a nearly full-grown male, had become unable to keep up with the herd. Worse, he was so lame that he was barely eating and hadn't found his way down to the watering hole in days. We set off to take a look at him, driving into the park and then following him on foot. Tony felt this would be best, though I'd never gotten close to any hoofed animal without remaining hidden in a vehicle. We scrambled through the thorny acacia, but could get no more than a distant glimpse of our patient.

We switched back to the truck. An hour later, after driving slowly through the bush with the thorns screeching against the metal sides of the car, we finally got a good look at the giraffe and were able to take pictures. The young bull had a dark wound encircling his lower left front leg above the hoof and the entire leg was swollen to twice its normal size.

He also looked thin. The problem was not new, we learned; nor were we sure we were seeing a snare. If we decided to try anesthesia, the difficulties would be even greater than I'd envisioned. Darting alone would be a challenge, since this was not open savanna. I urged Tony to call the South African experts. Two hours later we heard that they couldn't get to Rwanda any time soon.

I thought to myself, "Do I do this?" It's true that I'm the only one in all of Rwanda who knows how to anesthetize a giraffe; on the other hand, since I've never worked on a wild giraffe, some of the experience will be new to me, too. The recommended anesthesia involves a three-drug combination that has only been recently studied in this species. Plus, these anesthetics are dangerous to handle and our team members will be speaking different languages — English, French and Kinyarwanda. But if we don't act, the giraffe will continue to suffer — veterinarians take an oath to help animals in need.

I decided the right thing to do was try. But by then, the day was mostly gone; we'd have to stay the night and make the attempt first thing in the morning.

We (MGVP) quickly helped set up a team and moved the infant to a house rented by the Dian Fossey Gorilla Fund International. Simon Childs, who works for that organization and coordinates our orphan facility in Rwanda, spent several days in Goma with the new orphan getting things organized; Andres, one of the ICCN park rangers, agreed to be the baby’s primary caretaker. As part of this cooperative effort, we took on the role of health care.

Everything went well at the start. The little gorilla immediately took to the bottle. But two days ago, she developed respiratory problems. By the next morning, she'd become too weak to drink her milk.

Ironically, Simon, along with most of the MGVP staff, was due in Kigali (Rwanda) for a long-planned meeting about creating homes for orphaned animals just like this infant. Instead of leaving for the meeting, one of our DRC-based vets, Dr. Eddy Kambale, stayed with the baby gorilla while the other, Dr. Jacques Iyanya, drove to our main office in Ruhengeri (an hour-and-a-half drive) to pick up medical supplies. He turned right around and headed back to Goma with our regional field vet, Dr. David Gardner-Roberts.

The gorilla was so small — only about 18 inches long and weighing five-and-a-half pounds. I didn't have much hope that she would survive, no matter what we did. If the infant had aspirated milk into her windpipe, she would die quickly of bacterial pneumonia.

The baby was given antibiotics and started on regular subcutaneous fluid therapy. Eddy also started her on a simple form of nebulization using a pot of steaming water infused with eucalyptus leaves. The vapor seemed to calm her. He planned to monitor her vital signs all night. Still in Ruhengeri, I searched the Internet for treatment options for infant pneumonia. The others went on to Kigali.

If she had a bacterial infection, I thought, she should have a fever by now. But she didn't. I began to think her problem was viral pneumonia, a severe respiratory infection not unlike the one that had killed Mugeni's baby (see Big Gorilla, Big Cough, Tracking a Patient).

Simon and David hurried back from Kigali, confessing that they'd been too concerned about the new orphan to get much out of the meeting. We left for Goma early the next morning, crossing the border from Rwanda to the DRC by 7:30 a.m. The tiny gorilla's condition was worse than I'd imagined. I could not hear any air moving through her lungs, only squeaks and pops in my stethoscope as she struggled to breathe. Her gums were pale gray, her mouth half-open, her body limp.

Curious about the nebulization, I watched as Andres, cuddling the gorilla, pulled a heavy blanket up and over his head to create a tent. I stuck my head underneath as well. The baby lay quietly in the darkness. The strong eucalyptus vapor indeed felt calming.

Before we left for Goma, I'd thought a lot about this tiny patient. Oxygen therapy might be her only chance. The first thing to do was check her blood-oxygen saturation. If it was low, we could try flowing fresh oxygen gas by her nose.

I attached an oxygen monitor using a sensor designed for human infants. It fit the baby's tiny thumb perfectly. At first, I couldn’t believe the numbers. Normal blood oxygen saturation is between 95 percent and 100 percent. The monitor read 40 percent to 50 percent. She shouldn't be alive. We opened up our emergency oxygen tank, placed the hose by her nose and turned the flow up to two liters per minute.

. Within a few minutes, the monitor numbers increased: 75 percent, 80 percent and eventually 98 percent. The gorilla began to open her eyes and weakly move her head. She pursed her lips and yawned. Her gum color had turned from gray to pale pink. She made a tiny squeak. We discussed improvising an oxygen chamber for her, like the incubators used for human babies with breathing troubles. Maybe she could regain her strength enough to take in some milk and a few calories.

