DRC – not just the Kivus!

The roosters start at about 4:30 am and are joined by a chorus of wailing babies at daybreak. A car roars to life in the early morning, as our teams get ready to head out. The quiet “flip-flop” of an expat’s sandals can be heard outside my door as an early riser heads to the latrine.

Quiet conversations between the water Mama’s also start early, as they are busy pumping and filling 20-liter jugs at the hand pump in the compound. They will be back and forth many times throughout the day, balancing these heavy jugs on their heads and delivering water to all of the distribution points in the project. The dull thump-thump-thump of manioc being beaten into a fine powder can always be heard. Recently, the swishing and crunching of a peanut de-shelling apparatus starts early and goes on all day.

Each Sunday, the village is filled with song and the deep beat from dozens of drums as the various congregations meet for church.

Mating season for goats and the guinea fowl was especially noisy.

Funeral processions involve the combined chorus of dozens of people chanting and singing and wailing, as mourners progress down the main street and out of town.

Ceremonies from traditional healers or “witch doctors” can last more than a full day and undoubtedly involve chanting and screaming as they chase the evil sprits away. One of our neighbors practices this type of medicine and must be good as he has lots of clients and is often busy well into the night.

As the sun sets, things slow down but don’t really stop. Some nights, the village ‘cinema’ blares out the sounds to a Congolese movie for everyone to hear. There is a sort of bar not too far away and the loud chatter of those who’ve had a bit too much to drink floats over our fence.

The MSF generator shuts down at 9:00 pm and the hum of Concern’s generator dies out at 10. Sometimes an expat’s music or the movie from a laptop can be heard through the tukul walls. The scratching of rats in my roof will often wake me in the middle of the night.

The guards quietly make their rounds.

The crickets are suddenly very loud.

…but it is never completely quiet.

There is always a flurry of activity when the outreach team is preparing to head out. Someone is busy collecting vaccines from the refrigerator and putting them into a small cold box loaded with ice packs. Someone else is packing folding camp beds, mosquito nets and cooking pots into the car as the driver does his daily checks and fires up his Land cruiser. Another member is busy signing out the satellite phone and getting MSF vests for the team. Last minute instructions are quickly passed to those staying in the base and off they go.

Our Setup

Outreach is a major component of our project here in Shamwana, as MSF supports a network of five rural health centers where the Ministry of Health (MoH) is providing basic health care to the population. While these clinics are operated and staffed by the Ministry of Health, MSF provides support in the form of free medicine and technical support. MSF also provides a ‘prime’ or monthly bonus to all MoH staff to ensure that all of these health providers receive a fair wage.

Although each health center is a bit different, they all have an outpatient department and a maternity. Staffed by a registrar, pharmacist, consultation nurse, mid-wife and a cleaner, they provide frontline care in a classic primary health care setting. Supplies are limited, the clinics are absolutely isolated and staff experience varies. All serious or complicated cases are referred to the MSF hospital here in Shamwana and, as crazy as it may seem, it is not uncommon for someone to ride a bicycle through the night to inform MSF of an emergency in a health center.

The Outreach Team

The MSF Outreach team consists mostly of national staff and is made up of 2 nurses, 2 community mobilizers, a health educator and a mid-wife. Supervised by a dynamic Expat nurse (also Canadian!), they enforce MSF protocols, give training sessions, raise awareness and, in general, monitor and supervise the operations in all the health centers. Spending approximately 4 days a week in the field, they also help out with consultations, vaccinations for newborns and reporting.

The relationship between MSF and the Ministry of Health is delicate and just maintaining this dialogue is a never-ending struggle. Here in Shamwana, the success of the project largely depends on the MoH’s ability to take over from MSF so there is a huge emphasis on capacity building within this existing Congolese system.

This afternoon, the team just came back from 3 days in Kyango where we are running a bi-weekly mobile clinic to see if the needs are high enough to justify the support of the MoH clinic in the area. They saw over 200 patients and brought 3 serious cases back with them for further treatment in the hospital. Tomorrow, they are off in the other direction to supervise the activities in one of the standing clinics and to collect their monthly medical order. With 5 different centers to support, there is always more then enough work to keep them moving!

