The women were still chanting and playing the drums on their jerry cans, now circling in front of the health center, as we took our seats with the village chief, as it is customary to do in the DRC. King, one of our national staff team members, joined the women in full force and represented all of our joy and excitement for having arrived. The national staff was probably even more elated than the expats. They had been hearing for months, probably years, about the health status and conflict in the region. They’ve wanted MSF to come just as much as the community; these are their people.
After King was done doing his laps he joined us sitting. Most of the village was present for our arrival and all standing in front of us, some had their phones out to take pictures, I’m sure I was not at my photogenic best! It felt so good to be sitting. Elisa introduced everyone to the chief and we all divided into our respectful teams; Elisa and King in charge of security situation, Tobias and Swedi in charge of water, sanitation and logistics, Patrick, Roger and I in charge of health. I changed back into my running shoes and introduced myself to the two nurses stationed at the health post. We were hardly able to move around as there was such a large entourage. Patrick looked through the registers, Roger began explaining to our community health worker how to complete a malnutrition screening and I began my list of questions. I’m sure the nurse felt like he was being interrogated. I asked questions ranging from the vaccination status of the population to the cost of a pregnant woman delivering at the health post. I took a detailed inventory of all the medication and equipment they had available, and unfortunately, that didn’t take very long. I felt a pain in my heart when the head nurse asked if we could donate a thermometer because theirs doesn’t work properly. We did not come to treat patients but to complete an assessment, so unfortunately, I had to tell the nurse the truth which was that I did not have one on me to donate. The health post has had intermittent support from different international and local NGOs, unfortunately, none have been constant or sufficient to meet the needs of the village and its neighboring communities.
The 2 nurses had only recently been appointed to the health post, 2 weeks earlier the village had been without medical support for months. If someone was sick they had to trek the path we had just come from. I am so privileged to come from Canada, a country where healthcare is free and of good quality. If a child is ill their parents can bring them to the nearest hospital, where a team of health care professionals are prepared, where medications and supplies are in sufficient supplies and of the highest qualities, for free. You may have to wait to be seen, however, if you are a really urgent case that waiting time is under 5 minutes. Here, if a child is severely ill, their mother must walk as fast as she can to the nearest village with a health post through the forest, at any time of day and take a motor bike to the hospital in Walikale, and that is if she can find a motor in the middle of the night and afford the costs. Those 2 or 3 hours she takes running uphill and through mud and water are probably the scariest moments of her life, and can mean life or death for her child if she doesn’t make it on time.
The hour went by quickly. Patrick, Roger and I all agreed we had collected all the information we needed to complete our health assessment. The 3 separate teams met up again at the health post, where a crowd of 40 or so still remained to answer our questions and revel in our presence. Our community health worker had prepared us a lunch of chicken in a red sauce and fufu, sticky, thick balls made of magnock flour. They insisted we eat before leaving, which we could not refuse, but had to eat quickly in order to make it back in time before curfew. It was delicious. As I was eating I thought of the fact that our community health worker had had enough time to meet us at our first rest point, walk back to her village (about 10 kms), shower, change and make a meal all before we arrived. Incredible. I was tired just thinking about it. Once we finished eating the men who had been waiting pounced on the left over food and began their feast. Tobias told me he had learnt that meat was not common in their daily meals as it is in low supply and that men usually ate first as they often worked hardest, followed by the children then the women. As a woman and healthcare provider it is hard to hear this knowing just how hard women work in these communities and that they deserve and need meat sources in their diets just as much as men, if not more if they’re pregnant or breastfeeding. Once again, I am grateful and humbled for having grown up as a woman in Canada.