While David set up a second oxygen tank, Simon found a picnic-sized cooler and put a hot water bottle in the bottom and a foam pillow on top to make a bed for the gorilla. Andres placed the infant inside, laying her on her back. We ran the tubing from the oxygen tank into the cooler and made a cover using plastic wrap. We left the area over her head open to allow for fresh air.

Just as the monitor showed a stable set of readings, we realized that the second tank would soon run out and the third tank was empty, too. Evidently, the tank-filling machine in Kigali had broken down the last time someone tried to replenish the oxygen. David and Eddy grabbed the empty tanks and ran out the door. Maybe they could get them refilled in Goma.

We ran out of oxygen soon after they left. I watched the baby's numbers drop back down into the 50s. Her eyes rolled back into her head. A wave of horror hit me. Was I was going to sit here and watch this special creature die because we had no oxygen?

Twenty minutes later, David and Eddy returned — there was no oxygen in Goma, either. That didn't sound right to me. I told them to try again, somewhere else. The DRC is a big place; there are hospitals here. Back they went. When an animal's life is at stake, I don't take no for an answer.

Somehow the baby continued to hang on. Hypoxemia, a long period of time with low oxygen, can damage the internal organs and brain. Even if we saved her lungs, she might not be all there mentally or she could lose kidney function.

Then David called with exciting news. The DRC United Nations (MONUC) military doctors were offering their help: oxygen, an oxygen machine, a proper nebulizer and their own expertise.

Forty-five minutes later, two Indian doctors arrived with supplies — not only a tank of oxygen, but also an oxygenator machine. We set up the tank first. Within minutes on pure oxygen, the little gorilla's gums were pink once more. But the doctors explained that they receive only a dozen oxygen tanks every three months for the entire DRC; it would best if we could get the oxygenator machine running soon.

Just then, the power went off. David, Eddy and Simon dashed off again, this time to set up the generator. The generous doctors left, too, to find a special cable. While they were gone, the MONUC tank ran out of oxygen, though it had been in use for only about 20 minutes. I got back on the phone, calling and sending texts. Where was everyone? Was there another tank? An ambulance arrived with a new one minutes later. The gorilla pinked up again; she squeezed my fingers. Ugh — what a roller coaster of a day.

Was it wrong to be using a precious supply of oxygen on a mountain gorilla? I didn't know. I only knew we'd found a way to give this little one a chance to live, and I wasn't going to lose it.

To be continued . . .

Today, I went up to the forest to do a routine health check on the Cantsbee group of gorillas. I hadn't seen this big family in many weeks and was looking forward to the visit. With 30 or so animals to observe, I'd come prepared to take my time with the trackers, see each gorilla and maybe even work on my nose print recognition. It didn't quite turn out that way.

Cantsbee, the No. 1 silverback, and his family have a colorful recent history. This group is actually a subset of the 60-plus member Pablo group. When I first arrived in Rwanda, everyone predicted something had to change: Pablo had far too many gorillas. They were right.

Last fall, a respiratory outbreak hit Pablo group. Several animals became very ill, an infant died and another newborn was killed by Cantsbee (probably not his). For unknown reasons, the group moved west into the Democratic Republic of Congo, where they encountered poachers.

.The poacher scare splintered the family for several days. Three infants were separated from their mothers and two of them died before the group reunited. Then there were fights among several lone silverbacks and two young silverbacks left the group. A few months later, the No. 2 silverback disappeared and was later found dying of pneumonia. (We couldn't save him.)

The big family, reduced by seven, moved into the far corner of its range on Visoke Mountain at very high altitude and in steep terrain. It seemed that Pablo himself, an older silverback and no longer No. 1 chose to separate from the main group. He began to lag behind with "his" half-dozen females and their infants — or rather, they stayed with him.

Then several other adult females left to join a lone silverback, Bwenge, who now leads a group of nine. It's interesting that the Pablo group females who left for Bwenge were all mothers who'd lost their infants last fall; maybe they no longer felt safe.

Cantsbee held his own, but although he continued to lead the bulk of the group, he seemed nervous without the protection of multiple silverbacks.

Pablo group is one of three under study by the staff of the Karisoke Research Center, the legacy of Dian Fossey. Though the gorillas belong to Rwanda and remain the responsibility of the government and the Office Rwandais Du Tourisme Et Des Parcs Nationaux (ORTPN), the Karisoke trackers and scientists do the day-to-day tracking and monitoring. Typically, they observe the research groups for four or five days a week, staying with them for several hours at a time.

When the Pablo group dispersed in dangerous and distant terrain, even the scientists stopped their visits. The Karisoke trackers were with the gorillas on most days, however, so their location and overall health status was being monitored as usual. But until access to the scattered members of the group improved, we'd put our regular vet checks on hold, visiting only when there was a reported problem. The last time I'd been in Pablo group, weeks ago, it was to treat another dying animal — an old female named Puck — who had cancer.

Today's trek up to the section of the park boundary nearest the group's location was a difficult one — and high, up to 10,500 feet. Thankfully, the Karisoke team moderated their pace on my behalf. Once we reached the stone boundary wall, the soldiers, porter and all but one tracker stayed outside. Obviously the gorillas were close.

A military escort is standard any time we enter the park, but the soldiers must maintain at least a 400-foot distance from the gorillas.

