One Health expedition to the Central African Republic

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04/11/2024

Report from the HIOH and HZI trip from February 5-18, 2024

Fabian Leendertz, Director of the Helmholtz Institute for One Health (HIOH) in Greifswald, and his team have been working for more than a decade in the south of the Central African Republic, in the Dzanga Sangha Conservation Areas. As part of a close collaboration with the WWF of the Central African Republic, the HIOH supports the monitoring of the health status of wildlife in these protected areas, with a focus on lowland gorillas. Over the years, activities have been expanded to better characterize the interface between humans, animals and the environment in this extraordinary ecosystem.

A delegation of researchers recently traveled to the Central African Republic to strengthen cooperations with local stakeholders in the fields of public health and animal health management. Fabian Leendertz, Katharina Schaufler, Fee Zimmermann, Livia Patrono and Sébastien Calvignac-Spencer from the Helmholtz Institute for One Health, a site of the Helmholtz Centre for Infection Research (HZI), as well as Josef Penninger, Scientific Director of the HZI, took part. They were accompanied by Frédéric Singa, the head veterinarian of the Dzanga Sangha Conservation Areas, as well as Jörn Auf dem Kampe and Adrienne Surprenant from GEO. The researchers also planned to present the activities of the HIOH's One Health Surveillance Core Unit and to visit the Dzanga Sangha Protected Areas and their current conservation and research infrastructure on site.

The following report was written by Sébastien Calvignac-Spencer:

06.02. - Tuesday

[Translate to English:] Ufer — View in Bangui

After a long journey, we arrived in Bangui. Bangui is the capital of the Central African Republic and the political center of the country, with around 900,000 inhabitants. The city is located in the south of the country, directly on the Ubangui River. On the other side of the river is the Democratic Republic of Congo.

From our hotel, we have a breathtaking view of the river and the southern edge of the city. The city itself stretches out at the foot of wooded hills, and dusty streets connect poorer districts with old and new buildings. The streets are busy with small stores and populated by cars, motorcycles and pedestrians.

07.02. - Wednesday

[Translate to English:] Straße — In the streets of Bangui

We stayed in Bangui for two days to meet and talk to the people in charge. Frédéric is a Central African and Adrienne had been a photographer in the Central African Republic for years, so we had two travel guides.

In the afternoon, our route took us to the national veterinary laboratory, a department of the Ministry of Animal Husbandry. Marie-Noëlle Mbaïkoua and her team welcomed us. They are responsible for monitoring animal health and planning measures to contain the spread of pathogens in domestic animals. One focus of their work is rabies, which is also an example of the interplay between human and animal health and thus shows how effective One Health approaches can be. Cases of rabies in humans are almost always the result of a dog bite. Rabies can be prevented in both humans and dogs by vaccination with the vaccination of dogs as the most effective method of control. If carried out on a large scale, it can lead to the local eradication of the disease.

[Translate to English:] Schild — Visit to the national veterinary laboratory - a directorate in the Ministry of Livestock

[Translate to English:] Gebäude — Garden in front of the veterinary laboratory

08.02. - Thursday

[Translate to English:] Baum — Flying fox colony next to the Pasteur Institute Bangui

Thursday morning, we were back at the Ministry of Animal Husbandry to meet Minister Hassan Bouba. He supports our work with WWF in the Dzanga Sangha Conservation Areas. We then continued our day with a visit to the Institute Pasteur Bangui (IPB). Pasteur developed the first vaccine against rabies. He and his successors built up a large network of public health institutes around the world. The IPB was founded in 1961, one year after the Central African Republic gained independence. The institute is located on a 5-hectare site within the city. Surrounded by 200,000 straw-colored fruit bats (Eidolon helvum), which form a large colony in the surrounding trees, the IPB consists of 150 researchers and employees.

Director General Yap Boum II gave us an overview of the IPB's activities and objectives. The Scientific Director Emmanuel Nakoune, our host, then invited Josef and Fabian to a meeting with the Minister of Research.

