Congo Week Two

Saturday March 1

This day the agricultural team and Murray headed out to the bush to visit some of the farms and connect with the leaders of the agricultural co-op programs.  As 6-8 hours in a very full Landover did not appeal to Jenn and I we arranged to visit one more clinic in Kikwit.  This clinic was not one that was connect with the International Mennonite Health Association but Murray had contacts here as one of the young doctors he had supported through medical school.  Murray had arranged for us to have a translator for us for the morning and a taxi picked us up at 8 and took us to the clinic. 

We traveled through town and then about 20mins up a hillside.  The road was more like a dry stream bed, rough because it was dry completely impassable if it was wet.   The Kazumbi Clinic was the largest of all the clinics we visited.  Its location in a agriculture based town allowed it more space.  It was a collection of separate buildings in a large field with the church, and a school. Unfortunately there is a lack of strong leadership at this clinic limiting the programs and advancement of the healthcare here.    There was no electricity or running water at all.  They had a large impatient areas here with good ventilation and natural light.  We toured all the wards, met with the director to understand their vision for the clinic and some of their needs, saw the lab and the pharmacy and then did some consults with the doctor. 
The peds ward.   This little girl had complex malaria and was receiving a blood transfusion

 The clinic was a collection of similar buildings forming a U shape

 Young nursing students

 Children from the surrounding homes

What happened as we were doing consults with the doctor was one of the most stressful/helpless/prayfilled times of my life!!!

One of the nurses came in and talked with the doctor.  through our translator we understood that a women had come in, was not actively in labor but the baby was breech. No one seemed concerned and in any hurry so I assumed that someone in their prenatal checkup had been examined and that the baby was in breech position. 
As a side note... as an ER nurse I know a little about a lot.....except labour and delivery... those pts go straight upstairs.  I had had my maternity nurse friend run through a regular delivery for me so I would know what to expect but nothing in this world would have prepared me to walking in to the mat room at the clinic and seeing a lady with a foot delivered and that's all. 
Jenn and I immediately started talking quietly to each other.. the conversation went something like
"is that a foot"
"think so"
"that's not good,... right??"
"now what?"
"C-section right??"
The doctor examined the mother.. listening for the baby's heart beat.  He looked up from that and to our shock announced that it was TWINS!!!

Then he handed the stethoscope back to the nurse and told us that we were going to head back to the office for refreshments.  Jenn and I were in shock.  We KNEW this lady needed help and help fast if the babies were going to survive.  We asked him what his plan for care was.  He said that they needed to wait for the family.  Why?? we asked.  They said they had  to see if they could afford to pay for a c-section and the post op care.  We were astounded!!  He named the price.  A price that neither of us would have blinked at for a new jacket or two months of our cell phone bill.  We quickly stated that we would cover the cost and to not delay based on that.  He said we still had to wait for the family so that the women could talk to her husband.  We allowed our selves to be guided back to the office where we continued to sit in a bit of shock.  Jenn tried to phone Murray but he had no service... we were on our own!!.  After about 5-10 mins of sitting there we again asked what the delay was... no one seemed to be in any hurry which was killing us!!! The reply came that they were waiting to see if any of the family were the same blood type as they could not go to the OR without a Blood donor.  Without thinking I said that my blood type was O and I was willing to be a donor.  That seemed to surprise them.. it certainly surprised me and the feelings of fright, guilt, and continued hopelessness continued.  We were praying so hard as that was the ONLY thing at this point we could do. It was a weird and not nice feeling not knowing or being able to do anything. I deal with life threatening/stressful situations on a daily basis at work but there I have knowledge, supplies and tasks to do here I was strictly an observer.    Eventually after about 1hour 15-30 mins after we had first seen the lady we headed to the OR.  Jenn and I huddled in one hot corner of the room as they prepped her for the surgery.  C-sections in rural Congo SOOO  much different then Canada.   I won't shock you with the details.  

We sweated, prayed and held our breath as the final cuts were made and the first baby was pulled from the womb.  That 2 seconds of waiting for the baby to cry have never been so long and then the laughter, tears and rejoicing have never been so sweet as when both the baby boy and girl were born alive. 

 They named the babies after us  Girl- Melanie                                   Boy- Jean,

 The first 15 minutes were are overwhelming blur as we dashed back and forth between the babies and making sure the mom was doing well in the surgery. 

 
They were so gorgeous.  (the white powder on their and our foreheads is a sign of celebration)

 Their very thankful very overwhelming family!!!

 

Once the mamma was all stitched up we left the clinic with promises that we would be back in the morning.  It was only 3 in the afternoon but the day had been full and we were exhausted.  That evening we sat on our porch and just reflected on the day.  The emotions raw and close to the surface the story was hard to convey to our companions when then returned from their day.  The processing of the experience took some time.

Sunday morning we got up at 630 to head back to the clinic before church.  We visited with the mom and the twins for a short time and then headed back to the mission.