Sure enough, instead of having to hike for several hours into the forest, we nearly ran into the advance tracking team and the gorillas. Great — it was still early and the weather looked good. The Karisoke staff normally spends several hours collecting routine behavioral data; I'd be able to stay with them — and the gorillas — the entire time.

Francois, one of the trackers, greeted me and we began the health check. A few gorillas walked casually by us. We followed for a few steps and then stopped to let several others pass. Francois named each one as they emerged from the dense vegetation: Mafunzo, Dushishoze and Irakoze. Umuco and her infant appeared next. Her baby had grown since I'd last seen it. Afrika followed her. They clearly had a destination in mind. We continued on their trail

Suddenly, I realized we were about to step up and over the stone wall and back out of the park. The gorillas were filing along, one by one, into the adjacent field. Some were eating thistles on the other side of the wall, others were walking along the top of the wall, and several had already sprinted into an open grassy area. I'd heard of this happening and seen pictures, but this was the first time I'd seen it..

My jaw half-open, I followed Francois. We climbed up over the wall and walked quickly into the field with the gorillas.

Scurrying to keep up — and take pictures — I stayed with Francois. We soon reached the side of a ridge covered by a thicket of small eucalyptus trees. The gorillas were stripping the bark and eating the pulp, just as the other Francois (the ORTPN guide) had shown me a few weeks ago. A sweet mint smell filled the air. The stripping of the bark sounded like cardboard being ripped apart.

We moved again. While some of the group remained in the thicket of trees, others bounded back across the field close to the wall. In the span of 15 minutes, I'd seen the entire group except for two females and Cantsbee himself, though we could hear him eating on the other side of the wall. The group as a whole seemed remarkably calm. The infants played and pounced all around us.

To my mind, these special animals seemed frightfully exposed. Thank goodness there were no cows, goats, farmers or schoolchildren nearby. What if we'd been called on to intervene in some way? I couldn't — still can't — get the contrasting images out of my mind: mountain gorillas playing in a field soon to be planted with pyrethrum or potatoes.

I asked Francois how often this happens. About a dozen times a year, he said, usually during the rainy season. I wondered if the gorillas purposefully picked a place to leave the park where there were no domestic animals or people.

As I stood among the gorillas outside the park, trying to digest the scene around me, a call came over the radio. I heard the words "vétérinaire" and "Shinda." A few minutes later, several trackers appeared to lead me to a different group about a two-hour hike away where there was a sick silverback and a baby with diarrhea. Ah, well — at least I'd done the health check, even if I hadn't made much progress toward learning my Cantsbee group nose prints. Another day, perhaps

June 13, 2007
Art class

Sitting on one of the varnished wooden benches in the back of the classroom, I listened and watched as Eric taught the class. He spoke to the kids quietly but firmly, gesturing with chalk-covered hands.

stylish, white, tunic-style shirt and black pants, he looked every bit the artist. His easygoing manner obviously appealed to the kids. There were 50 of them, mostly 8- to 15-year-olds.

It was Saturday morning in Kinigi, and this was the MGVP Art of Conservation Visual Learning Class. Julie (see "Sunday in Ruhengeri") runs this new program. She hired Eric as the teacher and Valerie as the translator; Julie provides inspiration and subject matter. Together, they give weekly drawing lessons to three groups of 50 people from three different villages near the park. I was today's invited guest.

Though I couldn't understand the lesson in Kinyarwanda, I got the gist of it as Eric continued. He was asking the kids questions, and they were raising their hands enthusiastically, snapping their fingers, hoping to be chosen. When he called on one of them, he or she would stand up and politely give the answer.

He reviewed the words written on the chalkboard, e.g., "Mountain Gorilla Veterinary Project," pointing to each one, pronouncing it in English, and asking if anyone wanted to try repeating it after him. Several hands whipped into the air, and he called on a couple of students.

The first, a tiny boy with a surprisingly deep voice, repeated the words almost perfectly. The next, a tall, thin girl, had a little trouble with "veterinary." She tried twice, but used the French pronunciation, "vétérinaire." Eric corrected her gently.

The kids in this class were all from Kinigi, the town where the gorilla park (Parc National des Volcans) has its headquarters. Though some may have parents who work as guides, trackers or porters, most know very little about the forest. They've heard about the gorillas, but few will ever see one. Daily life here is about getting by, going to school or working on the family farm, not about hiking up the mountain. Besides, it costs money to trek in the park and the minimum age is 15. Though Rwandans pay considerably less than the international tourists who come to see the gorillas, relatively few locals will ever join the foreigners.

When class began today, a group of girls asked Valerie if they could welcome us with song and dance — one about gorillas, one just to say good morning. Everyone clapped along, smiling. Then Julie introduced me.

I spent about an hour at the chalkboard explaining my job, speaking partly in French, partly in English, with Valerie translating into Kinyarwanda.

I described the mountain gorillas, explaining that although they live isolated from people, they can get many of the same illnesses we can. Uncertain if the kids could grasp numerical comparisons, I tried anyway: We protect the mountain gorillas because there are so few — 700, compared to 8 million people in Rwanda and 6 billion on Earth. The kids responded with wide-eyed expressions, though I'm not certain they really got it.

