The Mystery of Lacor

The Ebola epidemic. The story of Doctor Matthew and other staff at St. Mary’s Hospital, who gave their lives for the patients infected with Ebola. A testimony till martyrdom

by Andrea Costanzi

It is January 10, 2001. There have been 428 cases and 173 dead, yet the word “end” cannot yet be written under the Ebola vicissitude in Uganda. The last recorded case was on December 23rd. The country, deeply affected by this mortal epidemic and, above all, by the witness of the St. Mary’s Hospital staff in Gulu, who gave their lives for the patients infected by the hemorrhagic fever, is waiting for the end of the quarantine. The new martyrs of Uganda are thirteen nurses and one doctor, Matthew Lukwiya, who was proclaimed “Man of the Year” in Uganda, second only to the eternal President Museveni. Matthew, 43, a Protestant Christian, married and the father of three, was the man in whom Piero and Lucille Corti, the founders of this hospital, had placed all their hopes for the future, naming him the Superintendent.

The Tridentine rock
Facts. In the space of a few days, three students of the Nurse Training School and two untrained nurses of Lacor Hospital had died of a mysterious disease. Matthew was in Kampala for study, and was summoned urgently back to Gulu. Reviewing all the medical charts in one night, he discovered that 17 cases of death were compatible with the Ebola virus. The last epidemics had taken place in the Congo in 1995 and in Gabon in 1997, causing 244 and 45 deaths respectively. Blood samples sent to South Africa soon confirmed his suspicions. The prospects were terrible: Ebola spreads by direct contact in a short time and strikes almost every organ, inflicting unbearable pain while the patient’s mind stays clear to the end, in most cases. The work of medical personnel is essential for containing the disease, reducing pain, and preventing contagion.
On October 9th, an isolation ward was set up in Lacor, in keeping with the directives of the World Health Organization, and became operative immediately. In this tragedy one positive point was soon evident: the virus had struck the only structure in Uganda equipped to handle it.
With his grizzled beard and his big hands always in motion, Elio Croce, a Combonian brother born in Moena di Fassa, Italy, who has served in Lacor since 1985 as Logistics and Maintenance Manager, was the rock that everyone gripped, for he would withstand even this latest storm. Fr. Peter Tiboni, the leader of the Movement in Uganda, saw him in action. “His workers and friends acknowledged in him a pillar not only in facing Ebola, but for their own lives. When the disease was at its peak, it was dangerous to meet for School of Community. The only help people could get was watching Elio and following him.”
Brother Elio at once took upon himself the task of organizing the isolation wards and the very dangerous tasks of bringing in suspected cases and of burying the Ebola victims. The friendship between Elio and Matthew and their personal dedication, risking their own lives, conquered the fears of the personnel. Maria Santo, responsible for the nursing staff, who was at the end of her contract from Italian Cooperation, decided to stay over to lend them a hand.
On October 22nd, at the Beginning Day of CL in Kampala, the Apostolic Nuncio Christophe Pierre, declared, “There are Christians in Lacor, both Protestant and Catholic, who give their lives in the front line treating the Ebola victims and saving the country from a worse catastrophe.”
Brother Elio recounts, “It was hard at the beginning to overcome the fear of the virus and to convince nurses to care for the patients. The examples set by Dr. Matthew and young Dr. Yoti before the doctors, and that of Maria before the nurses, were vital. I too started driving the sick to the hospital in the ambulance, and others followed me; a team was set up that carries out this service. It is up to you to set an example, then others will follow. We are here for Jesus Christ and what we do we do for Him; to Him we witness by our service so that everyone may know Him, and know that He is the truth of themselves and of their own destiny.” This same position was visible in his team of drivers and workers, among them Kilama, who was ever ready to take up the leadership of the CL community whenever Elio was too busy and could not attend.