Meanwhile, the rest of the group was given a tour of the IPB's impressive facilities. The IPB offers biological analysis and vaccination for the public, as well as an infrastructure for infectious disease research - from medical entomology to molecular epidemiology.

At dinner, the mood is relaxed and excited at the same time: The next day we would fly to Bayanga, to the Dzanga Sangha Conservation Areas.

09.02. - Friday

[Translate to English:] Gruppenbild — Flight to Bayanga

After arriving Bayanga, a village with 8,000 inhabitants, on Friday morning, we visited the WWF laboratories. Working closely with the forest management authorities (APDS), WWF carries out a range of activities aimed at conserving the exceptionally rich wildlife in the region, including protected area enforcement, ecotourism and research, with a focus on western lowland gorillas and forest elephants. The HIOH supports the health monitoring of the gorillas and has been sending veterinarians to the region for more than 10 years.

One of the vets is Yanthe Nobel, who was instrumental in organizing this trip. Her work includes tasks such as dissecting wild animals that are found dead in the area. She also supports the local teams and the WWF in the field and in the laboratory during disease outbreaks. Her work also requires close contact with the local population to understand their views and needs and their relationship with domestic and wild animals. In the evening, Yanthe, Fee and Fabian took part in a local radio program about One Health and our activities in the region.

10.02. - Saturday

On Saturday morning, we drove to Dzanga Bai, a clearing that is world-famous for its 50 to 200 forest elephants. After a one-hour drive, we set off on a 30-minute walk through the forest, accompanied by a local guide and a Ba'aka tracker. Ba'aka trackers know the forest very well and can easily spot elephants by the barely perceptible sounds they make as they move through the forest. Elephants are an important part of the ecosystem and the fastest route in the forest always follows their tracks.

Once on the platform of the wooden tower that borders the bai, the view was breathtaking. This morning, we could see about 90 elephants that have come to get minerals from the ground by digging large water holes.

[Translate to English:] Elefanten — Forest elephants in Dzanga Bai

Dead elephant cow surrounded by warthogs

Ivonne Kienast heads the forest elephant monitoring program and is committed to protecting the animals through conservation work and research. A team of local and international scientists continuously monitors the elephants during the day and one night per week. This week, they witnessed the killing of a female elephant by a large bull. Although the cause of death was not infectious, it would have made sense to sample the carcass, but this was organizationally not possible in this case. In order to close such gaps, the HIOH would like to further strengthen its support for local projects.

In the afternoon, we were back in Bayanga to take part in our first One Health soccer tournament. We have brought jerseys with One Health symbols and slogans for all 10 teams, which we saw everywhere in the village. The tournament provided us with many enjoyable moments, with the HIOH/HZI/WWF team being knocked out of the tournament after the group stage, with a respectable record of one win and three defeats. Josef scored the winning goal in our only victory in the penalty shootout. The winners of the first tournament were the Diamonds, who dominated the final in convincing fashion.

One Health football tournament in Bayanga

11.02. - Sunday

On Sunday morning, we headed back into the forest, this time to Bai Hokou. Bai Hokou is one of the sites where western lowland gorillas are being habituated within the Dzanga Sangha Conservation Areas. The HIOH has been advising WWF and the APDS (forest management authorities) for more than a decade on how to protect the gorillas best from human pathogens. Fabian's work has been instrumental in demonstrating that contact with humans carries its own risks. The most serious is the introduction of respiratory diseases, which has led to significant morbidity and mortality in the great apes in the past. Because of this, WWF tested us all for COVID-19 before we left Bayanga.

Like the day before, we walked through the forest with an experienced Ba’aka tracker, as elephants also live in this part of the forest. Shortly before we arrived, we put on our face-masks, a measure whose effectiveness has been proven time and time again. Fabian has introduced it at several sites since the late 2000s, where it has reduced the frequency of respiratory disease outbreaks. It was also important that we kept a minimum distance of 7 meters from the gorillas. After a few meters, we could already spot the back of one of the two adult females in the group, and shortly afterwards Makoumba, a male silverback, woke up from a nap and slowly revealed its huge silhouette. The group followed the old male into the treetops, with the four younger gorillas playing on branches and defying their father's 300 kg weight.

