Sliding through magic bamboo

Suddenly around one of the many twists of the muddy path, we arrive in a forest, which solely consists of bamboo. So much that I can’t believe my eyes! And so large! Now I know where the brothers Grimm got their imagination when writing their fairy tales. (“Maybe they were here?”, I ask myself) It is magic; there is no other word for it.

The muddy path goes steeply downwards, becoming more and more slippery. Like thick black mud turned into ice. I slide from bamboo to bamboo and praise the strength of these fast growing, tall, wonders of nature.

A couple of hours further on, we enter a valley with grass taller than me. I have no idea where exactly I am anymore. The heavy rain, which seems to drop ten times larger than it should, doesn’t help. I imagine that I can hear the sound of my socks sliding around in the murky water in my shoes. I imagine how awful the smell will be when I take them off.

Lubumba Health CentreFinally, Lubumba, a small village in the Itombwe Forest, and our final destination!

As if my wishes are being heard, the rain stops almost at the moment we enter the village. We make camp around the health centre. On one side our sleeping tents and on the other, the consultation tents. I decide to sleep in a hut specially prepared for me (the preparation being that they moved the cows out of it….)

The evening falls fast. My colleagues and I sit in my hut around the babula drying our clothes and eating our famous rice and beans, prompting dreams of better food and “haute cuisine” in a 5 star restaurant, slowly munching a shrimp cocktail while sipping on a glass of Beaujolais at a perfect temperature.

Hotel Lubumba

Hotel Lubumba

I slide into my sleeping bag and before my head hits my pillow of dry clothes, I go out like a candle in a tropical rain storm.

In the middle of the night I wake suddenly. Are the flees waking me up at this horrible hour or is it something else? I know. My mind is busy with flashes of a very good friend of mine, Philippe Havet. He was my head of mission last year. When he was in the Hauts Plateaux in October 2010, he was struck by malaria typhoid. I had to medevac (medical evacuation) him fast by helicopter to the hospital in Bukavu. He was a man with a huge heart and always ready to go where there are people in need. His sense of humour was contagious and all the staff here, with no exceptions, loved him very much. It makes me indescribable sad, as I realise once again, that he is not there anymore. He was killed in Mogadishu while working for MSF not long ago. I’m missing you “mon petit grand” (my little big one), I think out loud. Rest in peace my brother!

BootsI realize that my work for MSF is not without danger. MSF works a lot in conflict areas and there is always a risk, no matter how strict the security rules. More and more I notice a decline in respect for humanitarian workers – it is as if our field of operation is getting smaller. In October last year, two of my colleagues, Montserrat Serra and Blanca Thiebaut, were abducted in Kenya and are still not released today. “Courage” you two! Where is this humanitarian world going to? More and more we are unable to do our job. Something needs to be done and fast. Not for me, or MSF for that matter, but for the beneficiaries, the people in need. They suffer the most!

In the morning, I step outside my “Lubumba Hotel” carefully avoiding hitting my head again by bending almost halfway to the floor. To the right, on some bamboo fence, rubber boots are steaming in the early morning sun. A large crowd already sits, waiting at the edge of our small, improvised compound. They have come from far. One of them, a woman, was brought last night on a stretcher carried by two men after walking for two days, just like us. Their faces look tired, but happy: MSF is there! Finally!

Baby born in Lubumba

Baby born in Lubumba

The Itombwe Forest is a region which is totally forgotten by other NGO’s (Non Governmental Organisation). The health system collapsed a long time ago, if it ever existed. We have work to do….. A lot of work!

In 4 days we conduct 1,100 consultations. We work hard and are satisfied, much like the people themselves. We even assist with the birth of a beautiful little baby girl. The faces of these people will forever be engraved in my memory, their smiles, their feelings of relief, the hope in their eyes, burning with the question, when MSF would come back again?

It will be the last time for me here. It is time for someone else to take over. Someone with a fresh vision and new ideas of how MSF can best assist these people. Soon I will continue to another mission: Yemen. A different environment with different challenges and I am more than ready……..

Ferry taking a photo


This post was first published in Spanish at 20minutos.es

Posted in Democratic Republic of Congo, Field Coordinator, Healthcare provision | Tagged , , | 10 Comments

People are waiting for us!

We are on our way in the direction of Musonjo, a long line of porters moving slowly through a palette of different greens in an almost snakelike motion. Every small but determined step reduces the distance to our goal for the day; a thought that always makes me smile.

I think of the German invaders, during the First World War, who stopped their attack just before hitting these mountains and decided that the occupation/control of Lake Tanganyika, and the smaller Lake Kivu was enough. Who would want to climb these huge mountains? And for what? By comparison, today would be a nice exercise, something to loosen up my muscles a little bit, no steep climbs, just like a Sunday afternoon stroll……

In the far north-west I can already distinguish Rubuga, our destination for today, a small town with only a couple of houses, a health centre and a church. There we will change the porters for tomorrow. The objective is to let as many villages participate in our tasks, in order to share the jobs equally. The news of our arrival preceded us by one day, so there will be no problems finding new porters tomorrow morning.