Julie wanted to know if the kids had ever seen the orphaned gorillas that live in a facility in Kinigi not far from their school. Some said they knew the place, but none had actually ever seen the animals. I explained that it's a special home for eight orphans: two mountain gorillas and six lowland gorillas, all of them taken illegally from the wild by poachers. We (MGVP) take care of them and hope someday to release them back to the wild, though that will require a lot of work on the part of several conservation groups.

I asked the class if they would like to see the orphans someday. No one is allowed inside the facility except the staff, but often the gorillas are visible from outside, high up in the trees We could arrange for the class to see them from a distance. The answer was a chorus of "yego" (yay-go) — yes!

I had one more question for the kids. Did they think the orphaned gorillas should go back to the forest? To my surprise, they answered "oya" (oiy-ya) in unison — no. Why? Because they have a nice home, they should stay there, where it is safe. Julie and I glanced at each other. Of course, from the kids' perspective, this makes sense. How could they imagine the forest as a safe place for anyone or anything? They've never been there.

Digesting all this, I sat at the back of the room while the drawing lesson began. After wiping the board clean, Eric turned back and asked several more questions. Once again, the eager hands went up. Those who answered correctly were given pieces of chalk and allowed to go up to the board. Each child drew a different line pattern — a horizontal, a half-circle, a vertical, a double loop. He was asking them to give examples.

The positive energy in the room impressed me. It already seemed as if this group of kids and their teachers had been together for weeks. Wow! This was just the beginning, I thought. Soon, they'd really be drawing, expressing their ideas about animals and nature and what it's like to feel healthy. In the end, all of their drawings will be put on public display. That's when we’ll really begin to understand what Rwandans think of the concept we call "one-health."

A message popped up on my phone. One of the orphans was sick. I had to go. Maybe next time I could stay for the whole class.

June 12, 2007
MVGP in Pictures

The Mountain Gorilla Veterinary Project (MGVP, Inc.) is one of the few conservation programs in the world to provide health care for an endangered species in its natural habitat: the mountain gorillas of the Virunga Massif and Bwindi Impenetrable Forest. The MGVP’s mission is to improve the sustainability of mountain gorilla populations via health monitoring, lifesaving veterinary care, relevant health studies and the dissemination of information.

The MGVP field vets visit the habituated wild mountain gorillas regularly to monitor their health; they also respond to problems reported by park staff. Each year, the vets make hundreds of visits to check on the gorillas. The number of hands-on procedures, however, rarely exceeds a dozen — the veterinary team intervenes only in the case of a human-induced or life-threatening problem.

The MGVP employs 21 people in Africa. The multinational professional staff includes one regional veterinary manager (American), one regional field veterinarian (British), four in-country field veterinarians (one Rwandan, two Congolese, one Ugandan), one research veterinarian (Ugandan) and one microbiologist/lab manager (Rwandan). Fieldwork is done in all three countries: the Democratic Republic of Congo, Rwanda and Uganda.

The MGVP's international headquarters and its director, Dr. Mike Cranfield, are based in Maryland, though the focus of the project is Central Africa. Leading scientists from around the world also provide their expertise on topics ranging from infectious diseases to pathology. Together this team helps provide the vital information needed to protect this fragile species.

The MGVP works in close partnership with the regional protected-area authorities throughout the range of the mountain gorilla: the Office Rwandais du Tourisme et des Parcs Nationaux (ORTPN) in Rwanda, the Institut Congolais pour la Conservation de la Nature (ICCN) in the DRC and the Uganda Wildlife Authority (UWA) in Uganda. The MGVP also partners with other conservation organizations, particularly the Dian Fossey Gorilla Fund International (DFGFI). The result is a unique collaboration for species conservation.

The health of the gorillas is inextricably linked to that of their surrounding ecosystem — the local people, tourists, domestic animals and other wildlife, as well as the soil, air, plants and water they rely on. The movements of people and animals in and out of the park create countless opportunities for the exchange of diseases and pollutants. The MGVP staff has adopted a "one-health" approach, and provide.

The schoolchildren in a nearby village may never see a real mountain gorilla, but their lives are connected nonetheless. In order to maintain a healthy population of gorillas, the MGVP staff strives to create an umbrella of health for all species that encounter them. The project’s activities include health care for other animals, relevant research studies, employee health programs, capacity building and community outreach.

Mountain gorillas are found in two regions: 1) the Virunga Range, which includes Volcanoes National Park in Rwanda (Parc National des Volcans), Virunga National Park in the DRC (Parc National de Virunga) and Mgahinga National Park in Uganda; 2) the Bwindi Impenetrable Forest National Park in Uganda.

Mountain gorillas are the only great apes whose numbers are actually growing. The most recent census estimated more than 740 mountain gorillas are living in dense forests in the national parks of Rwanda, the Democratic Republic of Congo and Uganda. There is no fallback breeding population of mountain gorillas in zoos. Despite recent gains among wild gorilla families, these animals remain highly endangered due to threats from war, poaching, habitat destruction and human disease.