Photo: G Assenheimer. MSF outreach team

A comment posted to one of my entries asked why I choose MSF and what brought me to where I am now. Its not the first time I’ve been asked this question and, in reality, it’s a fair question. I left behind a pretty comfortable life. Good job, amazing girl, hot showers. My brother had a baby and I became an uncle for the first time. My sister is building a new house a mile from where we grew up. Wedding planning and ring shopping are all going on without me. These are just some of the things that I’ve left behind for MSF.

So… why?

Essentially, because I can. I have a family that supports me and a fiancée who truly believes in me in this environment. I have the unusual combination of technical ability, personal drive, flexibility and compassion that make me good at it. I am blessed to have come from a family, a country and overall circumstances that allowed me to follow a dream instead of struggle to survive.

I also like the adventure and relish the opportunity to learn on so many levels (about management, cultures, geo-political issues, myself, the world of relief work). Finally, while I had done some reading on development and relief, I truly believe that the best way to learn is simply to GO. With my skill set, personality, support and a strong desire to help those who are truly in need, the question really became how could I not…

More Specifically

There are 2 events that really specifically helped to shape this desire.

The first was watching the aftermath of the 2005 earthquake in Pakistan. All the news channels were reporting that relief workers were walking for hours – sometimes days – to bring urgently needed supplies and medical care to remote villages. The needs were great, the challenges were enormous and I thought to myself, “I can do that…I can totally do that!”

The second was reading “Another Day in Paradise” by Carol Bergman (2003). This is a book of short stories about humanitarians working in the field on a variety of projects from disaster relief to war zones to feeding centers. I read the book twice and still remember feeling totally inspired by what these people were actually doing.

Naturally MSF

I had been a donor to MSF for a few years and the more I learned about the organization, the more I came to admire what they did and where they worked and how they did it. I was simply fascinated by ‘these people’ who were doing such great things in remote corners of the world largely forgotten by our western media.

…and here I am. Helping those truly in need, directly supporting a great organization and absolutely living a dream.

Ahh Sunday…my day off and a well earned rest. Sleeping in, making real coffee, reading a bit, exploring Shamwana itself and the luxury of a lukewarm mid-day shower. There is usually time to make and enjoy a nice meal for dinner, to catch up on emails and, of course, my weekly ‘date’ over Skype with my fiancée.

Sorry for the slight lapse of entries over the past month! I just got back from a 2-week vacation in Kenya… a bit of time on my own to rest and recuperate and then I met my parents for an 8-day safari through four of Kenya’s famous national parks and game reserves. It was a wonderful vacation and a great break and I returned back to the project energized and ready for part two.

Getting Out

Getting to my vacation was another story! Right now, the mission is in the middle of a transportation crisis. Largely due to funding cuts brought on by the global recession, our flight provider suddenly cancelled all flights to Shamwana and pulled their plane from Katanga. While this has far reaching impacts for our operations, it immediately meant that I had to get to Lubumbashi by car. It couldn’t have happened at a worse time as the rainy season is in full swing and the roads are quickly deteriorating!

…and that is exactly when I realized just how far in the bush I am living. Instead of the relaxing 1.5-hour flight, it was a gruelling 3-day, 32.5-hour, 600 kilometre drive. We got stuck 4 times and averaged 20 km/hr. In places, the ‘road’ is nothing more than a wide footpath. This was a mind-blowing realization of how remote and isolated we are in Shamwana.

Photo: G. Assenheimer | Going up.

Photo: G. Assenheimer | Helping out.

During the dry season, I’ve heard that you can make the trip in 2 days. On the other end, a big truck carrying supplies for the project, plagued by breakdowns and constantly getting stuck, took 6 WEEKS to arrive. Crazy. In the DRC, they even have a verb for “getting stuck in the mud” and our cars are constantly “embourber” in this “saison d’embourbements”.

What is even more amazing is that the first logistician here in Shamwana actually built the runway. He didn’t have a satellite Internet connection and definitely wasn’t receiving a weekly supply of fresh vegetables. And that isn’t some story from the early 1990s… MSF opened Shamwana in 2006. Incredible and hats off to the team who started this project from the ground up.

While we sort out a more reliable solution to our transportation problems, I’m back in the project and have no plans to leave any time soon!