1
MATERNAL COURAGE
My mother had endured and triumphed twice before, for the births of my two older sisters. When the contractions gripped her body this third time, for me, she was familiar with the feeling but no less apprehensive. As she paced our family home, the pain and the phases of labor seemed to be following their usual pattern, but the outcome was anything but certain. Might fate, with all of its indifferent cruelty, inflict the suffering of fetal dystocia, the various birth complications that I would later learn by heart?
If so, there was little hope. My mother was alone, save for a neighbor who had joined her when her waters broke. My sisters had been sent to friends’ homes. My father was away studying in the south of the province.
The neighbor mouthed words of support and encouragement. She walked in step with my mother when she took to her feet and mopped her brow when she lay down. She readied a razor blade for the final act of delivery, but she brought no medical expertise.
It was 1955. Our house was a typical homestead for poor Black families of the era: flimsy wood and brick walls in a rough rectangular shape, with metal sheeting slung over the top to protect us from the tropical rains that fall throughout the year in Congo. It was the most basic of human constructions, still found today wherever families must shelter with little means.
Comprised of a single room, it had been knocked together rapidly next to others accommodating Congolese families who had come to seek a new life in Bukavu. Once a small fishing village on the banks of Lake Kivu, Bukavu had grown into a colonial outpost in what was then known as the Belgian Congo.
Bukavu sits on the far eastern flank of this vast territory, an area the size of western Europe or the United States east of the Mississippi River. Congo is just south of the equator, close to the middle of the world and the heart of Africa, though it never feels this way. Few places have been as fascinating, and become the subject of such dark fantasies, as Congo yet been so misunderstood and overlooked.
As she faced the lottery of childbirth, what went through my mother’s mind as she found herself doubled over in pain or resting between contractions on one of the thin mattresses stuffed with raw cotton that we used to sleep on at the time? Did she allow herself to think of her own mother, who had died after giving birth to her twenty-three years previously? That loss, more than anything else, had shaped her hardscrabble childhood and her stubborn personality.
Her marriage, too, had been influenced by this bereavement. My father’s mother had also died during childbirth, meaning both of them faced deprivations, economic and emotional, as they grew up in their village of Kaziba, an arduous day’s walk through plantations and forests to the southwest of Bukavu. They both had reason to celebrate the gift of having their own children but also to apprehend the difficulties of delivering them.
There are no reliable figures for the number of maternal deaths at this time in Congo, this being an area where the Belgian colonial authorities did not collect data. An estimate from the first national census carried out between 1955 and 1957 concluded that most women did not reach their fortieth birthday. Life expectancy was a mere thirty-eight years, and childbearing was a major killer.
Giving birth without medical care was, and still is for millions of women, a game of Russian roulette. My mother survived this round for me—and a further seven for the births of my younger sisters and brothers. But I nearly did not.
Several days after my birth my cries became piercingly high, then feeble. My skin turned pallid and my body grew feverish. When I refused to feed, it was clear I was gravely ill. My mother, still recovering from the delivery, knew she needed to act quickly and would have to do so alone. Papa was reachable only by letter.
She bundled me up in one of her pagnes, the colorful patterned fabric wraps worn as dresses in Congo, and strapped me to her back, my limp and burning torso pressed tight against her. She left my two sisters, then ages three and seven, with the neighbors again and headed off down the hill outside our home. Her destination was one of the only two medical dispensaries accessible to the Black population in Bukavu at the time, and she knew that being admitted would be difficult.
Both were run by Catholics, and relations between them and Protestant families like ours were still tense. The Catholic Church was one of the pillars of the Belgian colonial system, along with the state administration and the private concessionary companies that were given free rein to organize, police, and extract from large swaths of the country.
Competition between Catholics and Protestants stretched back to the first wave of European arrivals in the late 1870s and 1880s, at the start of the “Scramble for Africa,” the competition among colonial powers for territory and resources. Young white traders and soldiers set out for adventure, lured by accounts of bountiful ivory and abundant precious stones, while in London, Paris, Berlin, Lisbon, and Brussels politicians schemed, plotted, and waged war to thwart their rivals.