June 07, 2007
How to Identify a Mountain Gorilla

Inyongera (ee-yong-gara) sat up to reposition herself. The bright sunlight etched shadows into the wrinkled area above her nostrils, a pattern we refer to as a nose print. This pattern is unique to each mountain gorilla and serves as an identifying mark, like a thumbprint. I'd describe hers as a disjoined "Y," like a letter drawn with a magic marker during a bumpy car ride.

When the mother gorilla stretched out on her back, her infant, Byiringiro (ebee-rin-giro), ambled over from the clump of vegetation where he'd been playing. He climbed onto her belly for a nap. I couldn't see his nose print at that point, but I knew him by his mother. Unfortunately, his position also prevented me from seeing the reported swelling on his mother's lower abdomen, one of the reasons for my visit.

Though I keep a list of the mountain gorillas' names and a copy of their nose prints in the side pocket of my camera bag, I've by no means mastered the art of identification — and not only among the gorillas. It's taken me seven months just to learn the names of the many trackers who work in the Parc National Volcans (PNV). They, of course, know me as one of the Mountain Gorilla Veterinary Project (MGVP) field vets, since there are only seven of us serving all three countries, Uganda, the Democratic Republic of Congo and Rwanda. Moreover, I'm the only white woman among them.

I do know most of the gorilla names (about 280) and many of the adult gorillas. In Umubano group, for example, I know the silverback, Charles, and can make an educated guess about the mothers with infants; there are only so many choices in this small group.

But when it comes to the confusing juveniles, subadults and black backs (young males) in the larger gorilla groups, I need help.

Even with the drawings of their nose prints in front of me, I cannot be entirely certain who is who among the healthy gorillas. Our patients, by contrast, almost always have distinctive features like a cut or a limp, or, as in Inyongera's case, swelling still hidden by her infant.

About 10 feet uphill from where we stood, another mother gorilla, Umurimo (oo-moo-reemo), rested in the sun with her as-yet-unnamed baby. (On June 30, the park's officials will name the 23 gorillas born in the past year.) Our lead tracker for the day, Leonadas, had noticed Umurimo moving slowly yesterday, and he felt she hadn't eaten normally.

Finding and identifying each group member, then reporting on their daily location and general health status is the job of the trackers. They locate the gorillas every morning, then relay the information to park headquarters. If there are tourists visiting, the guides bring them up the mountain. We usually go up with the trackers early — 6:30 a.m. at the park boundary — and do our vet checks first.

Today we adhered to the usual routine: Leonadas led us up the mountain to the group, about a one-hour climb. He methodically followed the trails made by each gorilla, leading us close and whispering their names. Then he'd stop and give us time to observe each one and take notes.

We first saw Umurimo high up in a tree eating favorite white flowers with her infant hanging on. We saw her again a bit later, moving quickly up a steep slope and eating as she went. Now, during the rest period, she looked the picture of health, her baby suckling loudly from time to time. Good news.

Inyongera had proved harder to find. We'd seen Byiringiro off by himself, playing with another infant. Where was his mother? Suddenly she appeared in front of me. I could see the abdominal swelling clearly, but didn't have my camera ready. We try to keep our distance from the gorillas, for their safety as much as ours (one of us could be carrying a flu or cold virus, for example). But sometimes the gorillas will walk right up to us.

In this case, the mother gorilla hesitated long enough for me to pull my camera out of the bag. But just as I hit the power button, I slid off a slippery log into a hole, nearly taking Elisabeth with me. Inyongera gave us a sidelong glance and continued on her way. We needed to get a better look and also record the problem photographically. Hers is a case in which pictures taken on different visits will be extremely useful.

Vets in the field may have different opinions about the cause of swelling based on whether it's changed in size or appearance; the camera can document this information objectively.

When Inyongera settled down for a rest with her infant sleeping on her belly, we still hadn't gotten our picture. While we waited for one of them to move, I studied the nose prints of the two mother-infant pairs.

Umurimo's baby has barely developed a pattern; he's young and the marks on his nose will change over time. I'd describe Byiringiro's print as a series of shallow nestled "Vs" — hard to distinguish from those of other gorillas with similar V-shaped prints unless you see the nose up close. As for Umurimo, her nose print starts off as a wide "U" and ends in a deep "V," very different from the messy "Y" on Inyongera's nose. (There are "official" drawings of the nose prints for each known mountain gorilla, kept on file at park headquarters.)

Byiringiro got up to play with another infant. Finally, we could see his mother's abdomen and take our photos. The swelling looked more like an old umbilical hernia — and egg-sized accumulation of fatty tissue under the skin — than an active problem. Of course, it could be something serious, like an abscess or a tumor, but the gorilla appeared in perfect health otherwise.

Though I don't think we have to be concerned about Umurimo, we'll keep an eye on Inyongera for sure. One of us will be back tomorrow, and if it's me, I'll do my best to identify her among the group without Leonadas' help. If I can't, I know he won’t mind helping me. That's his job, after all.

June 06, 2007
Tracking a Patient

Crouching as low as possible, I peered at Nyiramurema through the bamboo thicket. This was our first glimpse of the wary gorilla after hours of tracking. I could see only part of her brow and a few tiny fingers — her infant's — gripping a clump of hair at the base of her neck.

