The River and the Vessel: Emerging Pathogens’ Science in Action

In 2017 one of my dearest friends (a phenomenal scientist) gave me “The Monkey and the River” by David Quammen, one of the most prolific writers of science books for non-scientists. In this 2015 book, Quammen narrates a real story of how the spillover of HIV-1 went from a chimpanzee to humans.

The book is fascinating, especially because it elevates the Sangha River to the role of a character in the story, it becomes the hypothetical avenue down which the virus traveled to reach Brazzaville and Leopoldville (now Kinshasha), from whence it spread out to infect 60 million people around the world. Without its reservoir, the monkey, the HIV-1 may have not existed; without its vehicle, the river, it might not have spilled out of the forest.

The Sangha is affluent to the majestic Congo River, the second in length and discharge volume in the world, only topped by the Nile and the Amazon respectively. The Congo and its affluents act as an intricated lifeline that connects Kinshasa and regional capitals with rural areas deep in the forest. Rivers are a natural solution in a land where roads and railways are scarce. Boats are used to deliver goods and services, as well as transport people. They also transport health

Vysnova has been using fluvial routes in the Ruki River for the past 12 months to transport samples, reagents, supplies, equipment, and personnel forth and back from the laboratory in Ingende to the Mbandaka reference lab in the Equator Province. This has reduced the transport time by 70% as well as reduced the risk of road accidents and damage to the goods.

 

To areas where internet connection is poor to nonexistent, and therefore online training is impossible, Rivers have transported knowledge. Staff from Vysnova, CDC, and its implementing partners (George Washington University and INRB) have used boats to deliver goods and training on sample management and new diagnosis methods. These visits have served as a source of knowledge to better understand the challenges faced on the ground, to design and develop tailored and comprehensive solutions in the context that compensate the challenged with the level of engagement of its people. The problems that are proper of a developing country become an opportunity for creativity as well as the chance to strengthen the link between all the parties.

 

Navigating the Congo or its affluents is not an easy task, the vessel requires a savvy captain, but it also needs a reliable first officer, an adaptable crew, a resourceful cook, a dedicated cleaning team, and more importantly, the motivation and the drive to be a joint team, with the objective to get from here to there.

In our most recent field trip to the DRC, our multi-agent team worked on strengthening our connections and clearly defining our route and objectives. We realized through the work we have been doing these months, that all of us are in a vessel, through a wonderful scientific journey, we have all different and important roles towards our goal. Through this journey we learn, once we arrive on the other side, we have all realized the journey was as important as the destination.

 

Our first year of work in DRC has confirmed that cooperation and collaboration are the keys to sustainable results. Creating and enhancing capacity is only possible when all the involved engage and commit, not only to their roles but to the objectives. The trainers become trainees and the funding agency also receives, from the host country, the intimate understanding of what is really needed and how we can all be part of something impactful. 

As the river was a vehicle for an emerging pathogen in Quammen’s book, the river is now the vehicle for the prevention of future spillovers. As the monkey was the reservoir that contained HIV-1, is the vessel now that contains the resources (including human resources) and tools that will spread the knowledge needed to build a safer world. 

 

Written by Nohelia F. Navarrete, MBA/MPA |  Director for International Development Practice/ IDIQ Program Manager