First impressions

I won’t write much because I fear the internet will crash again and I’ll lose everything. But I can say that this is the most beautiful place I’ve ever seen! Green hills, fertile ground, friendly people and the perfect climate. It’s like late August at home, 15 degrees at night and in the morning, then it goes up to 25-35 degrees during the day.

I was initially easily fooled by the beautiful scenery, perfect climate and wonderful people. But the reality is this: a 14 year old girl was raped outside our village on my first day, 3 children died within the first hour of ward rounds on my first day, women walk with their dying children on their backs for sometimes over a day to get to our hospital, and everyday locals risk death on the roads due to armed robbery, sometimes just so the assailants can steal less than a dollar. This is life in the Kivu provinces. The fact that EVERY Congolese person I encounter on the road easily breaks into a smile and a 'Jambo Sana' is a testament to their resilience.

To be clear, I am safe. But we are currently on restricted movements (ie. no mobile clinics or outreach) because of increasing ambushes on the roads. What this means is that patients have to walk EVEN FARTHER to access care. Our hospital is not even close to capacity, and if people aren’t in Mweso General Hospital, they must be dying on the road, in the forests, or in the swamps.

But on a positive note, let me tell you what Médecins Sans Frontières is doing here. We are supporting Hopital General de Reference in Mweso, North Kivu. It is a 200-bed referral hospital. Services include Internal Medicine, Surgery, Neonatal, Intensive Care, Pediatrics, and Inpatient Nutrition (CNT: Centre Nutritionel Therapeutique). Oh ya, and psychiatry, which I got voted to run! Our psych mandate includes only those patients who are so floridly psychotic that they pose a danger to themselves or the community.

Everyday, including Saturday, I start rounds at 8AM in Intensive Care and then make my way to TFC (therapeutic feeding centre) and Pediatrics. TFC is currently holding 30 malnourished children. I won’t be cliched and describe all the skeletal children lying listlessly in their mothers arms, but I will tell you it is scary as hell!!! It is no exaggeration to say that you can be looking at a well-looking malnourished child, turn your back, and 10 seconds later that child is dead. As the pediatric folks reading this blog know, the subtlety of pediatric physical diagnosis is one of the great challenges of my profession. But the nuances in picking up an imminent death in one of these children requires a whole new skill set. This learning process has been a bumpy ride and not everyone makes it to the end…