At 12:45pm we started our trek back towards the forest for the 12kms trek to the cars. I immediately changed back into my rubber boots, my feet screaming against it, but my brain knowing better now. We had a little entourage of 10 kids or so who accompanied us on our way out. The one directly in front of me was barefoot and so agile. I was still clutching onto my walking stick, so much so that I was starting to blister at the pressure points on my hands, and realized how jealous I was of his speeds and finesse of jumping over mud patches. The sun was shinning hard down on us and we had a little stop before entering the forest, and that’s when our same community health worker told me she was joining us back to the village on the main road, and she was carrying a load on her head to boot… she would walk over 30kms that day. We retook our positions in line, and I was once again in between my two outreach nurses. King was still in super high spirits and encouraged me that he had only counted 3 hills to conquer then it was flat grounds until the exit of the forest. I was a little skeptical but thought my exhaustion probably had clouded my judgement on the way in and he was more accurate then my over exaggerating thoughts.
After an hour we had climbed what I had counted as 3 hills, when we approached a fourth and I had to stop half way up and look at the team as I knew I was in trouble. I felt so hot, was so tired and now afraid I would get heat stroke at this point. I had to yell to the front that I needed a break at the top, but the top just never seemed to appear. The walking stick was now supporting over 75% of my weight with each step and it took all my mental strength to reach the summit, then I immediately slumped down on a log. Patrick, after being behind me and probably realizing the severity of my struggle, was kind enough to get me water. I ate a couple of peanuts and drank about 400mls of water and saw that the path looked pretty flat. But when I mentioned “at least we have climbed the 3 hills” King and Swedi laughed saying we had only climbed one… another reminder of our completely different definitions of hills. After a few minutes I felt much better and as though the danger subsided so we trekked on. I tried to once again enjoy the beauty of the scenery surrounding us, but kept tripping over tree roots. I commented to Patrick that they were all out to get me and he simply said “No, your fatigue is making you sloppy. Keep your eyes down”. Love the honesty. Roger, however, would turn around and tell me how much further we had gone and how great I was doing. Both complimenting me and encouraging me in different ways, both equally effective.
I could tell that the team was getting tired and thirsty as at every stream we passed they were collecting water and quickly guzzling it down. None of us expats were courageous enough to try our hand at the fresh stream water, and the possible consequences it may cause. We took frequent breaks at the security checks but we were all in high spirits. We had made it to our destination and we’re now on the way home. Elisa and Tobias were craving chocolate and I began to imagine how delicious dinner will taste. We didn’t have to speak much but the atmosphere was light and satisfied. I had heard some thunder rolling in the distance and was a little worried; all we needed was a typical Congolese downpour to make this trek even more adventurous! But when everyone kept saying that it will be hours by the time the rain would fall I was slightly reassured and kept walking.
At about 2:30 the skies were starting to darken and we could see flashes in the distance. That’s when the estimations of when the rain would come began to change. By 2:50 we started to feel a few light drops. At 2:55 we stopped to put our rain jackets on, and at 2:57 we had a full thunderstorm downpour. Now we were waking in waterfalls and it made the mud even more slippery. My boots were full of water, I could feel and hear the “squish” with every step. At one downward slant Roger warned me it would be slick, and I listened, but not enough because before I know it I was in a bush and Patrick had a face of pure panic. We walked over an hour in the hard rain, and I learnt just how not waterproof my jacket was, but I didn’t mind because I started to recognize landmarks again, we were close! We stopped at our first rest stop again to re-fuel our minds and stomachs and not long after we reached the first stream that made me change my mind about the running shoes on the way out.
It was 4:30pm by the time we reached the cars. Over ten hours since our departure. The rain had stopped. But we still had some faithful community members who had been there all day waiting our return. Once again we had our hands shacked and given many words of gratitude. A group of kids serenaded us over and over with the local MSF song as I took off my boots and drank my left over water. Already we were laughing about the mishaps of the day and all looking forward to a nice hot bucket shower. I was very wet, very cold and tired but grateful for this adventure and impressed by the spirit and beauty of the Democratic Republic of Congo and its people. The sore muscles and blisters will heal but my memories of that day will forever stay with me and for that I am thankful.