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Congo’s KOKOKO! Makes Joyful Dance Music From Instruments Made Of Junk
KOKOKO!, a band from the Democratic Republic of Congo, performs at an NPR Tiny Desk Concert that will be posted at a future date.
Bob Boilen/NPR
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Bob Boilen/NPR
Before the members of Congolese music collective KOKOKO! take the stage at Washington, D.C.’s Rock & Roll Hotel, they slip into bright yellow jumpsuits.
The fashion choice, they explain, has utilitarian roots: That’s what a lot of workers in Congo wear. Their instruments have a similar no-frills style — they were crafted from kitchen pots, tin cans and air-conditioner parts.
“It started out because commercial instruments in Kinshasa [where they live] are too expensive to buy and also too expensive to rent. So it started with the necessity of creating your own guitar or your own bass,” says member Boms Bomolo.
The group’s name reflects their humble origins. “KOKOKO” means “knock knock knock” in the local language, Lingala. When they were getting started in 2016, they picked it as a call-out for somebody to open the door and let their music in.
And the door is definitely open for their joyful dance music, with energetic percussion, electronic beats and call and response vocals between the band members and audience. Even if the crowd at Rock & Roll Hotel doesn’t understand the Kikongo, Lingala, French and Swahili lyrics, they eagerly repeat the words back to singer Love Lokombe.
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In their first two years, KOKOKO! toured the world and released a slew of singles and an EP. They dropped their debut LP, Fongola, in July to rave reviews. Earlier this year, their performance at South by Southwest music festival in Austin, Texas, caught the attention of NPR’s All Songs Considered. Now wrapping up their first big tour across North America, they stopped by NPR’s Tiny Desk on October 1.
During the concert, the group’s instrumental inventory included rows of plastic containers, pots and pans and a guitar fashioned out of two cans and a wooden fretboard. Some of the objects were ready to be played with no adjustments, like the metal kitchen pots used for percussion. Others, like the drum kit that features parts of an old air-conditioning unit, took a bit more assembly — the musicians had to go out, collect scraps and combine them into one cohesive instrument.
Perhaps their greatest creation is a “monumental human-size bass harp,” as described by member Xavier Thomas — made from a wooden cross, metal cans and a plastic barrel. They call it “Jesus Crisis,” a humorous reference to evangelical churches in Congo, which Thomas says can get quite “inventive” with their religious interpretations. The harp was made by group member Dido Oweke, who, according to his bandmates, visualizes the instruments he wants to make as sculptures first.
KOKOKO! member Dido Oweke built the “Jesus Crisis” bass harp in 2016.
Xavier Thomas
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Xavier Thomas
“We brought [the harp] once on tour, but it’s so hard to transport. It’s like moving a house,” says Thomas, also known as Débruit when he does solo electronic music projects. Thomas, originally from France, is the only member of the band not from Congo; he acted as the interpreter for the other musicians interviewed for this story.
Thomas met his bandmates while working on a music project in Kinshasa. They jammed together at a block party in 2016 and formed the group shortly after.
The music itself, which combines homemade instruments with electronic synths, channels the sounds and spirit of KOKOKO!’s birthplace. Kinshasa, home to an estimated 12 million people, has a rich aural landscape, according to Bomolo, Thomas and percussionist/vocalist Makara Bianko. Street vendors clink nail polish bottles together. Shoeshiners call out to customers. Megaphones blast recorded advertisements for cellphone credits on a perpetual loop.
“With your eyes closed, you can tell who’s where — at what distance,” Thomas explains. “Boms is inspired by the sonic chaos and reorganizes it into music.”
KOKOKO!’s high-powered performance, yellow jumpsuits and all, is a demand to be seen and heard in the middle of Congo’s vibrancy — but they also make a point on their website and during the interview to highlight the challenges faced by Congolese people.
The world sees Congo as an Ebola hotspot — the country is currently is facing the second largest outbreak in history. But the musicians say the virus does not play into daily life in Kinshasa, which is more than a thousand miles away from the affected area. The members of KOKOKO! have other concerns, like violence, corruption and poverty. The World Bank estimates that 73% of Congo’s population lived in extreme poverty in 2018.
