Hello (from Cal) from Gemena!
This is the fourth letter I have been able to send out. There is way too much to tell in these letters, but I hope to have time to share more when I get home. If I have missed you on any of the prior letters, let me know after I get back to the U.S. and I will update you. It has been hit-and-miss to get things out, due to lack of electricity and/or internet access.
Dear family and friends,
Today is July 31. Things have been so busy here that I have had little time to write. I asked to skip hospital rounds today in order to get time to get some things down in writing. I hope that this gets out sometime later this week when we are back in Gemena.
My week in Tandala has been both educational and challenging. Besides the medical work, which is complex, there have been many meetings both among our team and with various Congolese.
The bulk of our team is here in Tandala now. The pastors, including my pastor, Martin, came in on Friday. They had stayed in Gemena to participate in the Pastors' Conference and see the work the church is doing there with widows and orphans. With their arrival, this brings our total at Tandala to 13. It was really fun to be part of the line-up of people who greeted them on their arrival; almost as if I were a local myself.
We still tend to go our different ways during the day as there is much to see and do. My time is spent mainly at the hospital and its associated clinic. This has been a stretch for me both in terms of the severity of the diseases (many of which I have only read about or, at best, not dealt with since I was in training) and the conditions we work under. I am thankful that God has made the Congolese so tough, because much of what I see amazes me that the patient has survived so long with such severe pathology.
Usually we start the day with either what we would call morning report (medical teaching) or chapel; they alternate the days except for Sunday. This starts at 7:30 unless it is raining (then we start later). After this, we do rounds, then go to the clinic. Typically we work right through lunch until 3-4 p.m., then go home for the day.
There are several interesting nuances to this process. First, many of the women have no education so they cannot communicate basic facts that we take for granted, such as the location or duration of symptoms. Second, many here do not even speak Lingala, much less French, so a nurse has to translate their tribal language. Third, when a patient needs lab work or x-rays, even if they are on the ICU, they must go to that part of the hospital for the test (in part, this is done to assure that they pay for it).
And it is not uncommon to see families sharing a hospital bed. While the hospital has about 180 "beds," the capacity is higher. I am told that sometimes even three patients will share a bed. Fourth, the family is responsible for seeing that the patient gets food, water, laundry, etc. In fact, if you are not on the ICU, you only have a nurse around for a few hours during the day. Add to all this that there is no electricity or running water in the hospital, and I think you can begin to understand the conditions here.
I would like to share in this letter more about the doctors. There are four on staff, but the eldest is in semi-retirement due to health issues. The three young doctors are part of the nucleus of what I would call the "vital force" which I see here in Tandala. They are in their early 30’s and were classmates in medical school in Kinshasa.
I will give you their "Christian names” … Dr. Narcisse is from the area. He is married and has a 1-year-old son. Dr. DeGaulle is not from here but was a classmate of Dr. Narcisse in Kinshasa. He is also married and has 4-month-old son. Dr. Zacharie was a year behind these two and also is from another part of the Congo. All three are strong Christians and are active in a group called GBH, a Christian medical professional Bible fellowship.
Dr. Narcisse is the head of the Tandala health zone. Dr. DeGaulle is medical director of the hospital. Dr. Zach is also the headmaster of the nursing school. The dentist, Bofio, is actually a nurse with dental training. He is also a strong Christian and hospital administrator. He is married and has six children. He has been in Tandala for many years.
As I said earlier, these three doctors and Bofio are the real force for innovation and change. Last night, I had the opportunity to speak with the doctors on a subject which is important to understanding this system. I am sure that God has put this hospital and clinic system here in order to both provide compassionate care and also in order to give the staff a chance to let their light shine before all men. In fact, this is what I preached on during chapel last Saturday.
However, there are so many problems here. As an American, the tendency is to come in and say that they need to fix this, this, and this problem. However, I felt it was important to find out from the doctors what was most important to them. I also wanted to understand what they saw as barriers to fixing these problems and who would be responsible for maintaining the improvement if it was fixed.
