Lubutu, DRC

Yikes. For the last several months I wondered what I was getting myself into. Now I know.

Yikes. For the last several months I wondered what I was getting myself into. Now I know.

After two days travel, I have finally arrived yesterday in Lubutu. Yep, it is as advertised. Very Africa. The drive here from Kinsangani was four hours and beautiful. The jungle was thick thick thick and all I could think about was — How did the early explorers possibly get here? To me, it looks as if it would take a day go to 100 meters in that forest, but for hundreds of years people have explored this territory and its beauty.

We arrived mid-afternoon and after a short break in my new home (an ex-convent!) it was off to the hospital and the office for an extended tour.

The Médicins Sans Frontières project here is impressive. The hospital is a rehabilitated government facility, staffed exclusively by MSF. There is everything I have seen in hospitals of reference in Africa: inpatient adult and pediatric wards, an excellent laboratory, radiology, intensive care, an extensive pharmacy, and everything incredibly clean. Of course, there are a couple of things lacking in most hospitals familiar to people in US – a cholera ward and an isolation area for hemorrhagic fevers (such as Ebola) for example.

This morning, it was up early to go to one of my two assigned Centres de Santé (Health Centers). Mungule, situated two hours away by car, was opened in May 2009. Kalibatate, within spitting distance of Lubutu's town center, opened four days ago. Both are staffed by national (Congolese) staff who provide primary care to the population. Both Centres de Santé do primary care, malnutrition screening, wound care, treatment for sexually transmitted disease, and health promotion. Mungule, the more distant, also has obstetrics.

Today we went to Kalibatate; tomorrow we go to Mungule.

The job ahead is formidable to say the least. Most health care providers in the Democratic Republic of Congo are not trained physicians. They are not nurses. They have little formal education compared to a western physician. My job is to train these providers to diagnose and treat disease. In French.

Fortunately, it appears I have a savior named Joseph. My predecessor in this position (who did excellent work here but departed the day I arrived) left me a thirteen page "passation", a description of my duties, obstacles, and assets. Chief among the last assets is Joseph, an "infermier", literally translated as "nurse" but more like a physician's assistant or clinical nurse practitioner. Joseph is to work beside me to improve the diagnostic and treatment skills of the local health care providers. My other savior is Sophie, my boss. An intensive care nurse from Sweden, she is kind and understanding and really smart.

I'm honestly kind of freaking out.

OK calm down. I know I can do this. I've kind of, sort of, done it before, and I'll hopefully do it again and I know I'll do a good job, but wow…… this is bigger than any educational challenge I've faced before.

But I'll do it.