[Translate to English:] Gorilla — View of gorillas in their natural environment

View of gorillas in their natural environment

12.02. - Monday

We also spent Monday in the forest, this time following the Ba’aka net hunters. Fourteen Ba’aka men and women demonstrated their incredible skills and navigated us through this extremely difficult environment. The community, stigmatized as an indigenous minority, legally hunts in some parts of the Dzanga Sangha Conservation Areas. Semi-nomadic hunting was their traditional way of life, and this activity is still an important source of food and income.

Once in the forest, the Ba’aka marked out places where the nets could be set up in a large semi-circle. The hunters then drove the game to the nets, making noise in various ways (shouting, shaking the leaves, etc.). The whole process took no longer than 15 minutes, after which the group changed locations. On the way there, the hunters collected plants that they could use as medicine. This time the hunt was unsuccessful. A duiker (forest antelope) was driven into the open on the run, but managed to escape the nets.

In the evening, we were invited to a barbecue by Thomas and Lena, a Swedish couple who have lived in Bayanga for more than 20 years and raised their children there. Thomas has dedicated his life to bringing clean water to the impoverished communities in the west of the country. Lena used to work as a nurse in the village, but unfortunately lost her job recently. The international funding ran out, but the local need did not. HIOH is trying to recruit her for one of its ongoing projects.

13.02. - Tuesday

The next morning, Fabian, Josef, Fee, Livia and our local partners attended a meeting with local leaders. The chiefs of Bayanga and eight other villages, as well as the district leadership, were invited to discuss intensifying our activities in the region and linking them better with public action towards One Health. Meetings like this are crucial if we want to not only understand how human, animal and environmental health are connected, but also respond to existing problems.

Group photo — Joint discussions about One Health initiatives on the ground

In the afternoon, we visited the local hospital. A single doctor is responsible for the entire district (more than 25,000 inhabitants) and is supported by two nurses. In Germany, a population of this size would normally be cared for by 100 doctors and 350 nurses. The challenges in healthcare are, of course, immense, but even such a small team manages to provide the community with important services. HIV-1-infected people (5 % of the population) receive antiretroviral therapy, many vaccines are routinely administered (and are completely free for children under 5), and the prevention and treatment of severe malaria works well within the village. However, with such a small workforce, there is no ambulance service, so health status and chances of recovery in the event of illness depend heavily on how far away from the hospital you live. For example, infant mortality is much higher in the remote Ba’aka villages. Any research activity in this area must be accompanied by a direct benefit for the population.

14. and 15.02. - Wednesday and Thursday

The next day it was already time to head back to the capital. We had some very interesting meetings planned for the next two days: First, we met the rector of the University of Bangui, Professor Gresenguet. The university is the only public place in the whole country where higher education is possible. We met motivated students and promised to come back for a series of lectures. Afterwards, we had the opportunity to meet Didier Kassaï. He is an illustrator who began his career as a cartoonist in the late 1990s and went on to document the war years in beautifully designed graphic novels. He talked very openly about his life back then, further north, when he documented his daily life under fire. He has also applied his skills as an illustrator to public health communication projects, and we will no doubt be working with him in the near future.

LeMonde on the work of illustrator Didier Kassaï

Journey home

After about ten days of intensive meetings, discussions and impressive encounters, we travelled back to Europe, knowing that it is a privilege to be one of the few who are allowed to work in such a beautiful country where people unfortunately have such a hard life. Of course, we will continue to expand our One Health monitoring project in the Bayanga region for the benefit of science and, above all, the population.

Press contact

Dr Ruth Suchsland

Scientific Coordinator

03834 3916-122 E-Mail

One Health expedition to the Central African Republic