The first piece of the puzzle

The first piece of the puzzle

(5 August 2026)

I’ve just dropped my little boy off at the summer art camp. Yesterday, amidst the chaos of my research, I had to scrounge together a metre-long stick, an old sock and three apples for him. I’m very curious to see what he’ll do with them. It’s quite fitting for these times. In research, too, you bring all sorts of separate pieces together and hope that they’ll eventually form a coherent whole.

We’re about to start a study into the Bundibugyo Ebola virus, which is causing a severe outbreak in eastern Congo. We want to better understand how patients fall ill and how the virus spreads. Colleagues on the ground are gathering information and taking samples from patients for this purpose.

It was two o’clock in the morning when I finished work, just like the night before. Just before the start of a study, there are always lots of pieces of the puzzle that still need to fall into place. You’re constantly spotting things that could be improved: this form needs tweaking, that section could be clearer.

At the same time, I know that a study like this isn’t finished when it starts. It's almost like a living, organic being. Over the coming weeks and months, we’ll keep making adjustments as a team if something isn’t working, is unclear, or if new insights call for it. I remind myself that today is a starting point, not an end point.

Our main task now is to clearly explain to the study staff in Bunia why we’re conducting this study and how they can collect the correct data. Their training starts today. The basics must be clear: which patients are eligible, what information do we need, and how do we ensure that everyone collects data in the same way? If we manage that, we’ll have put an important piece of the puzzle in place.

What makes it more challenging is that I’m not in Bunia myself yet. When you launch a study remotely, you have to trust that the people on the ground know what needs to be done and that you can rely on one another. Fortunately, my colleague Emmanuel Hasivirwe Vakaniaki from the Congolese National Institute of Biomedical Research (INRB), a long-time ITM partner, is already in Bunia and we’re working with a strong team.

Still, every day there are a hundred little things you’d really like to discuss together: take another look at one thing, and how are we going to tackle another? That’s sometimes harder when you’re working remotely.

Today we’re writing page one of the first chapter of this story. We don’t know much about the virus yet, and by the end of the study, we will have much more information. This journey is what makes it interesting. The past few days have been tough, but I’m looking forward to it.