Forty-two volunteers
Dr. Matthew asked for volunteers to serve in the Ebola ward. In spite of their colleagues already buried and of the discouraging records (in the Congo 60 out of 244 deaths occurred among the medical staff), as many as 40 nurses and two doctors volunteered. Sister Dorina Tadiello, a Combonian sister and a doctor, joined later. “Matthew introduced me to the new reality by explaining that from time to time Ebola strikes in some remote recess of Africa, kills a few hundred people, and disappears. It will hardly catch the eye of public opinion, or attract investments for research and treatment, since it will never be a big commercial business.” Yet he was determined to study it more deeply. His meticulous observations earned a mortality rate in Lacor that was lower than 40%, as opposed to 70% in Masindi and Mbarara (the other two centers of contagion in Uganda), and 77% in the Congo in 1995.
Sister Dorina goes on, “Life in the ward is far from easy. The protection gear (made up of hat, mask, eye goggles, cloth apron covered by a plastic one, boots, and two pairs of gloves), the heat, the tension at the possibility of a mistake in procedures lying in wait for you, drain you of all your energy.”
One week after the Ebola ward was set up, the number of admitted patients was 63 and the dead as high as 18. The numbers were swelling, and Brother Elio asked the authorities for space to create a cemetery. The dead from the government hospital were buried next to those from Lacor, wrapped in plastic bags and thrown into pits like garbage. “The corpses coming from Lacor were sealed in plastic bags as the health directives required, then they were laid in coffins, and let down slowly by ropes, as Christians are buried, while their relatives said a Requiem with us.”

Grace’s hymn to life
Nurse Grace Akullo fell sick in mid-November. Dr. Matthew took care of her himself. When she was nearing the end, he reassured her, promising he would personally look after her 4-year-old twins. Then he added, “Grace, you did your best, and we too did whatever we could to fight the disease. Now one thing is left to us: to place our lives in the Lord’s hands, and to accept that His will be done, incomprehensible as it may appear to us.” Sister Dorina stood nearby. “It was just past one o’clock Saturday morning, when she suddenly opened her eyes. I approached her and asked whether she wanted to say something. She nodded. Then I removed her oxygen mask. She looked hard at us all, then with a great effort, commanding the last bit of energy left to her, intoned a song: “God our Father, you are the Potter, and we the clay in Your hands. Mold us and transform us into the likeness of Your Son.” In the long painful hours leading up to her death, Grace had meticulously prepared her parting message. Then her voice stopped in her throat, she reclined her head and breathed her last. Her face composed itself with extraordinary beauty and brightness.”
At the death of Sister Pierina, a nurse belonging to the Little Sisters of Mary Immaculate, Dr. Matthew had said words that were like a prophecy of his own imminent death. “We have been through very hard times in Lacor: the war, the guerrilla activities [he himself was kidnapped by the rebels], looting, destruction, and sickness. We thought there would be nothing worse than what we had already been through, but we had not thought of Ebola. What is happening in me since the epidemic broke out is a reflection on my understanding of the medical profession, which we choose for prestige perhaps, or because we wish to save human lives. Today I understand more deeply that it is a vocation, and that service to life is inseparable from the readiness to give up your own life. I am aware of the risk today, but I’ve made my choice and do not look back. My life has changed, and it will never again be as it was before. The example of our personnel who died of Ebola throws new light onto my decision. They were all young, at the start of their careers, with futures in front of them and dreams they had seen finally coming true; and then, all of a sudden, they found themselves face-to-face with death. Never a word of regret, never resentment or repentance for having chosen such a risky profession. They have accepted the tragic reality with serenity. Daniel, on the point of death, gave thanks for all he had received in the Nursing Training School, and added, ‘I’m going to die, but you go ahead with courage. Our work is too important.’ They all are martyrs of charity.”

