Crossing Big Rivers by James Kenney

CROSSING BIG RIVERS is an essay on how AIDS first spread from the Mama Yemo hospital. In 1926, the colonizers of the Belgian Congo built a premiere hospital for the treatment of tropical diseases in the capital, Léopoldville, named for their king. When the Congo was rushed into independence in 1960, a chaotic struggle for power was unleashed. The country’s first democratically-elected prime minister was assassinated, and the dictator, Mobutu, was installed through the machinations of the capitalist West, who feared an expansion of communism in Africa.


To erase the stain of colonialism, Mobutu fostered African identity through renaming : the country to Zaire, the capital to Kinshasa, and the hospital to Mama Yemo, in honor of his mother. Some believed her to be a moderating force upon Mobutu, and after her death in 1971, his megalomania continued to grow. By the mid-1970s, the international copper market had collapsed, stripping Mobutu of his largest economic fulcrum. His methods became more nefarious. The country, its people, and their biggest hospital have suffered from decades of neglect.

In 1976, some of the first-identified cases of ebola travelled from the remote jungle to here for study. As AIDS in the West was recognized in the late 1980’s, some pointed to familiar symptoms identified earlier at Mama Yemo Hospital. But it wasn’t until the 2013 book, Tinderbox,1 confirmed long-held suspicions. Mama Yemo Hospital is the furthest back anyone can genetically trace the spread of HIV.


The writers of Tinderbox argue that HIV had existed in the jungle for at least centuries, but the disease was only able to spread when Europeans enslaved the native people, forcing their mobility along trade routes and crowding them into townships. Before that, HIV likely slowly burnt-out within the limited sexual relationships of small tribes, because it didn’t have movement and critical mass. It didn’t cross big rivers.

But civilization gave HIV the tinder – the binder – it needed.

After the fall of Mobutu in 1997, the hospital was renamed Kinshasa General Hospital. The Democratic Republic of the Congo is one of the longest-exploited countries on the planet. Its vast wealth of natural resources has historically left its people enslaved to the outsiders who capitalize on the country’s instability.

The people of the Congo are expected to survive by their wits and not from the care of a government. The hospital is an example of this in action, where desperate patients lay queued in open-air walkways, awaiting care for which they cannot pay. Their health indebting their families to pay a ransom for their release.

The few who receive beds are in more advanced stages of illness.


Open windows; five to ten to a room; the same dense and dusty air; unanswered egg-timers; food and trash on laboratory surfaces.

I was a competitive swimmer as a child. I held my breath when they pulled out the blood samples.

The only moment that I shut off my camera in the Congo happens in a room here, as two females in richly-patterned pagnes helped their elder sick male relative out of a bed. It was a long process before I realized that they were lowering him onto a bucket on the floor. Regardless of such personal moments, not one person gestured for me to stop filming. In fact, some patients did not even track my presence. Like open-eyed zombies, empty, the patients here are without rights. They are privileged to receive any care and would not jeopardize that. Throughout Kinshasa I was censured by people saying “No camera”, but here individual people did not have authority to regulate themselves. I had the permission of the state to which they were beholden.

The maternity ward was next down the corridor. In beds—looking normal, beautiful, and healthy, although clearly bored—were women who had had complications with the birth of their babies. At first, I didn’t realize that the babies were also in their beds, usually laid in a corner. Both mother and baby were being held hostage by the hospital because their bills were unpaid. It was, in effect, a maternity jail. An administrator explained that relatives and friends would need to raise the money for their release. In his office, he had shelves that reminded me of a thrift store. Random objects of little worth: clothing, boom boxes, cheap jewelry. Each was valued toward a mother’s debt.

I asked the administrator how they could most benefit from financial assistance. It became clear that monetary grants were not recommended, because corruption would likely absorb them. A nurse said that clean bed linen would be the most helpful. I couldn’t help but notice the administrator’s flashy watch.

Directly outside the gates of the hospital is a street of burial wreaths, synthetic colorful flower arrangements, some big enough for the winners circle of a horse race. These vendors were hedging their bets against cures.


Bio : James Kenney has produced and directed three feature documentary films. Jim completed the Practical Film Laboratory at Pixar Animation Studios, and he has degrees in painting and design. He was an Associate Professor of design and film for thirteen years. He is a published author, photographer, and artist. Film projects to which Jim has contributed have been awarded by prominent international festivals and organizations, including The Sundance Film Festival and The Academy of Motion Pictures. (

Artist, writer, and filmmaker, James Kenney, traveled to Mama Yemo Hospital for his documentary feature film, Housewife in the Heart of Darkness with its co-director Bonnie O’Neill, and he wrote stories from his Congo travels in a chapter of the book, Searching for Hell.

  1. Timberg, Craig, and Daniel Halperin. Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It. Penguin Books, 2013.