Congo is rich in natural resources, making it a top producer of metals like cobalt and coltan. But Bianko believes that the wealth from those resources mainly profits industrialized nations and the multinational corporations that mine in Congo.
“Every time the industry needed something in the world, they found it in Congo, but they didn’t leave anything behind,” says Bianko.
The Congolese way is to not let those struggles haunt their everyday life, says Bianko. People in Kinshasa maintain a spirit of resistance, the group explains — of not letting the financial and political turmoil affect their ability to get dressed up, go out, have fun. Or make music.
That’s why the magic of KOKOKO! is not just that they worked with what they could find to make music. It’s that they dove deep into the research of harnessing sounds from unusual objects and became a project of sonic revolution in the process.
“Now, this is what makes our sound, these instruments,” says Bianko, noting that they’re still adding new objects to their repertoire with every tour. “We wouldn’t switch back [to traditional instruments] because these instruments are the identity of the band.”
The “knock knock knock” of their names has evolved as well. As political instability rocked Congo in 2017, they were literally knocking on the doors of embassies across Kinshasa, trying to get visas approved so the band could tour internationally.
Now, they say, they’re knocking on people’s consciousness “to open up to the kind of musical innovation we’re proposing.”
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PHOTOS: Why Lynsey Addario Has Spent 10 Years Covering Maternal Mortality
Addario’s coverage of maternal mortality took her to a remote village in Badakhshan province, Afghanistan in 2009, where she photographed a midwife giving a prenatal check in a private home. “In these areas someone will announce that a doctor and a midwife are coming, and any pregnant and lactating women within a certain radius come if they want prenatal or postnatal care,” she says.
Lynsey Addario
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Lynsey Addario
Editor’s note: This story includes images that some readers may find disturbing.
When photojournalist Lynsey Addario was awarded the MacArthur Fellowship in 2009, she took it as a chance to work on a topic that many photographers and editors shied away from: maternal mortality. Her photos of overcrowded hospitals, bloody delivery room floors and midwives in training illustrate the challenges women face in childbirth and what the global health community is doing to overcome it. The series was featured at this year’s Visa Pour L’image festival in Perpignan, France.
Addario has borne witness to some of the most intense global conflicts of her time. She has worked for publications like The New York Times, National Geographic and Time Magazine and has covered life under the Taliban in Afghanistan and the plight of Syrian refugees. She has been kidnapped twice while on assignment, most recently in Libya in 2011 while covering the civil war.
Every two minutes, a woman dies from childbirth or pregnancy-related causes, and many of these deaths are entirely preventable. While the global health community has made great strides bringing down the rate of these maternal mortalities since efforts intensified in the early 1990s, the reality for many mothers is still harrowing.
We spoke to Addario, author of the 2015 memoir It’s What I Do: A Photographer’s Life of Love and War, about what drives her work and what she’s witnessed over a decade of reporting on this topic. The interview has been edited and condensed for clarity.
Addario recalls visiting Tezpur Civil Hospital in Assam, India, “where there’s tea plantations all around. In that area I was looking at the conditions for women, and you can tell that [the hospital] is grossly overcrowded. There were women waiting to deliver, some had already delivered — there were even women sleeping in the hallways of this hospital on the stairs leading up to the main ward.”
Lynsey Addario
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Lynsey Addario
How did you get interested in the topic of maternal mortality?
In 2009 I was named a MacArthur Fellow. It was the first time in my career where I was given money to work on a project without an assignment, so I could choose something that I felt was important to cover. I started learning about the incredible number of women who were dying in childbirth every year. It wasn’t a story that was easy to get published — I think most editors felt it wasn’t a sexy topic. Most people just don’t realize what a big deal this is.
[Early in the project,] in the very first hospital I walked into outside of Freetown, Sierra Leone, I literally watched a very young woman, Mamma Sessay, hemorrhage in front of me on camera and die. And I knew that it was a story I had to continue with.
You write in your book Of Love & War that what compels you to do photojournalism is “documenting injustice.” How does that apply in this series?
If you’re a poor woman living in a village where there are no medical professionals around, and you don’t have enough money to get to a hospital, then you run the risk of dying in childbirth. That’s injustice. I think everyone is entitled to a safe delivery. In 2019 there should be medical facilities within reach for anyone to be able to access them, or mobile clinics.