Even before entering the village, we are greeted by the pastor and the nurse responsible for the health centre. And, of course, a flock of little children, curious as ever about this strange white man.

The church seems a good place to stay the night, but the pastor insists we sleep in his house, which he has already evacuated prior to our arrival. A chicken had been indentified to be sacrificed for dinner and pans of water are being heated for a “shower” before I even reach the house. Could I wish for a warmer welcome?

The pastor’s wife prepares a small room in the adjacent house to take a shower. The living room is packed with family members who sit all around the open fire place. Smoke is everywhere, since the they don’t have a chimney. I set another record for the day by taking the fastest shower ever. Stepping into the house while holding my breath, I run to the specially prepared room, undress, water, soap, water, dress and run out again for some smokeless air. I still wonder how they are able to just sit there, eat, sleep etc…. I decide there and then to stop smoking as fast as possible.

The next day, the whole village is gathered around the house. It is light and the roofs are already smoking. The last part of our journey begins after shaking a lot of hands; large and small, old and young.

Now we are going up steeply again, up the mountain that separates the Hauts Plateaux from the Itombwe Forest. It goes slowly as usual and I am very happy to finally see both on either side when I reach the top.

The weather seems to be changing. Clouds seem to be hanging on one side, as if they are afraid of passing. Unfortunately, they are on the side we are heading. My well deserved rest on the edge is rudely interrupted as the first drops start to fall. Time to get moving again. Rain… What is rain other than falling drops of water, touching our bodies and soaking our clothes? A human body consists of a minimum of 70% water, so what are a couple of drops more? Just keep on moving. People are waiting for us!

To be continued

Posted in Democratic Republic of Congo, Field Coordinator, Healthcare provision | Comments Off

Preparing for a walk of 6+9

And again it is 5 o’clock in the morning. After a couple of days rest I prepare myself for our trip to the Itombwe Forest, 2 days walk across the most eastern mountain range of The Hauts Plateaux. Yesterday we advised the local community and the surrounding villages that we would need porters. A lot this time – 34!

It takes me at least 30 minutes to find the courage to move my, still aging body, towards the side of the bed. However, dressing in under five minutes is a personal victory and something to celebrate, I think to myself! Will remember that when I get back next week….

The first porters are already here when I make my way to our toilet, a pit latrine protected by a small bamboo structure with grass on the roof. An almost romantic sight! The valley is filled with low hanging clouds covering the river below and at the far end is the market of Magunda. I imagine this will be a beautiful, bright and sunny day and I stop to inhale this moment of peace.

Behind the office, I can see a long line of material, neatly packed, rain protected and ready for transport. Foldable tables and chairs, consultation tents, piles of plastic sheeting, boxes with vaccines, a large blue cool box, which needs to be carried by 4 porters, plastic bags with rice, beans, dried and salted fish, babula’s (traditional charcoal stoves) and of course the charcoal, sleeping bags and personal sleeping tents. In short, everything needed for our mobile clinic.

I plan to get the Itombwe Forest in two days. First, a 6 hour walk to the valley at the edge of the Hauts Plateaux, sleeping in a small village with the very hospitable local population and then the next day up the mountain further to the west, until finally descending into the tropical rain forest, which will take another 9 hours. Why it is called tropical “rain” forest, I would find out soon enough.

There are multiple ethnic groups in the Hauts Plateaux , like Babembe, Bafuliro, Banyamulenge, etc… The population of Kihuha (and Marungu for that matter) are Banyamulenge, also called Congolese Tutsis. Originally these people came from Rwanda 2 centuries ago, with a couple of influxes since. The name “Banyamulenge” was chosen in the early 1970s to avoid being called “Banyarwanda” (people from Rwanda) and seen as foreigners. Ethnic tensions against Tutsi rose following the end of the colonial period, as well as the 1972 mass killing of Hutu in Burundi. In response the Tutsi appear to have attempted to distance themselves from their ethnicity as Rwandans and associated themselves with Mulenge, a village in the so-called, Moyen Plateaux, so they are now Banyamulenge; “people from Mulenge”……

Just before we leave, I meet a woman with a pile of rocks on her head. I always wonder how the women here could carry things on their heads, walk straight and climb and descend these mountains, with grace and definite pride. Amazing! I tried once and was so busy trying to find my balance that I tripped over a tree trunk and almost broke my neck in the process……

To be continued

This post was first published in Spanish by 20minutos.es

Posted in Democratic Republic of Congo, Field Coordinator, Healthcare provision | Tagged , | 3 Comments

Smiles, Kings and Heavy Breathing

It’s again 5 o’clock in the morning. Slowly, most of the staff wake up and start moving towards our newly-built shower, hoping to be the first to enjoy the nice warm stream of water, which the guards put in the 100 litre container on top of the small shed. I know that the assistant logistician is already busy putting boxes outside the stockroom, wrapped in trashcan bags to prevent rain entering.