 At the mission we packed up our van that we were going to drive back to Kinshasa in and then headed off to church.
Church was joyous and filled with much singing. Both African and African renditions of familiar hymns. 

Here we said good bye to the Agricultural team which was staying in Kikwit for a few more days.  Also said by to our translator and our Kitkwit Contact-  Delbert and Guy

 After church we piled into the van headed down the only paved highway in the Congo. It was a 10 hour drive back to the capital.    Passing was a bit sketchy. The other vehicles on the road were the big Overland trucks loaded to the max. It was very sparsley traveled but when we did come across them it was while going up hill and ususally around a corner ( if you look closely you can see the people hanging on the back as well as all the gas jugs)

There were lots of checkpoints along the way and any time the van stopped there were lots of people selling things.  Others in our van loaded up as produce is much cheaper in the rural areas then in the city.  

 Most of the Congo is very tropical but this highway traverses a plateau which is more classic Africa looking.

 Sunday afternoon soccer match.    A van loaded with a goat on the roof

 

 Almost back in Kinshasa and we had flat tire

 

Congo Part One

I have been home from the Congo for 21 days.  21 days of first a mix of mind numbing jet lag and night shifts and then followed by the sad reality of the shift swaps that I did to go to the Congo.  But through those days close to my heart and mind were the experiences that I had had in the weeks previous.  Experiences that are requiring processing  Only so much can be told and shared through stories and pictures, deeper is the emotion that was tied to those moments.  Here I hope to share a glimpse into our journey. 

as an aside I was somewhat frustrated by the photo limits - both camerawise as well as socially.  Any photos in which the person is obviously posing ( patients/staff) were taken legally all of the other photos were very discreetly taken on my iphone while pretending to talk on it or it was just poking out of my backpack or the car window.  It did, however, all me to be a full participant rather then just recording events behind the shield of a lens.


Day One - which was actually day one and two.  Door to door time was 36hours for the way there although it didn't seem that long.  Short connection in Brussels as well as room to stretch out and icecream served on the flight from Brussels to Angola helped.  Flying over the Sahara was probably the highlight- Just sand for as far as the eye could see.  In Brussels we also connected with Clarence and Denise who were headed to Kinshasa to connect with the orphanage that their church in Saskatchewan supports

A low point in my life - Crammed in a United Seat with 6 hours to go in flight 2 of 4.   The Congo is at the bottom right corner of the box

We landed in Kinshasa at about 9pm local time.  The arrival terminal was bright and airconditioned.  Passed through customs with no problem, then it was on to health check where we had to show proof of Yellow fever vaccination.  If you didn't have your yellow fever card you could always buy one for $50 =).  Picked up our bags and went to exit the baggage room.  It was a small door with two guards standing in front of it letting people out and physically blocking those trying to enter the area.  Kinda feeling like a salmon swimming up stream we followed our driver to a waiting area keeping our eyes down and saying "non merci" to the 5-10 guys who were trying to offer to carry our bags for us.   We piled in to the van and headed off to MPH.    The main highway from the airport was well paved (a gift from the Chinese) and at that time of night had no traffic on it.  The highway was lined with little buildings with people all out front sitting around gas fueled lights.  We made it to MPH and settled in to our rooms.  The place we stayed at MPH was a hostel for missionary kids going to school in the capital in the 50's and 60's.  It now runs as a guest house for ex pats doing work in the country. Jenn and I stayed in a dorm style room.  A ceiling fan did its best to keep us cool.  The bathroom was down the hall with its "coffin" concrete spider filled showers.   It was large and sprawling with a huge fenced compound of overgrown gardens. 

The back of MPH and the gardens

 

 The next day it was breakfast and a 8 am pick up for the clinic.  We had our first lesson in Congo time.  8 really means any time between 830 and 9 lol. We met Dalphen the head doctor and visionary for the Bon Berger Clinic.  Then we all piled in and experienced driving Congo style as we headed to Bon Berger. 

 Tire Shop =)

 To get to the clinic we would drive about 20 minutes from where we were staying into a middle class residential area.  We would leave the vehicle at a friend of the doctors and then walk the rest of the way into Camp Luca which is the neighbourhood the clinic is in. 
This is pictures leaving the camp which is boarded by this "stream".  So we would cross the board bridge on to the alley pictured on the right where clinic was.

The Bon Berger Clinic

 Clarmone.  One of the nurses

 The first day we were there with the entire group. We toured the clinic, met the staff and also walked around the neighbourhood learning about some the other programs associated with the clinic through the church.  They are very concentrated on trying to provide holistic programs- there is a bank, a sewing program for women, orphanage for street/unwanted children and a literacy program for children. 
The bank- this small space used to be the clinic

 Introduced to a new love- the Mangosteen-  looks like garlic cloves tastes like heaven!!

 The view from the second floor of the clinic

 

 

While I didn't really experience cultural shock this day was the beginning to the reality of Africa.