One thing that our group of Americans believes is that God needs to lead us in helping our Congolese brethren in what they cannot do, but not doing for them what they can do. It was in this spirit that we discussed their priorities. I had this meeting without any of the former missionaries to translate; in part, because we all communicate well now and, in part, because I wanted to have the doctors share with me what they might not with the missionaries.
Their top priority was addressing a sense of isolation. Their idea for addressing this would be internet connectivity. This would include a reliable power source, probably solar, because gas for generators can be a big barrier here, both in terms of cost and of even being able to obtain gas during certain seasons. Solar would be a larger initial investment but would be cost-effective over time.
Ideally, they could then get VSAT for internet connectivity. Again, the initial cost is high but it is low maintenance afterward. Other than the obvious barriers of start-up costs and transportation issues, they also realize another barrier to this is have a person on staff who could understand the system well enough to troubleshoot and keep it maintained.
They really do sense a need for this connectivity, for several reasons. Most obviously, there is a need to be able to get continuing education and information on complicated cases. These guys are all general practitioners with less postgraduate training then almost any doctor in the U.S. They also hope to be able to stay in contact with mentors in the medical profession and in the Free Church globally. Finally, they are getting some really good data collected on various diseases and would look for those who could partner with them for publication of this information.
Their second priority was for more medications and medical supplies. This is another difficult issue, again due to the transportation barriers. They used to get help from the Congolese government in a program called SANRU III, but the funding for this has shifted to eastern DRC now. Now the only source of supplies and medications is the Free Church in America. Logistically, there are issues here of the cost of transportation from the U.S. as well as what can be sent. They tell me know that they have to ration which medications they use for which patient.
I can add that they are limited on what we would consider as basics in the U.S., such as surgical gauze and drapes. Where we would throw these away after one use, they will launder them and re-sterilize many times. I got my first experience in the operating room yesterday and it was shocking to see what they had to work with. They do believe that they have people who can manage this inventory well if we can get the supplies to them. I think we need to prayerfully consider how to help them with this; perhaps new partnerships or new mechanisms for getting supplies in?
Their third priority was for transportation. They have many outlying health centers to visit. Bicycles or motorcycles would be a great help. A truck would be even better. Thankfully, the dirt roads around here are being improved gradually after many years of neglect. There are people available to do the maintenance.
Finally, they have concern for a sense of "lethargy" here. They are not quite sure of the source. I suspect there are multiple factors. First: malnutrition, anemia, malaria, etc. during the early childhood years must influence people later in life. Second, there are probably cultural issues.
They were encouraged that the church has provided help in this, particularly oversight in how money is used. One of the doctors mentioned that you have to have oversight because, as he put it, if there is no oversight, a Congolese may "do bad." I followed this up by asking them why it was that they were not like this. I have found these men to be energetic and visionary. He shared with me, and the others agreed, that is was the church that had taught them this. He said that in the church, they were given a little responsibility and if they did well, more responsibility was given. If they did not handle it well, they would not be given responsibility. They learned to do well through this process.
As we thought about this, another of the doctors and I at the same time said that this was like the parable of the talents Jesus taught. This was one of the most encouraging things I have heard so far. I later found out that the pastors who had gone to visit Bau this same day had discussed the same biblical teaching as it applied to the success that they saw at Bau. It was heartening to see how God is making this role for His Church clear through several sources.
On Thursday, we leave for Gemena, and I may get internet connection again. Friday will be a debriefing day, first with the President of the Free Church in Congo, then as a team. Saturday we fly to Kinshasa, then fly out from Kinshasa to Paris around 9 p.m. Congo time (about 1 p.m. Pacific Time). We then fly from Paris to Newark and then Newark to Seattle, arriving at about 5 p.m. Sunday afternoon in Seattle (this will be like 3 a.m. Monday to us!).
