Research is ongoing to determine whether underlying disease may be exacerbated by exposure to volcanic ash. Working in informal gold mines like this site in Bukavu, South Kivu, predisposes workers to silicosis and increases risk of tuberculosis. “What we don’t know is if volcanic silica dust is related to the high prevalence of tuberculosis in Goma,” says Patrick Katoto. Image: © Patrick Brown, UNICEF/Panos Pictures.