“This is a fistula repair in Kabul, Afghanistan, with two surgeries going on side by side,” Addario says. “A fistula is a tear, often between the vagina and the anus. It’s common in many countries with child marriage, or where women have birth very young. It’s quite a shame — often women are shunned from their houses or don’t get care — there’s often a smell associated with fistula.”
Lynsey Addario
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Lynsey Addario
Were you a mother when you started the project?
No. In fact I always used to joke around on the delivery ward that I would never become a mother because I had photographed so many women delivering, and I knew it was such a painful and difficult experience. Then in 2011 I gave birth to my first son, so I ended up doing it anyway. Even though this project made me more scared to actually deliver because I know how many things can go wrong.
Ironically my own delivery in 2011 was not a great experience. I moved to London when I was 32 weeks pregnant and delivered at 37 weeks. I had no doctor, basically just showed up at the hospital nine centimeters dilated and delivered with whatever midwife was on duty. Now that I’ve been doing this project for 10 years, there are so many things I would suggest to first-time mothers — or second-time mothers.
Like what?
Like maybe have a doula or have someone with you who can be an advocate — who can explain to you what’s going on with your body, who can help you navigate the pain. Someone who can understand if something’s going wrong, like the symptoms of preeclampsia: headaches, sweating, swelling. There’s so much that we just don’t know, that we’re not taught. People take childbirth for granted.
What is it like talking to your male colleagues about this project?
Most of them just haven’t paid attention to this work. Colleagues have said things to me about some stories — like the woman giving birth on the side of the road in the Philippines and the Mamma Sessay story — because they’re sensational, but no one really asked me about the work, which is interesting in and of itself. I think people sort of shy away from talking about birth, you know? Unless it’s something happy and positive.
“This is part of Dr. Edna Ismail’s team doing outreach in a remote village in Somaliland,” Addario says. “They do a similar thing like in Afghanistan, where they make an announcement for any pregnant and lactating women to come for a prenatal check. That’s essentially the only way women can get care unless they walk or are able to get transport to the nearest hospital or clinic.”
Lynsey Addario
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Lynsey Addario
What has surprised you while photographing this series?
How much access people give me. I’ve photographed — I can’t even count how many — probably three or four dozen births. The women invite me into very intimate spaces. I obviously try to be very respectful of how I photograph something like this. It’s one of the most beautiful things I’ve ever witnessed, watching a baby be born. It’s something delicate to photograph because it’s so incredible and at the same time it’s very graphic. It’s hard, and it’s always surprising to me how many people have let me in.
That word “graphic” jumps out at me. I’m looking at one of your photos now, where there’s blood on a delivery room floor, and it’s uncomfortable in a way that’s different than looking at blood from violence.
A mother receives postnatal care in a Somaliland hospital. “She was brought [there] in a wheelbarrow,” Addario recalls. “She delivered her baby stillborn then started hemorrhaging. It was extraordinary for me to witness — it was very similar to what I’d seen a decade earlier when Mamma Sessay died but in this case the woman survived because there were trained midwives who knew exactly what to do.”
Lynsey Addario
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Lynsey Addario
It is different. It’s different because no one thinks of childbirth like that. They think of childbirth as Hallmark pictures, but there’s a lot that’s not beautiful about it.
You’ve been working on this project for 10 years now. What has changed?
The statistics [for maternal mortality] have gone down, which is incredible, and there’s a lot more awareness. There are so many organizations — like Every Mother Counts, which is Christy Turlington’s organization, and UNFPA and UNICEF — working to fight maternal death. There’s more information, but it’s still too many — one woman a day is too many.
Opioid Case With 2 Ohio Counties As Plaintiffs Set To Go To Trial Next Week
The first federal case against the opioid industry goes to trial Monday. Some companies have settled to avoid trial, others will get their day in court.
Whistleblower Alleges Fraud At A Large Medicare Advantage Plan In Seattle
Fanatic Studio/Getty Images/Collection Mix: Sub
Group Health Cooperative in Seattle, one of the United States’ oldest and most respected nonprofit health insurance plans, is accused of bilking Medicare out of millions of dollars in a federal whistleblower case.
