I was born and spent part of my childhood in Uvira, a small town in Eastern Democratic Republic of Congo, perched on the shore of Lake Tanganyika and surrounded by a range of mountains. When I was a teenager, three friends and I babysat a 2-year old from family relatives. His name was Guillaume. He was an active and happy toddler. He was dressed in matching outfits with the image of the Brazilian soccer star Ronaldo emblazoned on the back of the shirt.
It was normal practice for teens to take care of infants and babies in this part of the world. Soon after Guillaume’s mother left to run errands, we noticed that Guillaume was not running after his ball as he usually did. He was shivering and his body felt hot to touch. His mother was at the market trading goods with other women and had probably hoped that the fever would fade away on its own.
But as the day progressed, the fever did not abate, it grew in intensity. I suspect Guillaume had malaria, the most prevalent disease in my community. We had all had malaria many times and saw what adults did when one’s fever was too high. We bathed Guillaume in cold water but it did not help much.
Guillaume had a seizure. We were frightened and did not understand what was going on. My friends and I decided to take him to our closest health clinic so that he could get medicine. But the closest health clinic was very far away and there was no infrastructure like a good road or an ambulance get him there. We placed him on a bicycle, pushed the bicycle and tried as best as we could to get him to a clinic.
But it was too late. Guillaume died in our arms in the middle of a dirt road before we could get him medical help. Had there been a clinic near where we lived and basic infrastructure to get there, the child would likely have lived. Looking back at that experience now, we probably only needed Tylenol to bring down the fever. That experience left a mark on me as a teenager and sparked a lifelong interest in the medical field.
When I reached high school, I had to choose a major, as is customary in Congo. I chose biochemistry, with the intent to pursue a career in the medical field and fulfill a dream to bring healthcare services close to communities. Things seemed to be going well, despite a dozen occasional armed fighting incidents a year, which sometimes forced us out of our homes for a few weeks. This was part of life. We normally fled to neighboring Burundi when armed conflicts erupted in our small town and crossed right back after things calmed down.
In 2004, when I was in 10th grade, a war broke out, and my family and I ended up in a United Nations refugee camp across the border in Burundi. We stayed there longer than usual and spent two months living between hope and despair. During the third month, our refugee camp was attacked by militias. Guns were fired, grenades were thrown all over the place and the entire camp was set on fire. I lost everything dear to me. My younger sister Deborah was killed in our tent; my mother, sister, and brother were shot and sustained injuries and still carry scars. Many cousins, childhood friends and the majority of the people from my community lost their lives in a span of a few hours. A total of 166 people were killed that night in what became known as the “Gatumba Massacre”, another 116 people were injured. I escaped it alive but my life’s dreams were completely shattered. I was hopeless and my dreams ceased to exist for a few years.
My family was resettled in the United States and I started rebuilding my life. I am very grateful for the opportunity to have come to the United States and have access to education. I learnt the language, adapted to the culture and started a new family. I went back to school and became a registered nurse and currently pursuing my master’s degree. I have the enormous opportunity and satisfaction of helping patients in need and I can now put this to good use in my community. My hope of going back and helping to re-construct my community after years of devastating conflicts was reignited. I co-founded Jimbere Fund, a non-profit organization dedicated to helping Congo’s remote communities access critical services, especially healthcare services for children and women.
My work focusses on the High Plateaus of Itombwe that surround my hometown of Uvira and where some of the country’s most habitable remote areas are found. Villages are scattered over a large extent of land and lack access to critical health services. Many communities live beyond a 3-day walk radius from the nearest hospital. A few community health centers, which are supposed to be closer to communities, lack qualified personnel and basic medicines to treat most prevalent diseases such as malaria, tuberculosis, diarrhea and typhoid fever.
When I recently engaged healthcare personnel on the ground, they reported that most people die because they go to the hospital too late. When patients feel moderate pain, they usually go to the community health center, which normally has the most basic medicines like paracetamol and not much else. After they get worse and can not walk anymore, that is when they aretaken to the hospital, carried on wooden stretchers over men’s shoulders known as Kipoyo. Depending on where a patient lives, she or he can be carried on a wooden stretcher for up to four days. Local nurses and doctors have told me that by the time they arrive at the hospital,it is more often than not, too late.
Women and children face the most danger. Almost all women give birth at home with the help of elder peers. Taking into consideration the health and sanitation conditions, it is no wonder maternal mortality ratio in Congo is one of the highest in the world, at 846 of 100,000 live births in 2014 by World Bank figures. For comparison purposes, maternal mortality ratio in the United States was estimated at 18.5 per 100,000 live births in 2013.
The High Plateaus of Itombwe has an estimated population of 260,000 and you can count the number of medical doctors on one hand. Most inhabitants outside the villages of Minembwe and Mikenge have to walk for a day or more to get to one of these healthcare facilities to see a doctor. That is why it is not so uncommon to find people who have never been to a healthcare facility nor seen a doctor or a nurse in their lives. Tree-based traditional medicines are still widely used too, so people self-medicate when they feel sick. Although this has been passed on from generation to generation, not all illnesses can be cured with traditional medicine and in some cases, lives could easily be saved if the right medicine is provided in a timely manner.
One of the projects I am working on is to provide emergency transport systems to remote and isolated rural communities in High Plateaus of Itombwe, which will significantly expand access to primary healthcare. We have studied the area and devised 16 routes for motorized tricycle ambulances where navigation is possible in these remote and mountainous parts of Congo. The project will also operate a toll-free mobile phone center system to connect callers to the ambulances nearest to them. We plan on training 20 drivers to operate the ambulances and provide technical support for managing the tricycles. Drivers will provide transportation to patients and medical personnel for free along well-defined routes. At times when there are no patients, drivers will transport passengers for a small fee to help offset the operating costs of fuelling, maintaining and repairing tricycle ambulances.
The primary goal is to improve maternal and newborn health outcomes in the High Plateaus of Itombwe by providing transportation means to pregnant women to see a doctor and by increasing the number of women who give birth with the assistance of qualified healthcare personnel. Under-five infant mortality is higher in Congo than in most other African countries, with one in seven children dying before celebrating their fifth birthday.
The secondary goal is to reduce transmissions of infectious diseases, chief among them is tuberculosis, which results from carrying sick patients on people’s shoulders and provide medical personnel with transport means to provide preventative care for communities. With modest interventions such as providing transportation means for patients and medical personnel, we can save lives and improve the well-being of thousands of people in Congo. I survived a massacre but was unable to save a child from a high fever. No child should face such an unfortunate fate. No more Guillaumes.