Marc, our tracker, took my hand and tried to pull me closer for a better view. As he pulled, my left foot began slipping downhill on a pile of dry bamboo leaves, leaving my right knee to sink into the muddy ground. Struggling for balance, I couldn't move. No matter, she had already disappeared.

We resumed our slow crawl through the thicket. Marc moved with ease along the narrow, tunnel-like trail, cutting twigs and spikes out of the way with his knife. At one point, he got down on his stomach and pulled himself forward on his elbows. I followed clumsily, going down on my knees often and grabbing bamboo stalks for leverage.

Elisabeth and a second tracker, Jean, stayed some distance behind us. Later we would switch so they'd be first in line. Only extreme care would allow us to get a good look at this gorilla. Away from the security of her family, Nyiramurema feared people, even those she'd seen before.

Despite our precautions, the gorilla heard us and sounded a warning — not a typical grunt but a combination of a cough and a bark. I motioned Marc to stop for a moment so I could listen. Was her infant coughing also? We hoped not.

These two belong to the Kwitonda group, which had experienced a sad week already. After the silverback fell ill with coughing and lethargy, the respiratory disease spread through his family. Each day, one or two new cases cropped up. A few days ago, Mugeni's month-old baby had been found dead.

Mugeni herself had a mild cough; the baby had been the only gorilla without any signs of illness. Evidently, the coldlike virus had suddenly overwhelmed its immature immune system. Mugeni continued to carry the decomposing dead baby — typical gorilla behavior.

On the day Kwitonda felt better, he led the group far away in search of bamboo shoots. Nyiramurema stayed behind in the nest with a bad cough. The baby also began coughing.

Respiratory illness accounts for a third of all known causes of death in the mountain gorillas habituated for tourism in Rwanda. The majority of those who succumb to secondary bacterial infections are less than 2 years old, so we've been keeping a close eye on this infant. (Infant mortality is generally high in wild animals. For this reason, park officials wait a year to name the babies.)

Then, Nyiramurema and her infant disappeared. The Kwitonda group lost three individuals in the course of a week.

I'd worried about Mugeni's baby the day Kwitonda started coughing. But Nyiramurema's cough — and her infant's — seemed no worse than those of the others in the group. None of us believed Nyiramurema was dead, we thought that maybe she simply couldn't keep up. She lost a foot to a snare years ago and moves more slowly than the others. Then again, I've learned to my sorrow that sick gorillas sometimes just disappear.

Thankfully, the tracking team found Nyiramurema and her infant yesterday. The mother gorilla had been foraging near the park boundary. Marc predicted a short walk today to check her. Instead, after locating her night nest high in a tree about an hour's walk into the forest, we were on her trail for three hours, going steadily up. She seemed to be following a buffalo and elephant trail, rather than looking for Kwitonda's trail. Why the silverback wasn't looking for her, I had no idea.

Now Marc was pulling on my hand again, urging me farther into the dark thicket. I could hear the popping, crunching sound of a gorilla breaking and then eating bamboo. As we crawled another few yards the noise stopped. Nyiramurema was only about 4 feet away on the other side of the dense brush and this time I had a broken view of her upper body.

Quickly raising my binoculars, I found a small gap in the twigs and focused on her face. Her eyes and nose were clear; head up and alert, she appeared to be listening for us. Before I could adjust my cramped position to look for the infant, she moved off again. At least we hadn't heard the little one cough. And the mother was eating.

Elisabeth and Jean now took the lead. We were hoping the gorilla would move into a clearing so that we could see her whole body as well as the infant. I wanted to be absolutely certain that both were strong and recovering from the respiratory outbreak.

A few minutes later, Nyiramurema emerged from a thicket and walked along a narrow grassy patch to our left. Elisabeth hopped a fallen tree to get a look. I tried to follow, but got my foot stuck in a mass of vines. By the time I pulled free, the gorilla had almost disappeared again. But I had enough time to see the infant riding on its mother's back in a normal fashion, holding on firmly, head up and looking around. It glanced back at my binoculars with bright, curious eyes.

Nyiramurema sped on ahead. She appeared strong and fit. Elisabeth flashed her bright smile. She, too, had gotten a good look at both mother and infant, and agreed with me that, medically, there was no reason for concern.

We watched the back of the infant's head bob up and down with the mother's uneven gait until both disappeared into the greenery. The trackers would stay with Nyiramurema for another few hours and hope to pick up her trail again in the morning. At that point, I realized my legs and arms felt like jelly from all that crouching. I was more than ready to go back down the mountain for a hot shower.

Would this gorilla find her way back to Kwitonda? Would he find her? Or would she meet a lone male? To be continued . . .

June 04, 2007
Gorilla Food

Francois, our guide, slowed his pace just enough to pull a few eucalyptus leaves off a low-hanging branch. I guessed he would soon pop them in his mouth and chew — and he did. Raising my eyebrows and smiling, I held out my hand in his direction, ready to try a taste for myself.

Though we've met only a few times, I trust Francois not to offer me a toxic plant. He's one of those people who exude warmth and kindness; you feel as if you've known him forever. But that's only part of the reason I trust him. A tracker-turned-guide, he has worked in the mountain gorilla park for 30-plus years. Francois knows the place and the animals as well as anyone. He's undoubtedly walked every trail and cut many of his own through infinite numbers of bamboo stalks, vines and thistle. He also knows the people.