A separate and just as consequential scramble also began: one for African souls. In the footsteps of the colonial merchants, vigilantes, and slave traffickers followed the first priests and pastors: evangelicals concerned not with the pursuit of material wealth but with spiritual conquest—although some found themselves distracted by Congo’s riches, too. British Protestants in the form of the Livingstone Inland Mission arrived in 1878, followed by Baptists and Methodists from Sweden and the United States in the years after. Two French Roman Catholic missions, including the White Fathers, were active from 1880.1
The space was vast, the Congolese population mostly hostile, and the dangers obvious to any proselytizer daring to set out in this huge unmapped interior. Initially there was no need for competition among the various religious orders, which all felt they were engaged in the same “civilizing” mission. But this changed in the mid-1880s.
World powers recognized the territory, initially named the Congo Free State, as under the rule of King Leopold II of Belgium. Desperate to demonstrate control over his new colony—for in reality he had established merely a handful of trading points along the Congo River—Leopold enlisted the help of Pope Leo XIII in 1886.
The pope announced that Congo would henceforth be evangelized by Belgian Catholics. The Catholic faith became a tool of the colonization process, and Protestants found themselves squeezed to the margins. This schism split the early white colonizers and Congolese society as more and more people converted to the new faith.
Racked by anxiety, carrying a sick child on her back, and desperate for help, my mother stepped into this sectarian maelstrom when she approached the dispensary, a simple two-story building that offered basic health services such as vaccinations, bandages, and antibiotics. The latter would be needed to save my life.
It was run by Belgian nuns, and my mother asked them for help. She unwrapped me, sobbing as she did so. By then I was having difficulty breathing. She urged the nuns to touch my clammy skin and inspect my yellowing eyes.
But the sisters turned her away, unmoved. The dispensary was for Catholics only, they informed her. Christianity had a history of roughly seventy-five years in Congo at the time, yet the divide had hardened into a wall so thick and insurmountable that it could decide life or death. My mother pleaded with the nurses to no avail.
Did my father’s reputation play a role? Although he was out of town at the time, he had a growing reputation in Bukavu as the first Congolese Protestant pastor. My mother never knew if this explained the hostility of the nuns.
But as she trudged back up the hill in her sandals and her pagne, convinced I would be dead by the morning, she cried hot tears of sorrow and bitterness, and she cursed the stupidity of religious bigotry and her own powerlessness to overcome it.
As she rocked me later that evening at home, my slack body in her arms, she said she felt my life slipping away, that she was losing me under her gaze. She thought about the neighbor who had cut my umbilical cord. My mother was sure that she was responsible for the infection that had drained my body.
“I could see that she was making a mistake,” she later told me. “But I was lying down, I’d just delivered you. I couldn’t do anything.”
From everything she has described of the symptoms and treatment, I’m almost certain that I was suffering from septicemia, a blood infection that is fatal for babies if untreated.
The most common cause of infection is the severance of the umbilical cord, either in the wrong way or with a dirty blade. Once a baby has been delivered, the correct procedure is to clamp the cord in two places to stop the blood flow in both directions, then cut it in the middle, leaving a stump of several centimeters on the baby’s side.
The neighbor had sliced too close to my body, not leaving enough tissue to properly tie off the cord, which had exposed me to bacteria of all kinds. My navel had started oozing and suppurating days after my birth.
It might have been the end of me. I might have become a brief and painful memory for our family. But it wasn’t my time. A second brave woman would enter my life in the first few days of my existence, prefiguring the many others I have encountered since. I owe my survival to her.
Life in Congo often depends on chance encounters. In a moment of need, you might meet a compassionate stranger; when you least expect it, a man with a gun. In a world of chronic unpredictability, the divine hand of Providence appears at work constantly, perhaps explaining why we Congolese are so superstitious and such faithful believers. We all muddle through, trying to protect ourselves and our families, our lives seeming to depend on forces beyond our immediate sight. This was as true in 1955 as it is today.
As my mother feared the knock of Death at our home, someone in the neighborhood had set in motion events that would save me. This person—we never found out who was responsible—walked to the home of a missionary and teacher who lived in a small brick house down the hill. At around three A.M., they delivered a handwritten note explaining my mother’s predicament.
The missionary was from Sweden, a woman then in her late twenties or early thirties named Majken Bergman. She had elected to live in our area of Bukavu, a rare European to choose a Black neighborhood rather than the comfort and familiarity of the white center of town. In the strictly segregated society of the time, she was perhaps the only person locally who could cut through the prejudices at the dispensary.