Teresa Ross, a former medical billing manager at the insurer, alleges that it sought to reverse financial losses in 2010 by claiming that some patients were sicker than they were or by billing for medical conditions that patients didn’t actually have. As a result, the insurer retroactively collected an estimated $8 million from Medicare for 2010 services, according to the suit.
Ross filed suit in federal court in Buffalo, N.Y., in 2012, but the suit remained under a court seal until July and is in its initial stages. The suit also names as defendants two medical coding consultants — consulting firm DxID of East Rochester, N.Y., and Independent Health Association, an affiliated health plan in Buffalo, N.Y. All denied wrongdoing in separate court motions filed late Wednesday to dismiss the suit.
The Justice Department has thus far declined to take over the case but said in a June 21 court filing that “an active investigation is ongoing.”
The whistleblower suit is one of at least 18 such cases documented by Kaiser Health News that accuse Medicare Advantage managed care plans of ripping off the government by exaggerating how sick their patients were. The whistleblower cases have emerged as a primary tool for clawing back overpayments. While many of the cases are pending in courts, five have recovered a total of nearly $360 million.
“The fraudulent practices described in this complaint are a product of the belief, common among [Medicare Advantage] organizations, that the law can be violated without meaningful consequence,” Ross alleges.
Medicare Advantage plans are a privately run alternative to traditional Medicare that often offer extra benefits such as dental and vision coverage but limit choice of medical providers. They have exploded in popularity in recent years, enrolling more than 22 million people, just over 1 in 3 of those eligible for Medicare.
Word of another whistleblower alleging Medicare Advantage billing fraud comes as the White House is pushing to expand enrollment in the plans. On Oct. 3, President Trump issued an executive order that permits the plans to offer a range of new benefits to attract patients. One, for instance, is partly covering the cost of Apple watches as an inducement.
Group Health opened for business more than seven decades ago and was among the first managed care plans to contract with Medicare. Formed by a coalition of unions, farmers and local activists, the HMO grew from just a few hundred families to more than 600,000 patients before its members agreed to join California-based Kaiser Permanente. That happened in early 2017, and the plan is now called Kaiser Foundation Health Plan of Washington. (Kaiser Health News is not affiliated with Kaiser Permanente.)
In an emailed statement, a Kaiser Permanente spokesperson said: “We believe that Group Health complied with the law by submitting its data in good faith, relying on the recommendations of the vendor as well as communications with the federal government, which has not intervened in the case at this time.”
Ross nods to the plan’s history, saying it has “traditionally catered to the public interest, often highlighting its efforts to support low-income patients and provide affordable, quality care.”
The insurer’s Medicare Advantage plans “have also traditionally been well regarded, receiving accolades from industry groups and Medicare itself,” according to the suit.
But Ross, who worked at Group Health for more than 14 years in jobs involving billing and coding, says that from 2008 through 2010, the company “went from an operating income of almost $57 million to an operating loss of $60 million.” Ross says the losses were “due largely to poor business decisions by company management.”
The lawsuit alleges that the insurer manipulated a Medicare billing formula known as a risk score. The formula is supposed to pay health plans higher rates for sicker patients, but Medicare estimates that overpayments triggered by inflated risk scores have cost taxpayers $30 billion over the past three years alone.
According to Ross, a Group Health executive in 2011 attended a meeting of the Alliance of Community Health Plans, where he heard from a colleague at Independent Health about an “exciting opportunity” to increase risk scores and revenue. The colleague said Independent Health “had made a lot of money” using its consulting company, which specializes in combing patient charts to find overlooked diseases that health plans can bill for retroactively.
In November 2011, Group Health hired the firm DxID to review medical charts for 2010. The review resulted in $12 million in new claims, according to the suit. Under the deal, DxID took a percentage of the claims revenue it generated, which came to about $1.5 million that year, the suit says.
Ross says she and a doctor who later reviewed the charts found “systematic” problems with the firm’s coding practices. In one case, the plan billed for “major depression” in a patient described by his doctor as having an “amazingly sunny disposition.” Overall, about three-quarters of its claims for higher charges in 2010 were not justified, according to the suit. Ross estimated that the consultants submitted some $35 million in new claims to Medicare on behalf of Group Health for 2010 and 2011.
