[2] The French at that time were in a race with Leopold II of Belgium to establish physical occupation of the Congo region.

[3] Ballay saw an advertisement by Pierre Savorgnan de Brazza, who was looking for a young doctor to accompany him on a mission of exploration in Equatorial Africa, still a relatively unknown area.

[3] The first expedition in what is now Gabon was challenging, a journey of thousands of kilometers from the mouth of the Ogooué through the forest, up into the Batéké Plateau and down to the Congo Basin, where they found the Alima river.

They descended this river for two days before turning back, exhausted by three years of fever, illness and hostile local people.

[7] In 1886 Ballay was appointed lieutenant governor of Gabon, but due to disagreements over Brazza's management of the colony he resigned in 1889.

In 1891 he became the first Governor of French Guinea, based in Conakry, and began attempts to improve sanitation in the region, particularly in estuaries of the country of the Baga people.

The Governor General of French West Africa, Jean-Baptiste Chaudié, returned to France after catching the disease.