Tourists return from his treks glowing about what they learned, remarking on his repertoire of gorilla-like noises.

Equally important, to me anyway, this one man has as much experience as a dozen others combined when it comes to hands-on vet work with the gorillas. Over the years, Francois has helped out with many "interventions," the code word for anesthetizing a gorilla because it has a life-threatening problem.

Though rare, these events are challenging and risky for everyone involved. His experience runs the gamut of incidents: snare removed — gorilla recovers fine; vet team working on sick female charged by silverback — serious injuries avoided; mother and infant anesthetized for exam, baby stolen by other females — baby eventually recovered.

So, if there's anyone I'd trust to put me through a mountain gorilla food taste test, it's Francois. And today was my chance. I'd joined a group of tourists — supporters of MGVP from Maryland — on their way to visit the Sabinyo group. As we walked through the fields leading up to the park wall, the questions began to flow. Francois answered each one carefully, mixing a bit of French with his English. Listening to him, I realized yet again how much I have to learn.

As for eucalyptus, I know the gorillas often come out of the forest to eat the bark. No one knows for certain why they do it. This plant was introduced as a source of wood and charcoal 100 years ago. Mountain gorillas didn't evolve with it, but they routinely leave the forest for the farms to eat it. Some say they take it as medicine. Others think gorillas will go for any novel food item.

Francois shook his head when I asked if those particular leaves were safe for me to taste. I don't know why he answered no, actually. He swallowed them and led me over to another tree. Using his knife, he cut into the bark and peeled it away to expose the softer inner layer, then dug in a bit more. Using his fingertips, he scraped out a tiny bit of the pale green pulp and offered it to me, saying, "Take the water only." I interpreted this to mean that I should put it in my mouth without chewing it and then spit it out. So I did. The delicate, slightly sweet, mint taste answered my question. The gorillas must simply like it.

A half-hour later, just outside the park boundary, Francois picked a strand of gallium, a bright green vine with tiny leaves arranged in a starlike pattern. This gorilla food has a peculiar sticky quality — I'll find bits of it stuck to my sleeve or in my hair after a few hours in the forest. The gorillas pull it down from the trees and often wrap it up to make a big wad; they sometimes cough when it catches in the back of their throat. This plant has such a bitter smell that I wasn't surprised Francois didn't eat it.

Fifteen minutes into the park, we stopped again after a short but slippery climb. Francois put a thick green stalk in his mouth and began to chew. Someone asked him if this was something gorillas eat. He shook his head and continued chewing, now with his mouth open. Water began to dribble down the side of his chin. He grinned, pulled the green remnants out of his mouth, and explained that if you're in the forest and thirsty, this is the plant you look for.

I still don't know the plant's name and am not entirely sure I'd recognize this green stalk among the thousands of others. The scientists at the Dian Fossey Gorilla Fund International have catalogued the forest plants as well as the gorilla's diet; someday I'll make time to study them.

At our next rest break, Francois disappeared into the forest and returned with two kinds of plants, quizzing me on their names (lobelia, white celery) and smiling when I identified them correctly. He demonstrated that the sap from the lobelia plant can be wiped on your skin to soothe wounds from stinging nettles. (That fact I knew, though it hadn't helped me the one time I'd tried it.)

Next, he peeled the outer layer from the celery stalk, took a bite, broke the next bit off, and handed it to me. Having watched the gorillas eat this plant for hours, I confidently took a taste. Wow, even better than eucalyptus — sweet but mild, soft and very different from our supermarket celery, more like a tender stalk of fresh broccoli.

We took one more plant-tasting break before meeting up with the gorillas. This time, Francois displayed two very different choices. One was a type of thistle, not the smaller-leaved stinging nettle that's covered with tiny bristles, but a broad-leafed plant with large white spines.

He held the stalk in one hand, then bent each leaf back and down so that all the spines pointed downward. Again, I'd seen the gorillas do this, but I thought he'd stop there. Instead, he took several bites from the top of the stalk where the leaves bent, showing that if you handled the plant properly the sharp bits wouldn't get you. (This was not a move I was willing to try. Later in the day, Elisabeth told me she’d tasted this plant —just once. The spines weren't the problem; it made her violently ill!)

The final plant, a huge, thick bamboo shoot, appealed to me much more. One of the first subjects I'd tried to cover with the trackers when I arrived was my own diet: vegetarian. We often spend hours together moving from one gorilla group to another, and this is a topic for which I thought my French vocabulary was good enough for a casual conversation. But no one understood me until I pointed to the bamboo. Then, everyone laughed. Apparently, bamboo shoots are for gorillas, not people. I tried to explain that other animals in other parts of the world rely on bamboo, like giant pandas. This information effectively ended that particular conversation with the trackers. Theirs is a world of gorillas, buffalo and bushbuck.

When Francois finished peeling the bamboo stalk, he repeated the earlier move —taking a bite first, then breaking off the next section and handing it to me. It tasted more like water than vegetable juice. It was so refreshing that everyone else took a taste too. No wonder the gorillas grunt at each other and scuffle over fresh bamboo shoots.

