Grooming session with Umoja, Nyiramurema, Kwitonda, and others. Six days after Umoja’s surgery, Magda returned from checking on him with a worried expression. Her report sounded exactly like mine from the day before: he was alert, whimpering, crawling, nursing well, and nibbling—but not swallowing—bamboo leaves. Umoja could still develop complications, and we’d both hoped his appetite for solid food would return by now. He could have an abscess brewing in the muscle layer where we’d placed the sutures, or the wound on his wrist could become infected. Or—the worst possibility—his intestinal tract might be damaged. He could have a stricture.
Umoja riding on Nyiramurema’s back favoring his right leg. Alternatively, Umoja may simply be content for now with the milk and comfort of his mother. Because of his broken leg, he’s unable to wander around, try out new foods, or play with other infants. His behavior resembles that of a very young infant rather than that of a two-year old. Maybe he simply lacks the energy to manipulate bamboo. He burns extra calories every time he crawls after his mother. Moreover, the healing process increases metabolic rate. The pain from his wrist and leg may make him too uncomfortable to eat. Still, we worry about intestinal pain or cramping if he does have some scarring.
Umoja resting with Nyiramurema. Elisabeth checked Umoja one week after surgery, a time frame we viewed as a mini- milestone. She and the trackers started out expecting to find Kwitonda where he’d been all week, close to the park border. Instead, they found evidence of a fast-moving journey up the mountainside. They could hear hoots and chest beating. Nyakagezi Group was back, and Kwitonda was on the move, following them. Elisabeth and the trackers stayed with the Kwitonda group for several hours. Fortunately, there’d been no fighting. Nyiramurema carried Umoja most of the time. If she put him down, another gorilla immediately picked him up.
Grooming session with Umoja, Nyiramurema, and silverback Kwitonda. Nine days post-surgery, I made the next recheck. We were early, and found several gorillas still in their night nests. Kwitonda was resting on his elbows. Nyiramurema walked over to him, leaving Umoja sitting quietly about ten meters away. As she started to groom the silverback, the infant got up to join them. Instead of crawling, he walked on both hands and his left foot, favoring the right hand a bit and holding his right leg entirely off the ground. He made no sound. I was relieved that at least he could now limp normally!
Umoja, nine days post-op, riding on his mother’s back. I decided to continue on and do a routine check of the entire group on this visit. While picking my way through the bamboo with Leóndace, I temporarily lost track of Umoja. By now Kwitonda was sitting in a shady thicket with several juveniles playing around him. I had my binoculars focused on this group when I heard a familiar noise to my left: gorilla crashing through bamboo. Nyiramurema appeared out of nowhere, only a few meters from me. She stopped and stared at me for a few seconds, then moved quickly toward Kwitonda. Umoja crawled from where he’d been sitting, hidden from view, and climbed on her back as she moved away into the thicket.
Umoja climbing up on his mother’s back. I looked at Leóndace. He didn’t seem concerned. Nyiramurema’s behavior was natural and normal. She’s always been a very protective mother, and we’d unknowingly broken a basic rule–never get between a mother and her infant, let alone an infant you’ve darted. But after silently chastising myself, I realized our blunder had yielded a positive piece of information about Umoja I hadn’t yet picked up on: he’d been where a normal, healthy gorilla infant should be, playing near the silverback while his mother foraged.
Umoja, nine days post-op, with Nyiramurema and Kwitonda. Unless something happens to Nyiramurema, Umoja will survive his injuries. He may have a visible a wound at the surgery site for some time, and bits of suture may migrate out. He may never walk completely normally, or recover full use of his right hand. But the fact that he managed to survive those first few days before our intervention shows he’s every bit as strong as his tough-as-nails parents. He kept his appetite for milk even with his intestines sticking out, and had enough strength to drag a broken leg behind him while holding onto his mother’s back with one good arm and leg. As Magda remarked, if Umoja lives to be a silverback, he’ll be quite something.
Nyiramurema carrying Umoja one year ago, Kwitonda Group, Rwanda. For the better part of a week, I woke up at odd moments during the night thinking about Umoja and Nyiramurema. I felt sorry for the mother with her injured eye and missing foot, yet amazed by her strength and stamina. I wished we could relieve Umoja’s pain. Magda told me she wasn’t sleeping well either. Circumstances were beyond our control, as is often the case in wildlife medicine. We’d begun by worrying about whether we’d have a chance to treat the infant and waiting for the two gorilla groups to separate. After the intervention, we wondered if we’d operated in time.
Umoja in June 2007, a healthy infant in Kwitonda Group, Rwanda. Only during the two hours when the gorillas were anesthetized were we in control. It was clear that Umoja was slowly dying. Surgery was his only chance, despite less than ideal conditions for a procedure involving an open abdominal cavity. Both puncture wounds went through skin and muscle straight into the abdomen. They’d begun to heal, clamping down on his intestines. We did our best—Magda and I, Elisabeth, and the five trackers, Pierre, Peter, Leon dace, Aaron, and Jerome. But was it good enough?