In its motion to dismiss Ross’ case, Group Health called the matter a “difference of opinion between her allegedly ‘conservative’ method for evaluating the underlying documentation for certain medical conditions and her perception of an ‘aggressive’ approach taken by Defendants.”
Independent Health and the DxID consultants took a similar position in their court motion, arguing that Ross “seeks to manufacture a fraud case out of an honest disagreement about the meaning and applicability of unclear, complex, and often conflicting industry-wide coding criteria.”
In a statement, Independent Health spokesman Frank Sava added: “We believe the coding policies being challenged here were lawful and proper and all parties were paid appropriately.”
Whistleblowers sue on behalf of the federal government and can share in any money recovered. Typically, the cases remain under a court seal for years while the Justice Department investigates.
Heading Out On The Ice With Adam Rippon
Last year, Adam Rippon accomplished one of his biggest goals: heading to the Winter Olympics in Pyeongchang.
He medaled, even though he was a decade older than his teammates.
And while he was there, he became a star. He started by calling himself “America’s sweetheart.” And soon enough, he was.
His viral moments and charm offensive didn’t stop with the Olympics. He turned heads and made headlines when he wore a leather harness to the 2018 Oscars. And he brought his dynamic grace to “Dancing with the Stars.”
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He officially stopped skating earlier this year. Now, he’s out with a new memoir called Beautiful On The Outside, and has a brand new show cooking about celebrity throwback moments.
Rippon joins us to talk about his road to the Olympics and beyond.
Produced by Chris Castano and Gabrielle Healy.
Golfer Adds Big Penalties For Standing Caddie
Lee Ann Walker had to add penalty strokes for having her caddie stand behind her as she putted in a tournament in French Lick, Ind. She wasn’t aware of the rule change.
Hospital Giant Sutter Health Agrees To Settlement In Big Antitrust Fight
California Attorney General Xavier Becerra, along with 1,500 self-funded health plans, sued Sutter Health for antitrust violations. The closely watched case, which many expected to set precedents nationwide, ended in a settlement Wednesday. Above, Sutter Medical Center in Sacramento, Calif.
Rich Pedroncelli/AP
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Rich Pedroncelli/AP
Sutter Health, a large nonprofit health care system with 24 hospitals, 34 surgery centers and 5,500 physicians across Northern California, has reached a preliminary settlement agreement in a closely watched antitrust case brought by self-funded employers and later joined by California’s Office of the Attorney General.
The agreement was announced in San Francisco Superior Court on Wednesday, just before opening arguments were expected to begin.
Details have not been made public, and the parties declined to talk to reporters. Superior Court Judge Anne-Christine Massullo told the jury that details likely will be made public during approval hearings in February or March.
There were audible cheers from the jury following the announcement that the trial, which was expected to last for three months, would not continue.
Sutter, which is based in Sacramento, Calif., stood accused of violating California’s antitrust laws by using its market power to illegally drive up prices.
Health care costs in Northern California, where Sutter is dominant, are 20% to 30% higher than in Southern California, even after adjusting for cost of living, according to a 2018 study from the Nicholas C. Petris Center at the University of California, Berkeley, that was cited in the complaint.
The case was a massive undertaking, representing years of work and millions of pages of documents, California Attorney General Xavier Becerra said before the trial. Sutter was expected to face damages of up to $2.7 billion.
Sutter Health consistently denied the allegations and argued that it used its market power to improve care for patients and expand access to people in rural areas. The chain of health care facilities had $13 billion in operating revenue in 2018.
The case was expected to have nationwide implications on how hospital systems negotiate prices with insurers. It is not yet clear what effect, if any, a settlement agreement would have on Sutter’s tactics or those of other large systems.
Kaiser Health News is a nonprofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.
Doctors Faced With Tough Decisions Due To Shortage Of Drug Used To Treat Cancer
NPR’s Audie Cornish speaks with Dr. Yoram Unguru, a hematologist and oncologist in Baltimore, about a shortage of vincristine, a drug used to treat childhood cancer.
Washington Nationals Head To The World Series For The 1st Time
There’s not a lot that folks in Washington, D.C., seem to be able to agree on except one thing: there’s plenty of excitement about the Nationals making it to the World Series for the first time.