In some lucky places in the world, small crystalline rocks created deep in the earth’s magma, are forced to the surface; by the time they reach the light, they have become precious stones – the most precious, the hardest and the most fought over. People kill for them; people die because of them.

“Conflict diamonds”, “blood diamonds”, glittering pawns in civil and ethnic warfare. But could anyone possibly have known that diamonds are also partly responsible for another, more insidious enemy? Sleeping sickness, or Human African Trypanomiasis (HAT)?

Sleeping sickness is a fatal vector-borne parasitic disease, which threatens millions of people in 36 countries of Sub-Saharan Africa. As many as 70 million people live in high risk infection areas. The parasites causing the disease belong to the Trypanasoma Genus and are transmitted to humans by tsetse fly bites which have acquired their infection from human beings or animals harbouring the human pathogenic parasites.

The first stage of the disease is hard to diagnose - presenting in bouts of fever, headaches, joint pains and itching, but relatively easy to treat; the second stage, includes severe neurological symptoms - confusion, poor coordination and a disturbance of the sleep cycle, which gives the disease its name. If the second stage is left untreated, coma and death prevail.

The Democratic Republic of Congo (DRC) is a country where sleeping sickness remains a killer. The areas that harbour the tsetse fly tend to be rural, and remote - where health systems are weak or non-existent. People displaced by war and poverty are forced into overcrowded regions and thus transmission of the disease can be accelerated. The strain of tsetse fly that transmits sleeping sickness, is found in the vegetation alongside lakes and the alluvial plains of rivers.

Mbuji-Mayi, located in the East Kasai province in the south eastern part of the country, is the diamond capital of DRC. It is surrounded by a large network of waterways between the Lubi River to the west and the Sankuru River to the east. It is in the alluvial plains between the rivers that diamonds are found. Diamond mining in the Belgian Congo dates back to the early 1900s, when substantial placer diamond deposits were discovered here. After heavy rains the diamonds would be washed into the streams and rivers and could be picked out by hand.

The Democratic Republic of the Congo, formerly the Belgian Congo and then Zaire, is the largest country in the African continent. It is also endowed with abundant natural resources, not least diamonds. Since its independence from Belgium in 1960, the country has never known true democracy and has been fuelled by ethnic and civil strife; this has led to a country in a state of extreme underdevelopment despite the presence of its valuable mineral resources. DRC is the fourth largest diamond producer in the world. In 2005 some US$870 million worth of diamonds were officially exported from the country.

80 per cent of the diamonds mined are extracted by artisanal mining. This is "small-scale mining" involving nothing more than digging and sifting through the mud or gravel alluvial deposits from the river banks. Shovels, large conical sieves or even just bare hands are the tools of the trade. Artisanal labourers are called "diamond diggers". It is a form of "subsistence based" mining that is used in poorer countries throughout the world.

Artisanal diamond miners, are known in DRC, as ‘creuseurs’. They sell their diamonds to middlemen, known as ‘traffiquants’ or ‘négociants’ who in turn sell to the licensed exporters or ‘comptoirs’. There are thought to be over 700,000 ‘creuseurs’ and around 100,000 'traffiquants' operating here. There are only a handful of exporters.

The cutting and finishing of the rough diamonds, cannot be done in DRC, so this along with exportation is normally handled by Western firms……80% of the diamonds end up in Antwerp.

Despite the existence of a legitimate industry there is also a sizeable illegal trade which is where the terms 'conflict diamonds' or 'blood diamonds', emerge. The profits from the diamond trade are immorally used to fuel the civil wars taking place in many African countries even today.

The DRC is no exception…rebel forces control some of the diamond mining areas; they extract the stones, sell them illegally and use the money to fund their insurgency. As a result fighting around diamond rich areas such as Mbuji-Mayi has been particularly intense. This in turn has led to not only the displacement of people fleeing ethnic violence, but a gathering of the very poor Congolese looking for a way to make money by diamond digging. The concomitant overcrowding and insanitary conditions create the perfect environment for the tsetse fly and hence sleeping sickness.

Screening for potential infection amongst those at greatest risk, is of paramount importance if the disease is to be managed. Unfortunately, this requires a major investment in terms of human and material resources. In places such as Mbuji-Mayi, such resources are scarce despite the huge potential financial rewards of diamond mining, and eradicating this fatal disease depends on NGOs (non governmental organizations), the World Health Organization and others to fund diagnostic and treatment systems. Although a degree of political stability has been brought to DRC since 2006 with the election of Joseph Kabila as President, the great majority of the population are poor and have limited or no access to healthcare and epidemics break out with regularity.

Despite attempts to restrict mining to certain zones, diamond diggers extract the stones along roads, in fields and forests, and move frequently to avoid detection. These people also congregate on the diamond rich alluvial plains…adding to already overpopulated areas and providing ever more targets for the sting of the tsetse fly.

A large proportion of the local population believes the presence of diamonds to be a blessing from God or nature. Not only this, for many it is the only way to make a living in a politically unstable country racked for the last half century by civil war. If a way can be found to reinvest the staggering fortune that DRC diamonds earn on the export markets, diseases like sleeping sickness could be eradicated in a relatively short space of time. What a tragedy that the mining of such a beautiful stone can actually underpin one of the deadliest killers on earth.

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