I look forward to being back home with loved ones but will miss the people here. I have grown quite close to Bofio and the doctors.
In Christ,
Cal
Dear family and friends,
Today is July 31. Things have been so busy here that I have had little time to write. I asked to skip hospital rounds today in order to get time to get some things down in writing. I hope that this gets out sometime later this week when we are back in Gemena.
My week in Tandala has been both educational and challenging. Besides the medical work, which is complex, there have been many meetings both among our team and with various Congolese.
The bulk of our team is here in Tandala now. The pastors, including my pastor, Martin, came in on Friday. They had stayed in Gemena to participate in the Pastors' Conference and see the work the church is doing there with widows and orphans. With their arrival, this brings our total at Tandala to 13. It was really fun to be part of the line-up of people who greeted them on their arrival; almost as if I were a local myself.
We still tend to go our different ways during the day as there is much to see and do. My time is spent mainly at the hospital and its associated clinic. This has been a stretch for me both in terms of the severity of the diseases (many of which I have only read about or, at best, not dealt with since I was in training) and the conditions we work under. I am thankful that God has made the Congolese so tough, because much of what I see amazes me that the patient has survived so long with such severe pathology.
Usually we start the day with either what we would call morning report (medical teaching) or chapel; they alternate the days except for Sunday. This starts at 7:30 unless it is raining (then we start later). After this, we do rounds, then go to the clinic. Typically we work right through lunch until 3-4 p.m., then go home for the day.
There are several interesting nuances to this process. First, many of the women have no education so they cannot communicate basic facts that we take for granted, such as the location or duration of symptoms. Second, many here do not even speak Lingala, much less French, so a nurse has to translate their tribal language. Third, when a patient needs lab work or x-rays, even if they are on the ICU, they must go to that part of the hospital for the test (in part, this is done to assure that they pay for it).
And it is not uncommon to see families sharing a hospital bed. While the hospital has about 180 "beds," the capacity is higher. I am told that sometimes even three patients will share a bed. Fourth, the family is responsible for seeing that the patient gets food, water, laundry, etc. In fact, if you are not on the ICU, you only have a nurse around for a few hours during the day. Add to all this that there is no electricity or running water in the hospital, and I think you can begin to understand the conditions here.
I would like to share in this letter more about the doctors. There are four on staff, but the eldest is in semi-retirement due to health issues. The three young doctors are part of the nucleus of what I would call the "vital force" which I see here in Tandala. They are in their early 30’s and were classmates in medical school in Kinshasa.
I will give you their "Christian names” … Dr. Narcisse is from the area. He is married and has a 1-year-old son. Dr. DeGaulle is not from here but was a classmate of Dr. Narcisse in Kinshasa. He is also married and has 4-month-old son. Dr. Zacharie was a year behind these two and also is from another part of the Congo. All three are strong Christians and are active in a group called GBH, a Christian medical professional Bible fellowship.
Dr. Narcisse is the head of the Tandala health zone. Dr. DeGaulle is medical director of the hospital. Dr. Zach is also the headmaster of the nursing school. The dentist, Bofio, is actually a nurse with dental training. He is also a strong Christian and hospital administrator. He is married and has six children. He has been in Tandala for many years.
As I said earlier, these three doctors and Bofio are the real force for innovation and change. Last night, I had the opportunity to speak with the doctors on a subject which is important to understanding this system. I am sure that God has put this hospital and clinic system here in order to both provide compassionate care and also in order to give the staff a chance to let their light shine before all men. In fact, this is what I preached on during chapel last Saturday.
However, there are so many problems here. As an American, the tendency is to come in and say that they need to fix this, this, and this problem. However, I felt it was important to find out from the doctors what was most important to them. I also wanted to understand what they saw as barriers to fixing these problems and who would be responsible for maintaining the improvement if it was fixed.