Hauts Plateaux DRC Congo 2011-12I swing my legs over the edge of my bed and sit there in contemplation of what is to come. Did I think of everything? Is the way to the Base 2 safe today? Is the fridge not too heavy for 4 porters or should I add another 2? Don’t forget to take the jerry cans with kerosene, otherwise the fridge is useless! Come on, get moving! You need to leave at 6:00 at the latest……..

I look for my 2 empty plastic bottles to fill up with fresh filtered drinking water, my small contribution to recycling waste. After a small glimpse through the window, I decided to dress extra warm. It is not going to be easy this time. To the left of the “Anguale”, the first mountain to the south, I see large dark cumulus clouds building up. This is going to be even more of a challenge than I expected.

I push my mind empty and try to concentrate on the preparations. Water? Check! Raisins? Check! New food supplies for over there? Check! Satellite phone and radio handset? Check!

The compound is buzzing with the sounds of busyness when I finally step outside with my personal luggage. Without anybody noticing I count the number of porters and check that each of them is wearing the appropriate MSF identification. We will be entering a hostile environment, where many armed factions roam, and I can’t leaveanything to chance. I check the latest security info and I know it’s a go.

I step slowly to the gate and shout: “Tugende mugenzi”, “Let’s go my friends”, in the local language. The porters are laughing and literally look up to me, being an average 30 cm taller than most of them. I smile back at them and step out the gate. Kihuha here we come!

A long line of porters follow me carrying medicines and medical supplies in white boxes marked with MSF. Halfway along the line I can see the 4 guys who are responsible for carrying the fridge, necessary to be able to preserve ampoules for vaccination in our other base, neatly “packed” with bamboo and rope. Arriving at the first mountain range I reduce speed almost automatically and start climbing at a slow and steady pace. Looking at my feet and concentrating on every step, listening to the ever increasing frequency of my heavy breathing.

“Can the others hear me breathing?”, I ask myself almost in shame, looking at the porters carrying the boxes of almost 20 KG , watching them moving up the mountain with the elegance of kings, seemingly with no effort at all. I take it easy climbing the “Anguale”. I know what lies ahead of me. I should reserve my strength. Even on the other side, where we follow a long valley alongside one of the countless streams of the Hauts Plateaux, slowly approaching “Kirumba”, the second high mountain, 3,200 meters high.

On the top of Kirumba we take our first rest. The porters sit down and start eating their favourite bugali. I can already see Masango, where we have a health centre. It looks so close, almost touchable. I squint my eyes in an attempt to distinguish the MSF flag. Another 3 hours to get there.

It starts raining and the cold sends goose bumps up my spine. We have to go down fast. Staying at this height in these conditions is very dangerous. We move on, trying to find grip on the muddy path that has become a small river. I have a deep respect for the guys transporting the fridge. I can barely prevent myself from sliding, let alone carry a fridge at the same time….

To reach Masango we have to go up again. The thought that this will be the last big climb, comforts me. My shoes are drenched and my hat barely prevents the rain from hitting my eyes.

As suddenly as the rain starts, it stops, and I can even see shades of blue popping up out of nowhere. The children of Masango greet us on our way to the health centre. Why are they smiling? They are contagious smiles and I can’t help smiling back, despite my fatigue.

At the health centre we take another break and take the opportunity to talk to the staff and inspect the quality of both health centre operations and the waste zone. I make notes of their remarks and promise to send our logistics team the next day to repair the roof of the waste zone, which was damaged by the latest storm.

Two hours later, after 10 hours of up and down, we arrive at our final destination for today, our second base Kihuha, where we will prepare a mobile clinic towards the Itombwe forest, a distant, isolated area in the middle of the rainforest to the west, where the people are forgotten and the medical system has long since collapsed. We, MSF, have to go there to ensure that people can get quality medical care.

It’s a two day walk, so now it’s time to rest.

To be continued……

This post was first published (in Spanish) at 20minutos.es

Posted in Democratic Republic of Congo, Field Coordinator, Healthcare provision | Tagged , , , | 11 Comments

Waking up in paradise

It’s five o’clock in the morning. It’s quiet, so very quiet. I lie still. Eyes still closed trying to remember where I am. The cold fresh air strikes my face softly, waking me up slowly, like the soft whisper of my mother’s voice when I was still young, telling me that it was time to get up and to go to school. I have the feeling that this moment in time will last forever. I’m okay with it and let the soft morning breeze play its gentle play. Suddenly the silence breaks with the all-too familiar sound of a rooster, who has definitely a very wrong concept of time. He should know that is too early to get up, but it is too late now to fall back to sleep, so I slowly open my eyes.