Tuesday - Jenn and I spent a full day at the clinic. The main language here is French so that was a challenge as they spoke broken English and we spoke HORRRIBLE French.   We spent the morning with one of the head nurses. doing rounds with him- seeing pts, doing dressing changes and giving meds.  We spent time in the lab with one of the techs learning about malaria testing and viewing it under the microscope.  Malaria is leading cause of death especially in children under 5.  Children and Pregnant women are the most vulnerable of pts.  Malaria is easily diagnosed under the microscope- appearing as a "comma" shaped cell.  Treatments are standardized based on age and severity and range from a 3 day pill regime to IV infusions and blood transfusions. 

In the afternoon we helped out with prenatal consults.  Maternal Health is a huge component of all the clinics we were at.  At Bon Berger the expectant moms are followed monthly for things such as BP, weight gain, measurements and fetal heart.  Ultrasounds are also performed.  This day was draining- the heat really took a lot out of us.  It was 33-34 in the shade with high humidity.  Add to that a lot of hot sick bodies in small rooms had us feeling like wimps.   Back at MPH by 4ish the shower and garden were a welcome sight.

Wednesday we met the group from Manitoba that had come to work with the agriculture program.  They headed off to the clinic with us that morning as they had brought lots of supplies with them.  Driving was a nightmare that morning as the African President Conference was in town. It took us over two hours to get to the clinic. The police stopped us and we had to pay a bribe as well.  A car full of white people is just asking to get pulled over for invented infractions- our bribe was a fine for have more then 3 people in the back seat lol

At the clinic Jenn and I participated in a new mom education, vaccine and well baby clinic.  We gave vaccines and weighed babies.  Some well babies and moms that were doing good but also some heart breaking stories.  There was one little baby who was so tiny and sickly- his mom had died of HIV right after he was born so his aunt was raising him.  In seeing so many babies it was hard to imagine that the reality is that 1 in 5 of them would not see their 5th birthday. 

On our way back to MPH the bribe theme of the day continued-   We had to pay to cross the board bridge out of Camp Luca- Delphan said he normally doesn't pay but he wanted to make sure that we would not have trouble if we crossed in the future without him.  As we drove out of the resdeintal area we came around a sharp corner to the alley blocked by a bunch of teens with a wire and some potted plants.  Those boys sure got a talking to from Dephan!!! We didn't pay there =) After he read them the riot act those pots got moved and away we went!!

Thursday
A lot of people asked if I was scared to go to the Congo.. I wasn't.  What I was a little nervous of was our domestic flight within Congo.  The Congo had that most plane crashes of 2013.. a stat not super reassuring.   We were flying to Kikwit for 4 days.  Kikwit is a smaller city that is the agriculture center for the country.   We were up early and ready on time for the booked bus to take us to the small airport.  The bus never showed so eventually Murray went out on the street and found us a taxi to take us to the airport.  Open air check in went smoothly and then we went through security.  It was a very elaborate multi person process that seemed very subjective-  Jenn got her mirror and some other random stuff taken.  I however boarded with my water bottle =).   We walked across the tarmac passed a plane with no wings and got on our little 21 seater plane. 

 Over Kinshasa,  Coming down into Kikwit


In Kikwit we stayed at a Catholic Mission-  It was a gorgeous tropical place.  No electricity though equalled very cold showers =)

Africans are all about formal meetings so after we settled in we headed down to the MB church office to meet the local church leaders.   As with every time with met with people we had abundance of ripe bananas, peanuts and coke from a glass bottle 

The building beside the church office... the light was so amazing around 5 pm every day.. didn't really get to take advantage of it ever!!

 On our way back our taxi ran out of gas... no problem hop out, push it to the side and someone will come running up with a 4liter jug to fill it up. 

Stopping to buy bottled water

The verse that stood out to me that day from Galatians-  Since we live in the Spirit, let us follow the Spirits leading in every part of life. 

The next morning Jenn, Murray and I headed out to visit and assess needs at a clinic run by a member of the local church. It is small clinic.  Staffed by nurses with a doctor coming once a week.  It has a small pharmacy and lab, mostly sees outpts but does have room for about  5 inpatients. 

Top-  No electricity equals nothing to run an autoclaver with.  This pot of boiling water is the only thing which to sterilize with. Bottom - open air waiting room

 Pharmacy room and Lab-  Able to do malaria, CBC and blood typing.  No chemistry capability

 Eloise- The nurse who runs the clinic

 Left -  The birthing hallway.   Right- Patient Consult Room

 No electricity means they are dependent on day light.   Being here with Murray for the morning was great as not only was he able to translate for us but he also gave a running commentary on factors impacting the healthcare provided and the situation of the pts. 

After the clinic we walked to meeting of the agriculture society that that Manitoba group was involved with.  It is a program started by a Congolese man -  Basically it is a type of co-op program that helps farmers start up but also requires them to form associations to support healthcare clinics in their area.  It is also involved in developing sustainable farming practices, machinary and high yield crops. 
Edgard with the experimental cavassa/manihot plants which are a staple food.

 

To be continued.....