The Sabinyo group was resting in a small green clearing that was full of potential gorilla food. Francois positioned us a safe distance away so we could watch the family eat, sleep, play and groom each other. I backed up to give one of the tourists a bit more room and stepped on a huge stalk of celery, flattening it to the ground. Quickly, I looked around to see if the nearby adult female had noticed my clumsy move. Nope. Good thing. I remembered some early advice given to me by Dr. Chris Whittier, one of the field vets before me: Never stand on the gorilla's food. The more familiar I become with plants that gorillas regard as food, the harder not stepping on them is going to be.

June 01, 2007
Big Gorilla, Big Cough

The group's leader, Kwitonda, sat up and coughed several times, blowing a blob of clear snot out his right nostril. Some squirted onto the hair on his right forearm. Immediately, he licked it off, then pursed his lips over the wet hair to squeeze out the last bit of moisture. Next he cleared his nose, using a fat fingertip to scoop out the watery fluid. He coughed again and blew out a fresh supply. I imagined he’d have a busy day trying to stay clean.

After another coughing spasm, the 400-pound silverback repeatedly licked his lips. White phlegm covered his pink tongue. He must have horrible postnasal drip and maybe even a fever.

Then he paused to scratch himself on each inner thigh, one side at a time. At least he felt well enough to groom himself. He looked around, apparently noticing that most of his family had left to eat. A few feet away, two young females played in the nest (a big patch of flattened vegetation), waiting for the chief to get up — or so it seemed.

Elisabeth and I stood watching, hoping for the same thing. If Kwitonda ate something, even just a little, we'd feel reassured. We knew he'd gotten up late yesterday, too. That was when trackers had first heard the cough and called the vets to take a look. Jean Felix (Dr. Kinani) had made the first check. By the time he got to the group, Kwitonda had begun to move around and eat. We’d come back today to check on the chief and to discover who else might be coughing.

Minutes into our visit, one of the females and her 2-year-old coughed a few times. The mother ate; the infant played. Those were good signs. Mugeni went by quickly, holding her child; both looked fine. We heard one other cough from an unidentified gorilla in the distance.

We know gorillas get upper respiratory disease, often in the rainy season — which is now. They cough, sneeze, act lethargic and usually get over it, like humans. We believe it's viral, at least at first, though this has never been proven. Some gorillas get really sick, especially if they end up with bacterial pneumonia. The young and the old are at greatest risk, again, just like us.

We continued to observe the group. Gradually, they wandered off to feed. Kwitonda moved only to reposition himself. During the next hour, he continued to cough, pick and lick, sometimes sitting, sometimes lying down. By this time yesterday, he'd been up and about.

On the positive side, the discharge from his nose and on his tongue was thin and clear, not yellow or thick. And the cough seemed to start in his throat, rather than deep in the lungs. The bad news: all of the gorillas in this tightly-knit group would be exposed in a big way.

My face and hands suddenly felt cold and I realized clouds were rolling in. I put up my hood, glanced at the sky, and said to Elisabeth, "It would be good if the sun came out today." She laughed, having figured out by now that I'm overly optimistic about the weather.

We decided to watch Kwitonda a while longer (in all, we spent almost three hours with the group) and then check on each individual. Standing a few feet from the sick silverback, I thought, OK, there's nothing to be done at the moment. He doesn't need antibiotics yet; more importantly, his illness isn't life-threatening, nor is it likely to become so. He's in the prime of life and should get over this just fine. I was about to turn to Elisabeth when she whispered her thoughts to me: as usual, we were in agreement.

As if to illustrate the fact that the entire group was at risk for this nasty cough, a young female walked over and sat down next to Kwitonda. Occupied with the effort to keep his face and hair clean, he ignored her at first. She inched closer to him, staring. Kwitonda made a threatening gesture with his massive head. The youngster ignored the threat, perhaps sensing he didn't really mean it. Then she touched her mouth ever so lightly to the clear snot running down his lips. Great, I thought, it's only a matter of time before they all get the cough. I worried especially about Mugeni's baby. Her last one died of pneumonia just a year ago.

As we walked out of the park, I asked Elisabeth about the flu or grippe. It had been a particularly severe flu season in this region of Rwanda, starting in February and lasting right through April. The gorillas usually get coldlike symptoms during the rainy season, from May to June.

There seem to be two possibilities that would explain these symptoms in gorillas: either mountain gorillas harbor their own set of viruses that can cause colds or flu-like outbreaks, or they get them from people. I think it's the latter more often than not — and so do many other scientists who study gorilla health.

We have some data that supports this theory. When the vets anesthetize a mountain gorilla for any reason, like snare removal, they take extra blood samples to be stored for future analysis. Preliminary studies indicate that the gorillas have antibodies in their blood to a number of viruses, bacteria and parasites also found in humans. But taking this research a step further would require the unthinkable: repeated anesthetizing to collect tissue samples, perhaps even infecting wild gorillas with a low dose of an organism to see what happens.

We'd never do this to an endangered species — the risks are too great. And the answer might not change the outcome. The last time I had a bad cold, I nursed it with rest and green tea, then eventually got better.