The last gaze on reality
When Dr. Matthew was struck by the early symptoms of the disease, people hoped it was something banal, the blood test suggested malaria. But when fever persisted, the Ebola test was ordered, and came out positive. As he was taken into the isolation ward during the night he exclaimed, “My God, my God, I will die of Ebola in my service, but I want to be the last victim.” He went on singing, “Ahead with the Cross of Christ! The Church of Christ moves on–my brothers, we are walking on the roads of saints; we are not divided, we are one body, united in hope, in our call, in charity.”
His clinical picture worsened rapidly. He asked to be shown his X-rays, he wanted to know the results of his tests, he made his comments and proposals. He wanted to live intensely every moment granted to him. After a few days he was at the end of his strength. The only hope was to intubate him under general anesthesia in the attempt to improve his breathing. It was a hard decision to make, yet an inevitable one. He himself took part in evaluating all aspects of the decision, and gave his assent. His wife came and uttered a touching prayer, “Almighty God, if You wish, You can heal him, but Your will be done.” Sister Dorina, too, was present for this. “Matthew was helped onto the bed where he was going to be anesthetized. He sat down with great effort and looked around, aware that this could well be his last gaze on reality. As the anesthesiologists completed their preparations, he turned for a few last words with his close assistants. It was a moment of intense grief. We would have liked to embrace him, but it was not possible. All our protective gear seemed to put up a barrier between us and him. Yet his intense, strong look seemed to do away with every wall. When our eyes locked, with his deep and penetrating gaze that wanted to deliver his last message, I thought I couldn’t bear the pain.”

A doctor in the front line
Kitgum, Hoima, Kampala. Ebola spared the centers where AVSI (Association for Volunteers in International Service) carries out its medical activity. Apart from the preparations to face a possible emergency, there was one case of direct involvement. On December 3rd, AVSI Kampala received a request for help from Lacor. An expert in resuscitation was needed for the last attempt to save Dr. Matthew’s life. Gaetano Azzimonti, posted at Hoima Hospital, left on the morning of December 4th. When he arrived, he found the patient’s condition very critical. He took care of Matthew personally until his death by pulmonary hemorrhage on the morning of December 5th. Azzimonti says, “The whole staff on duty gathered in prayer. Brother Elio kept saying, ‘We all are orphans.’ His wife prayed over her husband as follows: ‘At this time of great, almost-killing grief, I thank You, Jesus, for the gift of my husband; I ask You to take him with You, he who was able to offer the whole of himself for his patients and for Your glory. From this moment on, O Lord, you are going to take Matthew’s place in my own life and in that of my children. You are going to be our comfort, our guide, our strength.’”
After taking part in the burial, Azzimonti returned to Hoima. “While I was nearing the house, I realized that inside the tragedy that had befallen Lacor there was something great, an event that was radically changing the lives of all the personnel involved.” Two days later, he had a high fever. Only four days had elapsed since his contact with the virus, but anything was possible. He had to go back to Gulu, which has the only laboratory equipped to test for Ebola. Brother Elio came to pick him up. The journey was a very painful one. “We recited the prayer of Consecration to Mary and Elio asked me to repeat, ‘Totus Tuus, we entrust ourselves to You, O Lord.’ The 4-wheel drive was flying over the road, every pothole causing my head to explode and my stomach to twist up. At a certain point I said, ‘I feel the disease inside me, there are all the symptoms.’ Elio countered, ‘In this situation, which I too have experienced, we feel truly naked, there is nothing left between ourselves and His mercy, between us and His love.’”
The following day the fever had disappeared and the test was negative. Dr. Matthew had kept his word: his was the last death among the medical personnel.

Out of the Depths I Cry to You

Pages from the diary of Combonian Sister Dorina Tadiello from her days as one of the doctors attending victims of the Ebola virus at St. Mary’s Hospital in Gulu

