When our Project Coordinator asked if I would come with him on an outreach trip to the distant communities of Mpati and Bibwe, I was thrilled.
I could use a change of scenery in Mpati and Bibwe – small towns nestled in the northeast corner of the Democratic Republic of the Congo.
Due to the road conditions, we hadn’t been able to make a trip for many months. However, these trips to far-flung communities are the quintessential MSF experience in my view.
Embodying the medical trainee’s mantra of “see one, do one, teach one”, outreach trips allow me to travel with local MSF staff to remote communities, supervise their medical care and help where I can by providing guidance to improve treatment in remote settings.
We were a small party as we set out on our mission: two jeeps and six “motos” – a cross between a dirt bike and standard motorcycle, perfect for handling the twisting, muddy, treacherous mountain roads.
By contrast, the jeeps had a heavy going of it. By the time we reached the town of Kalengara, the jeeps had got stuck twice, requiring a great deal of shovelling, laying down branches, and finally pulling out a metal cable to drag one Jeep out with the other Jeep.
We plunged down embankments to cross stone-strewn rivulets, ground upward over outcrops of igneous rock and skidded into bathtubs of gumbo mud."
However, the moto quickly became my vehicle of choice.
We everyone eventually made it to at Kalengara, a town cresting verdant hills, we unloaded the supplies from the jeeps.
The team quickly loaded the motos with boxes of Plumpy-Nut, which is a complete food used to treat malnutrition, intravenous fluids and medications. My backpack was stuffed with a plastic manikin and ambubag. This is a balloon-like bag and mask used with a doll to mentor nurses in communities on how to improve their neonatal care when babies are born unable to breathe on their own.
My moto was piled high with boxes, no room for my backpack, so it rode proudly upon the chest of my driver, Mucandirwa.
I was honoured with the biggest helmet with an arching face guard jutting out, the entire contraption slipping around and frequently bumping into Mucandirwa’s own helmet as we lurched along.
Bathtubs of gumbo mud
When we started off, me clutching Mucandirwa’s back, I promised myself I wouldn’t let out little gulping screams as we plunged down embankments to cross stone-strewn rivulets, ground upward over outcrops of igneous rock and skidded into bathtubs of gumbo mud.
At one point, as we spun wildly upon a muddy rock, I couldn’t help myself, leaping off the back of the metallic steed and racing uphill under the power of my own two legs and strong-soled boots. Mucandirwa was shamed to have the Mama slide off the bike! I was to remain firmly ensconced between his back and the two boxes of IV fluid and there was no getting out of it.
Onward and upward we lurched, spun, slid, mucked about, and finally after I couldn’t take another bone-crunching jolt, we ground out on the last hill into Mpati.
The golden minute
A new world awaited me, a world of friendly faces, warm handshakes and generous welcomes.
We had not been able to make it back to Mpati for seven months and our presence signalled to the entire community that MSF was continuing to support the health centre with materials, supplies and education.
The air was crisp and cold, and with no light pollution, the stars were so brilliant I felt I could reach out and touch them."
After a brief meeting, I was given 90 minutes to teach the healthcare team about neonatal resuscitation. By the end of the session my team was practising their “golden minute” – the time in which a newborn should be breathing – working together to dry, stimulate and commence ventilation with an ambubag if the infant wasn’t crying.We also practised cardiac massage, or CPR, and talked about post-resuscitation care.
I left the team with two “penguins” which are the name for our plastic bulbs used to suction out thick mucus, a copy of the resuscitation protocol, but, more importantly, with the hands-on experience to be able to provide ventilation in the first minute of life.
We spent the evening in our MSF compound high on a hill overlooking the health centre. The air was crisp and cold, and with no light pollution, the stars were so brilliant I felt I could reach out and touch them.
Bibwe and home
The next day, we continued on, up and over another pass before dropping down to the health centre in Bibwe for a two-hour visit.
It was a two-hour motorcycle trip to Bibwe and more than four hours back to our home base in Mweso.
The novelty of jostling and thumping along on the back of a moto had long since worn off. Rolling into our compound, we were greeted as returning heroes, with hugs, laughter and warm welcomes.
We were, one and all, filthy from mud and sore from the bikes, but had big grins on our faces for completing our outreach mission.
“Welcome back, Dr Lanice” one of our local staff called out.
“No more Dr Lanice,” I answered.
“My new name is “Moto Mama!”