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26 May, 2008
Perhaps you remember a recent post on this blog, “Between streams and mosquitoes”… the account of an evaluation after a measles alert somewhere in the eastern Province. After a few days of setting up, a PUC team started on the spot, in the health zone of Tshopo, to vaccinate children aged between six months to 15 years. As an expatriate in Kinshasa, I look after the communication of Médecins Sans Frontières projects in DRC. I accompanied this “Tshopo team” at the beginning of the vaccination campaign.
Tshopo: this health zone is located 80km from Kisangani, the capital of the immense eastern province. We are here to vaccinate children aged between six months and 15 years in the health zone of Makutano. It’s the most isolated zone in the area. The number of children we need to vaccinated is difficult to identify - there is no census available. It will be between 2,500 and 5,000. Approximately.
Last Thursday, with several members of the PUC team, we took to the road. The 80 km distance the health area of Makutano, in terms of travelling time, doesn’t signify a lot. According to the state of the road, the journey can last several hours…or several days. Here, the road is broad and out of beaten ground. Surprising if you know a little about the state of the “roads” in this country: catastrophic. Ironic when we know that the planned vaccination in the Makutano zone must proceed on foot, in the middle of the forest.
After several hours of driving, we arrive in the village of Nyonga, located on the edge of the forest. The logisticians have already installed a small base camp: some tents for sleeping, a kitchen corner, a tent for equipment and refrigerators to keep the vaccines cold. Today is Thursday and it is 6pm. It is almost night, like always at level with the equator. The next day, at 6am, three teams must set out on three tracks to vaccinate children against measles.
The last preparations are organised: freezing of cold packs, to keep the vaccines cold during the trip, last discussions on strategy, paths to take, villages to visit. After a sleepless night, punctuated with the sound of the generators essential to the running of the freezers, we welcome the porters who will accompany the teams. Two hours later, surrounded by eight porters loaded up and bare feet, we cross Nyonga and push into the forest.
For the team I’m with, we’re off for six or seven days in the forest, from village to village. The walking rhythm, fast, settles quickly. After the screeching of the generators, instead the splendid noises of the forest. The birds, insects, running water, our steps in the mud, our feet in the ferns.
The convoy advances well. At the front, we are not using the machete, because the small paths connecting the villages are well defined. Some parts in water, some tree trunks as a bridge. After an hour and a half of walking, we reach the first village with seven or eight houses. A community intermediary, or “sensitiser”, precedes us, informing about the arrival of a medical team and reminding about the importance of vaccinating children. Especially not forgetting that measles is a contagious disease - it’s the number two killer for children less than five years.
The first small group to be vaccinated is made up of 11 kids. They are all there, intrigued, frightened, aware that they will be getting a needle at any moment. The “mini vacci” went well. The villagers are very welcoming. We eat a banana, we rest for a few minutes. And we set out again.
Over the following days, the team will continue its progress in the forest and will vaccinate from village to village. All by foot. It will be hard. But it will certainly be an unforgettable experience for all the team, and for a good number of these villages which are so isolated, without access to care. And, it should be said, rarely faced with whites!
The main positive outcome of this trip is that several thousand children will be vaccinated against a disease which kills. That the children already affected by measles will be cared for by our teams, for free. That a few hundred families, isolated, alone, without access to much and especially not health care, will have been able to vaccinate their children and feel a little less forgotten.
On my side, after a few days spent with the PUC teams, I made a U-turn to return to Kinshasa. I tried to take with me the fabulous smells of the forest…only the images and sound remain with me.
Pascale Zintzen, Médecins Sans Frontières Communications Manager, DRC
P.S. It is true what they say about mosquitos - before causing this serious disease, these small beasts are unbearably present and give a very painful bite!
24 April, 2008
Emmanuel Lampaert is about to leave on an 'assessment mission' in Poko region, in the northwest of Province Orientale. Partner organisations have alerted the Médecins Sans Frontières Emergency Pool in Congo (PUC) that 2,500 people fled the town, due to movements of various armed groups in the region. Those people are not receiving any assistance and some are thought to be wounded. Listen to Emmanuel:
2 April, 2008
Hello everyone! The province of Bas-Congo is a region under the influence of the Bundu Dia Kongo; known here as the “BDK”. It’s a political/religious group accused of perpetrating violence against the local populations. In February, the Congolese police decided to put an end to this group, which contests the State’s authority. The muscled troops of the PIR (Police Intervention Rapide – police rapid intervention force) arrived from Kinshasa to “re-establish order” in the province. The ensuing violence in Bas-Congo left several people wounded, whom Médecins Sans Frontières then treated.
The PUC coordinator, Bertrand, conducted an explo mission – an evaluation - in the provincial capital, Matadi, and surrounding areas. It was then decided that I would be sent as the emergency coordinator to start up Médecins Sans Frontières’s activities.
On the evening of March 14th, the police arrived at the Kikanda hospital in Matadi, where we were treating the wounded. Some of the wounded were members of the BDK, but there were also people who had been shot or wounded while trying to flee the violence. Some of the BDK had been made prisoners, they were in a pitiful state and their bodies were covered in sores and wounds.