And now here I am. … The storm seems to be over. In our ward, there are just a few patients on the road to recovery. Thousands of people who have had contact with the Ebola patients are checked daily, but they do not appear to show signs of the illness. Maybe we are really approaching the end of this tragedy… and with a sigh of relief we begin to look back on what we have been through. It is a review backwards in time in the effort to understand the full depth of what has happened, to grasp the true meaning of these events, but also to look at our own wounds, to give vent to our grief, to feel our vulnerability and impotence in the face of this illness, and to wait for healing.
I arrived in Gulu just after the epidemic was confirmed, around the middle of October, to visit the Sisters of the two communities present in Gulu. The first public safety measures were already in effect: gatherings of people were forbidden, the movement of people from place to place was restricted, no hand-shakes, no “funeral rites,” suspected cases had to be reported, etc. As people received the necessary information, their panic and fear grew. At Gulu Mission, however, I found Sister Maria Grazia, Sister Katheryn, Sister Luisa, Sister Angela, Sister Innocenza, and Sister Ester serene and determined to stay here to share this new trial with the people. …
Meeting my former lay collaborators from my years working in Gulu on an AIDS program was very touching. As soon as they saw me, they had already hugged and kissed me before thinking about the fact that it was forbidden. They could not contain their wonder and gratitude at the fact that I had come to Gulu right at a dramatic moment, when all the foreign organizations that were there were leaving, and anyone who could tried to escape to safety. They said, “We shall never cease wondering at the greatness of the missionary vocation and, after all, we knew that you would come.”
The decision to cross the threshold of the Ebola ward was not so obvious, but was the fruit of a great struggle and one that was deeply felt. Among all the epidemics, Ebola appears to be the most threatening to health workers. The 60 health workers who died in Zaire during the last Ebola epidemic are a cry of alarm and a terrible threat. …
Doctor Matthew had told me that when he launched the appeal for Ebola, he had presented himself by saying that he was prepared for anything. Always available, day and night, he knew how to spread serenity and optimism, two particularly important things in stormy times. He spent a lot of time, too, talking with the nurses, especially in their moments of greatest discouragement. …
From the moment I entered the Ebola ward, death became more familiar to me: you could read it in the patients’ faces, you saw it in the coffins coming out of the ward. When a nurse died you would feel Death next to you; it seemed he was walking beside you, and you never knew if he was already working in you. I would try to prepare myself so as to lessen the shock. But it wasn’t easy. Foreseeing how things would develop, how much strength I would have to react, was an unfathomable mystery, and in any case it was entering into a reality that I did not have the strength to bear. So then I would turn to Grace, saying to her, “You help me, stay by me when I shall need it.” However, I chose the psalms with which I would have liked to bring my earthly life to a close, if the Lord called me and if He granted me the grace of a clear mind and of His peace. I would have liked to have someone read them to me if I were not able to speak. I chose Psalm 129: “Out of the depths I cry to You, O Lord! Lord, hear my voice!… my soul waits for the Lord more than watchmen for daybreak. O Israel, hope in the Lord! For with the Lord there is mercy, and fullness of redemption.” And then Psalm 15: “I say to the Lord, ‘You are my God; my happiness lies in You alone.’ … O Lord, it is You who are my portion and cup; it is You who are my prize. The lot marked out to me is my delight, welcome indeed the heritage that falls to me. … You will show me the path of life, the fullness of joy in your presence, at your right hand happiness for ever.” Then I chose the Magnificat and Psalm 44: “My heart overflows with noble words; to the King I must speak the song I have made. … You are the fairest of the children of men; graciousness is poured upon your lips, because God has blessed you for evermore.” For my Funeral Mass, I would like the following readings: Isaiah 42:1-7, 1 Cor 2:1-10, Mark 14:3-9, with the songs Grace chose at the end of her life. They became for me the meaningful prayers that accompanied my journey day after day and gave me serenity and peace.
The thought of death, however, also helped me look at reality in a different way. Problems and concerns that were so important faded away. The world around me–from persons, to flowers, to the sky–everything seemed to show forth a new beauty I had never seen before. I would think even more nostalgically of the persons who are dear and who mean something to me.
A week later Dr. Matthew got sick, almost as a confirmation of the forebodings of Dr. Yoti, who cried his eyes out at the lab results. … One afternoon Dr. Matthew reassured him that he would be the last victim. A few days after Dr. Matthew’s death, Yoti had a fever, but he said, smiling, “I am not afraid; Dr. Matthew will keep his promise.” And in fact, the test came back negative. …
Now that he is gone we feel the immeasurable void he left behind, but as the Apostolic Nuncio, Christophe Pierre, said in the Funeral Mass celebrated in Gulu Cathedral, “His truncated life is now a seed dropped into this soil, and it will give forth its fruits also through us, who are called to continue his example, to make present the values for which he gave his life.”