Majken read how the newborn son of Pastor Mukwege was gravely ill and had been refused treatment. She rose immediately, dressed, and came to the house by flashlight. My mother was dozing with me in her arms. She was initially startled but then sat with Majken and recounted her despair about her experiences earlier in the day when she’d tried in vain to see a nurse.
Majken promised to help.
At first light, she headed to the other dispensary in town, where she informed the nuns that my condition was critical and argued that my death, should they refuse to admit me, would be partly their responsibility. They issued her a red emergency admission slip, which Majken carried to my mother with instructions that she should use it immediately. This document enabled her to skip the long queue outside and head with me straight to the ward.
I was immediately administered a first dose of penicillin, and the nuns asked my mother to return in another six hours’ time. During the wait to go back, my mother watched over me at home, looking for signs of improvement as my small chest rose and fell in a succession of shallow breaths. I’ve seen these symptoms and the anguished look of mothers searching for the dawn of recovery thousands of times since.
At the time of the second dose of antibiotics, my condition had still not improved. The nuns tried to reassure my mother. “It will change, he’ll start reacting,” they told her.
It was only at the end of the day, at the time of the third jab, that I started to breathe more deeply, that the mask of pain began to drop from my features. By the following morning, the fever had receded.
My mother never forgot Majken Bergman. “It’s thanks to her that you’re alive,” she used to tell me. In 2009, when I was invited to Stockholm to receive a Swedish human rights award, my mother suggested that we invite Majken to the ceremony and the gala dinner.
She was by then a frail and elderly lady, well into her eighties, but her memories of Congo were still vivid. When we met, it was like a reunion with a long-lost grandmother. We hugged and laughed. She had become a firm friend of the family after my birth and was touched by the invitation to the ceremony. She reminded me of the games she’d played with me as a child.
My mother made a speech during the dinner and told everyone that the real star in the assembled crowd was Majken, a woman who had devoted her life to helping others and without whom none of us would have been there. Majken looked mildly embarrassed, then teary as the room thundered with applause.
My mother, who was devout to the end of her days in 2019 at the age of eighty-seven, was also convinced that my troubled birth set the course for the rest of my existence. “When we walked into the dispensary, God placed a message in your heart,” she’d say. “You should help others, just as you have been helped yourself.”
I’ve always been uneasy with the idea of fate, because I believe so strongly in the notion of human agency. God created us, I believe, but then left us free to make our own decisions. The idea of destiny implies we are somehow passive creatures, treading selected courses. I believe we constantly face choices, to be active or passive, to follow our conscience or to ignore it, and we use this liberty for good or ill. But my mother was convinced my path was predetermined.
Perhaps she’s right that the tumult of my birth and my family history had an impact on my later life. My first professional focus would be on fighting the deadly lottery of childbirth, in which hundreds of thousands of women perish around the world each year delivering new lives in unsafe conditions. Babies continue to die because of ignorance and neglect. Maternal, neonatal, and child mortality have been reduced to insignificant levels in the West, yet they continue to haunt large swaths of the planet, including Congo.
I still marvel at the courage my mother showed as she delivered me and my other siblings at home, knowing that an infection, a breech birth, or a postpartum hemorrhage could condemn her, like my two grandmothers, to death.
And I continue to admire the selflessness of Majken, who might have ignored the knock at the door in the dead of night or concluded that the life of a poor Black child who had been refused treatment once could not be saved. But she ignored the siren call of apathy or defeatism. She understood that her identity gave her power and responsibility.
* * *
My hometown, Bukavu, was originally built on five small peninsulas of land that extend like outstretched fingers into our lake, Lake Kivu. At times of strong sunshine, its waters turn a turquoise blue of the sort seen in the Caribbean or Mediterranean. In perfect stillness at the end of the day, they are a gently shifting mirror, offering up a reflection of the surrounding hills and mountains. At dusk, in a spectacle I could never tire of, they seem to glow orange, then pink, as the sun falls. Then inky blue, then ash and black and every shade in between.
It holds a magnetic and mysterious beauty. In its watery depths, there are believed to be vast reserves of absorbed methane gas, making life there almost nonexistent.
