"Sister Clarangela left us on May 6. . . . The fever and vomiting never left her in peace. The heart has given in, and in a tremendous way!"

"Sister Danielangela left us for Paradise after 13 days of fighting against this terrible virus. . . . Now it's Sister Dinarosa who since May 4 has had the same symptoms."

At the hospital in Kikwit, Zaire, where she had labored for much of the past 30 years, Sister Annelvira Ossoli watched with growing horror as fellow nuns and scores of patients died a painful death from the Ebola virus. She described the tragedy in an anguished letter to her mother superior in Bergamo, here beneath the south rim of the Alps, on May 11.

In another 12 days, Sister Annelvira herself succumbed in what she called "this very difficult test."

The deaths of Sister Annelvira and five other nuns from the Little Sisters of the Poor have deeply wounded the order founded here more than 125 years ago to work among the impoverished. The nuns at the headquarters in Bergamo, a prosperous industrial town, followed the events from tropical Zaire through roundabout means -- radio from Kikwit to Zaire's capital, Kinshasa, fax from Kinshasa to Bergamo. Fearful frustration increased with each piece of bad news.

"It was heartbreaking one day to the next to hear the news: Someone is sick, then getting better, then a relapse, then death," recalled Sister Bakita Sartore, a member of the order's governing board in Bergamo. "To hear of the symptoms, the horrible pain. . . ."

The experience left a feeling of helplessness that is now redoubled as the epidemic fades. The reality is sinking in that the poor of Kikwit and much of Africa may long be vulnerable to similar fates.

"After weeks of fearing the news, now we fear the silence," Sartore continued. "It is hard to accept that everyone will be content that the disease is going away, if it is. The problem is not just an isolated illness. Ebola is a symptom of a disaster, not the cause. The cause is an Africa that is being abandoned."

Such blunt and pessimistic words are unusual for the Little Sisters of the Poor, who generally couch their public comments in the language of the Bible, and attribute triumph and tragedy to the will of God. The painful deaths of the nuns in Zaire have tested this unquestioning reserve.

It has become difficult to view the deaths merely as casualties of the hazards of service, as if years of deterioration in Zaire finally came together in the Ebola deaths. The root causes, including the corrupt regime of Mobutu Sese Seko in Zaire and the indifference of the developed world as Africa lost its Cold War strategic allure, remain unchanged by the disaster, Sartore fears. "This tragedy has been building for years," she said. "The end of Ebola is not the end of the problem."

The Little Sisters of the Poor number about 1,000 and draw many of their recruits from northern Italy, long a source of nuns for service in the Catholic Church. The Little Sisters began their work abroad after World War II; China was a first choice, but the Communist revolution precluded a mission there. The order settled instead on Africa, in 1951, and went to what was then the Belgian Congo, now Zaire. The nuns also operate in Malawi and the Ivory Coast.

Over time, the hospital in Kikwit where they worked grew to 11 pavilions to treat different diseases; there were 450 beds, although the patients sometimes slept two or three to a bed. The Italian sisters numbered 58 in Zaire, 14 of whom were at Kikwit, before the epidemic. All were nurses and worked among about an equal number of Zairian nuns of the same order. Another 400 workers and eight doctors rounded out the staff.

In recent years, work in Kikwit had become more and more difficult, said Sartore, who visited the community in 1994. Supplies rarely reached the state-run institute, so the sisters had to dole out medicine carefully. Food was in short supply, and cases of malnutrition more and more prevalent. The road from Kinshasa is in bad condition, making deliveries difficult.

Government pay for the staff was sometimes delayed for months. Before the Ebola virus broke out, no one had received paychecks for several months. Sartore believes that the delay demoralized the staff, contributing to the general decision to flee once the virus began to take its toll. "They had been demoralized in their service," she said, gazing at pictures of some of the dead nuns with patients and workers.

At the moment, only one pavilion of the Kikwit hospital is open -- to treat the virus. The staff has not returned, although volunteers from outside have come to keep the hospital afloat. The diocese of Bergamo collected about $400,000 to donate to Kikwit.

The first of the sisters to come down with Ebola was Sister Floralba Rondi. She had returned to Kikwit last year after six years' labor in Kinshasa and another 10 years' work at a leprosy treatment center in Mosango, near Kikwit. She thought the initial stage of her disease meant typhoid, and she returned for treatment to Mosango, where she died on April 28 at the age of 71.

The next victim was Sister Clarangela Ghilardi, 64, a veteran of almost 30 years in Zaire; then Sister Danielangela Sorti, 48, a nurse in Zaire since 1976; then Dinarosa Belleri, 58, in Africa since 1966; Sister Annelvira, who worked in Zaire for 33 years; then on May 28, Sister Vitarosa Zorza, 51, who arrived in Kikwit in 1983.

For the past four years, Zorza was stationed in Kinshasa. She insisted on going to Kikwit to help out as the scope of the disaster grew. Since her death, two more nuns have volunteered to go to Kikwit, one from Bergamo and another who was in training in London.

Two weeks ago, the nuns who remained in Kikwit came out of quarantine. They hope to reopen the entire hospital soon if the fear within the Kikwit community subsides. Some townspeople believe superstitiously that the nuns themselves are to blame, Sartore said.

However, morale took another plunge last week when a total of seven victims of Ebola died after weeks of suffering. More than 150 Zairians have been killed by the virus.


The deadly virus has killed more than 150 Zairians. The Little Sisters of the Poor have been working in Africa since 1951.

The virus is believed to be spread through body fluids, not casual contact. Most of those infected with Ebola have high fevers and die from hemorrhaging. About 90 percent of patients die, usually within days. There is no treatment or vaccine.

SOURCE: AP CAPTION: An Italian Little Sister of the Poor helps Zairian health worker don gloves outside a hospital, above. Sister Bakita Sartore, right, talks of the lingering heartbreak of losing six nuns to the Ebola virus.