We were faced with a double-edged sword…. on the one hand we should provide care to the BDK members, as everybody has the right to treatment, but on the other we quickly realised that the presence of the police would stop other wounded, who had fled to the bush, from coming. These people had been in hiding since the start of the police intervention, and our hope of treating them in the Médecins Sans Frontières premises melted like snow in the sunshine.
So we decided to set up two mobile clinics in the rural areas north of Matadi. Two teams of two (each with a doctor and a logistician) visited about fifteen health centres located in the heart of the troubles and we handed over a total of 17 medical kits. This material will serve to treat potential BDK patients as well as the local population, especially since these health centres had been looted…
A bit frustrated that we could not offer more treatment to the victims of these troubles but aware of the fact we had done our best under the difficult working conditions, we left Matadi on Tuesday 25th March 2008.
The strangest thing for me was the way in which international organisations remained silent on this issue. Nobody really dared to speak out openly about the violence in Bas-Congo… For me this is a poor way of preventing this kind of “nasty business” from starting again. If everyone shuts up, then why not do it again?…
Philippe Havet, logistician and emergency coordinator in Matadi
20 March, 2008
Hi everyone! The activity of a PUC branch, like the one in Kisangani, involves responding to alerts and, if necessary, going to the field to evaluate them and prepare an intervention. We haven’t stopped for the last couple of months... We’ve travelled all over our intervention area, which consists of the provinces of Orientale and Maniema, and of Mongala district in Equateur province. Fortunately we haven’t seen a major epidemic. We’ve provided health care to patients, held training sessions and distributed medicines and medical material.
On two occasions, in really isolated spots, we witnessed minimal living standards, and very bad health conditions among the population. There was an alert in February concerning pulmonary plague in Wamba, right up in the north of the Democratic Republic of the Congo. We went to a place called BoleBole, which has a health outpost surrounded by mines where people live in deplorable sanitary conditions. It took us 4 days to cover around 600 kilometres and then a whole day travelling by foot to reach the affected sites.
Then there was the patient suspected of having a viral hemorrhagic fever, Ebola-style. It was in late February, in Maniema province. The PUC was responsible for drawing up the patient’s history and locating the people he’d been in contact with. In the end, the samples sent to the Pasteur Institute in France showed that it was a hemorrhagic fever transmitted by ticks, which kills up to 30% of affected patients. Fortunately, our patient survived. And two other contact-persons were isolated with him in the Médecins Sans Frontières hospital in Lubutu, before leaving cured. So all in all, a good piece of news before finishing this post! Bye for now.
Emmanuel Lampaert, nurse, manager of the PUC Kisangani branch
11 March, 2008
The most striking thing about a CTC – cholera treatment centre - is the amount of activity that goes on. The nurses run from one bed to another, setting up IV drips, examining the patients and giving them bottles of rehydration salts. Armed with their buckets and mops, the hygienists rub and scrape the floor, so spreading this unmistakable smell of chlorine.
Cholera is transmitted by patients’ excrement, so the room has to be constantly disinfected with chlorine. As Dr Hyppolite Mboma of the PUC says: “A CTC should not smell of cholera, it should smell of chlorine! »
When watching this video (filmed in February), you’ll be taken into Médecins Sans Frontières’s CTC in Likasi...
1 March, 2008
Let me introduce myself: François, I’m based in Brussels and I am in charge of communication for the Democratic Republic of the Congo. I visited Katanga in February to accompany a BBC journalist who was making a radio documentary disease outbreaks. Given the scale of the cholera epidemics that hit the towns of Lubumbashi and Likasi, Médecins Sans Frontières also sent me to carry out some public communication on this emergency situation. We first of all visited the two cholera treatment centres (CTC) set up by Médecins Sans Frontières in Lubumbashi. Bertrand Perrochet, the PUC Coordinator, was our guide.
After a night in “Kimbangu”, the Médecins Sans Frontières house in Lubumbashi, we left early for Likasi, which is around one and a half hours away, where the PUC had set up another cholera treatment centre.
I have spent a year in the Congo, I have followed Médecins Sans Frontières’s activities in quite a few places. But I’d never seen a road in such good condition. My colleague Patrick, a PUC logistician, said the other day that it was better than a French motorway! All this is really ironic when we take a closer look... Next to the flourishing mining sector in the region, hundreds and thousands of people continue to live in over-populated areas rife with poverty. With Dieudonné, who’s in charge of raising awareness in areas affected by cholera, I could see that people didn't have water in their homes, that they had to go and fetch it from little water sources strewn with rubbish and dirt. This is doubtless the cause of the epidemic, the reason why it’s getting worse. It’s certainly because people are reduced to this level that more than 100 of them have already succumbed to the “poor man’s disease” in Likasi and Lubumbashi this year.
27 February, 2008
A photo taken by Bertrand Perrochet, Coordinator of the PUC