The temperature here averages a warm sixty-eight degrees Fahrenheit (twenty degrees Celsius) all year round, owing to the altitude of nearly five thousand feet (fifteen hundred meters). We have none of the stifling heat or thick humidity found in our capital, Kinshasa, twelve hundred miles to the west on the other side of the country.
We live in a permanent springtime, rarely too hot, never properly cold. Plants flower in every month. The only major variable is the rain, which starts abruptly in the wet season, sometimes with a clap of thunder. It gushes down in great sheets, then vanishes just as dramatically as it arrived. Within hours, once the clouds roll on and the strong equatorial sun returns, limp wet grass will be spiky and dry again; roads of thick mud will again be baked hard, covered in fine red dust that gathers on the hair and eyelashes.
The ruddy brown of the mud, like dried blood or deep rust, is one of the elemental colors of the limited palette of eastern Congo. It is everywhere that humankind or nature has exposed the soil. And it contrasts with the luminous green of the thick, creeping vegetation that blankets our hillsides and valleys.
I say “limited palette” because green and brown, the colors of growth and nature, so dominate in Congo. We share our home with the world’s second-biggest tropical rain forest after the Amazon, an often impenetrable blanket stretching from the eastern border to the far west.
Amid the forest are dots of flowers: the yellow inflorescence of the mango tree, the purple corona of the passion fruit vine, the string of red and yellow triangles of the heliconia palm. Yet the eye is dominated by those saturated base colors, the vivid green and rusty brown.
Beneath the canopy fan out the murky streams and waterways that churn toward the mighty, curved spine of our nation, the Congo River. It begins in the southeast, makes it way northward, then bends westward in a giant arc, turning more than ninety degrees toward the Atlantic Ocean, where it empties its frothy, sediment-rich contents with such force that a vast canyon has formed in the seabed.
The landscape around Bukavu rears up abruptly from the jagged shoreline of the lake. Even the five peninsulas of the town are steep sided, a mass of ripples and ravines. Behind them, farther inland, the rock rises in ever greater folds and hills. In the far background lie the mountains—Biéga and Kahuzi at around three thousand meters high—that shift in and out of view as clouds gather around their peaks.
There are active volcanoes, too, including Mount Nyiragongo, sixty miles from Bukavu, a rumbling cauldron that erupts periodically, spewing lava and ash into the lake. It is believed that volcanic activity around twenty thousand years ago reversed the direction in which Lake Kivu drains, sending its waters southward toward Lake Tanganyika instead of north.
The landscape of my homeland and the riches that lie beneath it were shaped by tectonic activity that has invested the region with both its unique beauty and its abundant raw materials. The tearing and renewal of the earth’s surface over hundreds of millions of years explains why Congo is endowed with so much mineral wealth, so tantalizingly close to the surface. One colonial surveyor called Congo a “geological scandal.”
Bukavu at the time of my birth was strictly segregated in an apartheid-like system. The central European neighborhood was a place of waterfront villas, white men in suits with slicked-back hair, and women in cotton dresses. There was a soccer field, a library, and art deco buildings.
The center was built in a replica of Belgian towns—quiet, ordered, clean—only with bigger homes and tropical gardens. Grand schools set in large, leafy grounds served the children of European settlers. Our cathedral with its large, curved white arches and domed roof was added at the end of the 1940s.
Around this central area was the so-called Asian quarter, home to Indian and Pakistani merchants who lived and traded from their homes. Farther from the lake, up in the hills, were two distant Black suburbs: Kadutu, where we lived, and Bagira.
Each morning from first light, thousands of men would stream from these zones to their jobs as porters, guards, cleaners, and gardeners in the center of town or as laborers in the local brewery, pharmaceutical plant, or fabric factory. Farther out of town lay the vast commercial plantations growing citrus fruits, bananas, coffee, and tea for export.
The colonialists—les colons, as they are known in French—had swapped a life under leaden skies in northern Europe for the warmth of the tropics. Despite the threat of disease—malaria was still a major killer, as was yellow fever—many Europeans thought they had found paradise.
From the 1950s, adventurous foreign tourists began heading out to Bukavu for holidays, sitting under bougainvilleas and sipping imported wine in scenery that resembled a tropical Côte d’Azur. The town was known at the time, and until 1954, as Costermansville, after a Belgian officer and vice governor.
Copyright © 2021 by Denis Mukwege