I always sleep with my window open and always enjoy intensely the evening skies and the subtle sounds of the village of Marungu falling asleep.

Marungu is a small village high up in the mountains of the Hauts Plateaux in South Kivu, in the east of Congo, at an altitude of 2,900 metres. It is a very isolated village made up of a couple of dozen traditional houses, built out of bamboo and cow dung mixed with clay, most of them with a roof of grass.

I look around my 3m x 3m room. To the left, on a shelf, too many pieces of paper with reminders of what to do today, as if I could forget… In front, next to the door, some more shelves with my personal food stock.

Eating habits here don’t vary much beyond the traditional rice and beans, chicken, goat, salted and smoked fish, and corn dough, called bugali. I need, once in a while, something different. Once a month I buy some other stuff down in the valley, in a town on the shores of Lake Tanganyika called Uvira. I realise that I need to buy some more cheese and some sandwiches, having finished my last one week ago.

I decide to get up slowly. It is still a little dark and cold. The rainy season started a couple of weeks ago, and the temperature dropped in the night to five degrees Celsius. My babula, a small traditional charcoal stove, is cold and stands sad and forgotten in the corner. I will ask the guard to revive it as fast as possible. Life here is much more comfortable with a warm one.

I put my Italian ‘mocca’ on the revived hot babula in patient anticipation of a very good coffee and walk outside the gate to listen to the sounds of Marungu waking up. I can already see the smoke coming out through the grass roofs. The local population starts the morning by building a wood fire inside the chimneyless houses. Some more roosters follow the example of the one in our compound and don’t seem to accept no for an answer. The awakening of a brand new day in paradise.

 

Paradise. I call it paradise for different reasons. First of all because it resembles most people’s image of how paradise should look: serene, peaceful. Peaceful, however, is far from the truth. Here, high up in my mountains, is the hideout of multiple military factions in disharmony with the Congolese authorities and each other. There are frequently armed encounters between them and the Congolese army, resulting in whole villages fleeing to look for a safe haven, leaving everything behind that they have learned to cherish and to protect.

The area is about 50 x 70 km². Because of its isolation, and because of insecurity and difficult access, the health system is very weak or non-existent. People have to walk for hours and even days to reach a health centre to look for healthcare. Arriving at the health centre, they have to pay money for their medical care, a commodity they often don’t have. Even in the worst cases they often stay at home because they can’t afford to get medical care. Or they will make the sometimes-long walk towards the MSF structures, where they know they can get free medical care. At present, MSF supports six health centres in this area.

For me it is very obvious why Médecins Sans Frontières has decided to help this population in distress. As a field coordinator, I have no doubt whatsoever why I am here. We need to help these people. Help them to build up a good health system with good access and free quality care. Help the displaced population and provide them with shelter and the basic materials to survive, next to medical care, of course – and medical care I mean in the broadest sense of the word. All our efforts, including sensitisation of the population, are focused on detecting the victims of sexual violence before 72 hours have elapsed – the limit for being able to start medical preventive measures for HIV and pregnancies, for example. Adequate psychological care and follow-up of these victims, as well as those people who have been displaced from their homes by fighting – are of course important daily tasks of our teams.

Except for near our base in Marungu, there are no roads here in the Hauts Plateaux. We have to walk for hours, crossing even higher mountains, to reach the population. Our second base, Kihuha, is a 10-hour walk away. My team is divided between these two bases, which is a real challenge to manage.

It is six o’clock and it is light. People start moving around, some with loads of goats following them. Women go down to the water sources to get water for the day, the older ones carrying 20 litres and the children carrying five or 10.

Looking at these women, I remember a conversation with one of them. She came to the health centre in the village one night. She had been raped the night before and came to get help at night to avoid stigmatisation and condemnation by her husband, family and the rest of the community. She had been raped by four men in one night in the absence of her husband. It took all of her courage to seek help. We rushed to the health centre with a specialised sexual violence nurse and our psychologist in order to treat her in the best way we could. She told us that she needed our help, but the saddest part was that she didn’t really believe that we could help her, because, as she said: “Why, why? …tomorrow will be the same.”

No, I don’t need external motivation to work for MSF. I have lived here for more than one year now. I listen, I see and I do the best I can to help these people in need, with healthcare they never had before the arrival of MSF, here in their own “paradise”.

This blog post first appeared (in Spanish) at 20minutos.es

Posted in Democratic Republic of Congo, Field Coordinator, Healthcare provision | Tagged , , , , | 11 Comments