Nyiramurema with Umoja after his surgery, Kwitonda Group, Rwanda. As soon as the infant and his mother rejoined the group, our ability to influence the outcome ended. We could give Umoja more antibiotics after 72 hours, if we felt it would make a difference and if we could get a dart off; but the main event was over. If he suddenly weakened or the wounds reopened, it was unlikely that we could or would intervene a second time. Vets have post-operative control of their patients in many situations, especially when the animal can be confined or hospitalized, but not in this one. The next few days were up to the two gorillas. Umoja would either heal or develop complications. His mother would continue to carry him and let him nurse—or not.
Kwitonda silverback with his family, February 2007, Kwitonda Group, Rwanda. Magda checked on Umoja the day after surgery. When we’d left the group after the intervention, we felt optimistic about his immediate survival, but I didn’t relax until she called with an update. The trackers had found the group near where we left them—in a shady stand of bamboo. Umoja was clinging to his mother and his surgical wound looked intact. Not unexpectedly, Kwitonda had singled out Magda and displayed with a false charge, letting her know that he knew something had happened. Nyiramurema was nervous, too, though she allowed Umoja to nurse in front of Magda. So far, so good. Magda kept her visit short, knowing the gorillas would relax if left alone.
Umoja, 2-days post-op, riding on his mothers back as they leave their night nest. The next day I did the Umoja recheck. As we walked quietly through the forest, I could sense the trackers’ relief. They’d observed the infant nursing many times during the previous day after Magda’s visit, and he’d regained some strength. I heard Umoja whimpering even before we reached the gorillas, who were just leaving their night nests. The sound was a good sign. He’d been too weak or depressed to make any sort of vocalization for three days. I snapped my only photo of the day (it was too dark further inside the forest): Umoja riding on Nyiramurema’s back, bright-eyed and alert.
Kwitonda silverback, Kwitonda Group, Rwanda, May 2008. We followed the group slowly, in the hope that I could get a good view of the abdominal incision. Akareveru, the older of two black backs, felled a tree filled with flower buds and began to eat. Several other gorillas moved in to join him. Suddenly, Kwitonda appeared out of nowhere and ran at us. He stopped just a meter away, puffing out his upper lip and glaring at me. I stepped behind the tracker, Pierre; the silverback moved forward, backing us up further. I was aware that Nyiramurema was approaching from the left, and clearly Kwitonda was, too. I got the message: he knows me as well as Magda, and isn’t happy about either of us. As soon as the female sat down to eat, Kwitonda did the same.
Umoja, three days post-op, riding on his mother’s back; his surgical wound is healing. Nyiramurema didn’t seem to notice me, or if she did, she felt safe in Kwitonda’s presence and showed no reaction. She pulled up a bamboo shoot and let Umoja slide to the ground. He rolled onto his back and lay quietly. Through my binoculars I could see that the skin around his incision was puffy and moist on the surface. A major concern has been that the sutured tissue will break down, or dehisce. Since we expect some inflammation at 48-hours post-operatively, this was no cause for worry, especially given that other gorillas had undoubtedly been picking at the wound.
Nyiramurema got up to find another shoot, leaving Umoja several feet away. He whined, turned over on his belly, and immediately crawled over to her dragging his broken leg. Though he whimpered the whole way, he covered the distance quickly. A few minutes later, he nursed for some time. Once I was away from the group, I called Magda and Elisabeth with the good news: Umoja was stronger, vocalizing and still nursing, and that the incision looked okay. On the following day, Magda’s photos showed an even brighter and stronger Umoja. He nursed at every opportunity. The swelling around the incision had decreased and the surface was dry.
Kwitonda Group gorillas eating bamboo, Rwanda. Elisabeth checked Umoja on the fourth day after surgery. He whimpered throughout her visit, but nursed well and appeared strong. When I returned on day five post-op, the trackers were all smiles. We found Kwitonda and his group eating bamboo shoots in a dark, vine-filled patch of forest, close to where they’d been foraging all week. The trackers believe—and I agree—that the silverbacks know not to move too far or too fast when a member of the group has a problem. (This is noticeable when there’s a newborn baby.) Kwitonda stopped eating briefly to glance sideways at me. We found Nyiramurema nearby, sitting upright with her back against a tree.
Umoja, seven days post-op, (photo courtesy of our friend Louise Hurst who visited Kwitonda Group as a tourist.) At first, I couldn’t see Umoja. He lay on his back on the ground behind his mother. As she had the other day, Nyiramurema got up to look for more food, walking calmly past me at a distance of about four meters. She moved up hill, doubling the distance between us, leaving Umoja behind and to my left. He stayed quiet for a few seconds, then began to crawl after her, using his elbows and left knee while holding his right leg off the ground—and whimpering loudly. Halfway there, he turned to look at me and started to scream. He screamed all the way until he climbed onto his mother’s back. She simply continued eating. Jerome looked at me, smiling, and whispered, “They think you are the enemy, the doctor is the enemy.” But never mind—I’ll take that in exchange for a healed patient any day.
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