One thing that our group of Americans believes is that God needs to lead us in helping our Congolese brethren in what they cannot do, but not doing for them what they can do. It was in this spirit that we discussed their priorities. I had this meeting without any of the former missionaries to translate; in part, because we all communicate well now and, in part, because I wanted to have the doctors share with me what they might not with the missionaries.
Their top priority was addressing a sense of isolation. Their idea for addressing this would be internet connectivity. This would include a reliable power source, probably solar, because gas for generators can be a big barrier here, both in terms of cost and of even being able to obtain gas during certain seasons. Solar would be a larger initial investment but would be cost-effective over time.
Ideally, they could then get VSAT for internet connectivity. Again, the initial cost is high but it is low maintenance afterward. Other than the obvious barriers of start-up costs and transportation issues, they also realize another barrier to this is have a person on staff who could understand the system well enough to troubleshoot and keep it maintained.
They really do sense a need for this connectivity, for several reasons. Most obviously, there is a need to be able to get continuing education and information on complicated cases. These guys are all general practitioners with less postgraduate training then almost any doctor in the U.S. They also hope to be able to stay in contact with mentors in the medical profession and in the Free Church globally. Finally, they are getting some really good data collected on various diseases and would look for those who could partner with them for publication of this information.
Their second priority was for more medications and medical supplies. This is another difficult issue, again due to the transportation barriers. They used to get help from the Congolese government in a program called SANRU III, but the funding for this has shifted to eastern DRC now. Now the only source of supplies and medications is the Free Church in America. Logistically, there are issues here of the cost of transportation from the U.S. as well as what can be sent. They tell me know that they have to ration which medications they use for which patient.
I can add that they are limited on what we would consider as basics in the U.S., such as surgical gauze and drapes. Where we would throw these away after one use, they will launder them and re-sterilize many times. I got my first experience in the operating room yesterday and it was shocking to see what they had to work with. They do believe that they have people who can manage this inventory well if we can get the supplies to them. I think we need to prayerfully consider how to help them with this; perhaps new partnerships or new mechanisms for getting supplies in?
Their third priority was for transportation. They have many outlying health centers to visit. Bicycles or motorcycles would be a great help. A truck would be even better. Thankfully, the dirt roads around here are being improved gradually after many years of neglect. There are people available to do the maintenance.
Finally, they have concern for a sense of "lethargy" here. They are not quite sure of the source. I suspect there are multiple factors. First: malnutrition, anemia, malaria, etc. during the early childhood years must influence people later in life. Second, there are probably cultural issues.
They were encouraged that the church has provided help in this, particularly oversight in how money is used. One of the doctors mentioned that you have to have oversight because, as he put it, if there is no oversight, a Congolese may "do bad." I followed this up by asking them why it was that they were not like this. I have found these men to be energetic and visionary. He shared with me, and the others agreed, that is was the church that had taught them this. He said that in the church, they were given a little responsibility and if they did well, more responsibility was given. If they did not handle it well, they would not be given responsibility. They learned to do well through this process.
As we thought about this, another of the doctors and I at the same time said that this was like the parable of the talents Jesus taught. This was one of the most encouraging things I have heard so far. I later found out that the pastors who had gone to visit Bau this same day had discussed the same biblical teaching as it applied to the success that they saw at Bau. It was heartening to see how God is making this role for His Church clear through several sources.
On Thursday, we leave for Gemena, and I may get internet connection again. Friday will be a debriefing day, first with the President of the Free Church in Congo, then as a team. Saturday we fly to Kinshasa, then fly out from Kinshasa to Paris around 9 p.m. Congo time (about 1 p.m. Pacific Time). We then fly from Paris to Newark and then Newark to Seattle, arriving at about 5 p.m. Sunday afternoon in Seattle (this will be like 3 a.m. Monday to us!).
I look forward to being back home with loved ones but will miss the people here. I have grown quite close to Bofio and the doctors.
In Christ,
Cal
posted by Larry Short at 10:15 AM
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