Dignity, Unusual Diagnoses and Busy Days

Tuesday — a bit jet lagged, but enthusiastic and dressed in OR scrubs, we drive from where we are staying, at Maji, to the HEAL Africa hospital.  Our transportation back and forth is in a vehicle marked ambulance, although in Eastern Congo, rarely are ambulances used. The vehicle is sometimes used for the rare transport of very sick patients.  It’s not that sick patients are rare -- they’re not -- it’s just that people usually don’t come to the hospital via ambulance, if they are able to come at all.

Riding in the ambulance to HEAL Africa.

The road is paved for most of the way, a huge improvement over the past years.  Four wheeled and two wheeled vehicles dart in and out, dodging one another daringly, like dragonflies.  Near the hospital, the road turns to dirt with a predominance of pot holes. The sound of horns and motors and people is in surround sound.

Our first day starts out with a worship service at the chapel, called the "Tabernacle," on the grounds of HEAL Africa. Music, dancing and a sermon about the value of women is preached.  It is a beautiful way to start the day.  Patients who can walk, staff workers, doctors, school children and others gather together to praise God.

Dancing and worshipping at chapel.

Todd and Mary Ella working with the doctors in the clinic.

Afterward,  we walked to the clinic where Todd, Marc and Chris see patients with the Congolese surgeons, in consideration of possible surgery.  People come hoping for help with illnesses and physical deformities — they arrive with dramatically enlarged thyroids and miscellaneous masses and children struggling with intestinal issues, babies with cleft palates and cleft lips and young child with scars from burns. A list of patients in need was collected over the months, and now they come from near and far — some from as far as 200 km away, to see the doctors.

The hand of a young child who suffered an oil burn a year or more ago. Now it has scarred down and the child is unable to use his fingers.  

Mary Ella and I spent time with the surgeons, while the Family Practice doctor, Steve, and his son, make rounds on the hospital patients, with the medical doctors.

The afternoon is spent unpacking the 10 bins of surgical equipment, preparing them for surgery, and spending time with the physician residents, listening to a lecture one of them prepared, and building relationships.  They are gifted doctors.  Kind, smart, humble, and ingenious in the way that they make medicine work in a third world reality, and truth-seekers.  It’s amazing and humbling and life-giving to watch them work.  I witness dignity — a dignity for each other, a dignity for the people that they care for, and a dignity for God, all in exponential ways.

Today, Wednesday — our second day at the hospital, is a day filled with OR cases.  Todd works with a few of the surgeons, teaching them cleft palate surgery, while Marc and Chris, in other cases, teach other surgeons general surgery techniques.  In the morning, Mary Ella and I, Steve and Tom,  round with the medical doctors on the medical in-patients, poking our heads in and out of the OR during the day to see how everyone is doing.

The three operating rooms at HEAL Africa. 

Todd operating on a 2 year old with a cleft palate.

Siting around in the OR lounge, waiting for surgeries to begin. 

Recovery Room

On rounds, we visit patients in rooms scattered throughout the hospital complex.  Windows are open everywhere. There is no air conditioning.   Tests needed are only done if the patient can pay for them, up front, or if the family can collect enough money from friends and family.  While on rounds, the electricity goes out.  We hear rumor that the government has turned it off. Later we hear that surgery was done by headlamp, three times, before the generator started to work.

One of the buildings where patients stay. 

We see cases that I have only read about in textbooks -- diagnoses that are unusual to me. One young patient lies unconscious with a diagnosis of malaria and tuberculosis, but is not responding to treatment, and they cannot figure out why. They consider a rare infection — Brucellosis — but are limited to only certain tests and equipment and ability to pay. A middle aged woman, with tuberculosis, has a chest tube that drains infection, but she is improving on antibiotics. She finds out today that she also has HIV. A man in his 30’s with pancreatitis and malaria, writhes with back pain.    A child with right lower chest/upper abdominal pain and no diagnosis, looks up at the doctors, with pleading eyes. They cannot figure out what is ailing him.

Occasionally, I peer out a patients window, looking out at the fence below — stone or iron bars, with rolled barbed wire, rim this place of healing. Men with guns stand on guard, UN men with bigger guns walk by, outside the fence, to help ‘keep the peace.’  I catch myself thinking “Where am I?”   I see families cook food over open fires in the courtyards.  Food is not provided for patients. Their families come and cook or bring them food. Otherwise, they do not eat.  Colorful laundry, like flags in the breeze, are self strung by patient’s loved ones, on clothes lines near the patient ward.

Laundry lined up on self strung clothes lines.

We eat granola bars and trail mix sausage and cheese and chunks of bread for lunch. A meal that seems fit for a king in comparison to what I see around me.  In the afternoon, some of us go and find Mama Virginie — a lovely, older Congolese woman who has been involved in the “social aid” organizations that are a part of HEAL Africa, since it’s start in 2000.  We hear of programs that help women stand strong and develop skills to make money for their fractured families, of the micro-financing that is offered and encourage.  We hear from a man who is helping men in the community become men of honor and dignity, who will respect their wives and women, and not abuse them.  We hear from another group of people who are involved with the treatment and prevention of sexual violence.  We meet with a kind older woman who works with grandmothers who now care  for their grandchildren, because their parents have died.  I listen carefully, trying to take in the realities that are not part of myevery day realities, but are prevelant and painful in this place.

Our day ends with returning to Maji Matulivu (Still Waters). The rain pours down and I am reminded of God’s grace, a grace that refreshes and revives and soaks in to the dry and dusty area of our lives, of these people’s lives, too.

Maji Matulivu -- Still Waters

Then we meet together for dinner, with Dr. Lusi. A devotional is read, we pray and thank God for all that He did today, for allowing us to come and love and serve, and we thank Him for who He is, and we eat. (Some of us try a meet of unknown origin. Chris wonders if it’s liver, but then perhaps not because it’s not as friable as liver — and we all laugh because it is odd that we medical people would talk about the friability of liver and a piece of strange meat).

If you have made it this far, thank you my friends, for reading my story, for listening to my heart -- I  feel exhausted, burdened, overwhelmed, and yet, encouraged and hope-filled in these busy days.  Thank you for praying for us. God knows.