Mist hangs in the air the hills like steam after a hot shower. Gravel crunches under the ambulance’s tires and its shocks whine as we make our way over the pitted, cratered roads of Masisi, North Kivu.

Mist hangs in the air the hills like steam after a hot shower. Gravel crunches under the ambulance’s tires and its shocks whine as we make our way over the pitted, cratered roads of Masisi, North Kivu.

The MSF team received a call from the health centre in Nyabiondo this morning: someone has been shot and needs an urgent transfer to the MSF-supported Masisi hospital. So as not to waste any time, an ambulance has already left Nyabiondo. A team from here in Masisi will meet them on the road.

The MSF ambulance in MasisiPhoto: Sandra Smiley/MSF

When we catch sight of the other Land Cruiser, I mentally ready myself for what I am about to encounter: perhaps a soldier of the national army, or one belonging to one of a dozen or so armed groups operating in this area.

These guys are often tough customers, hardened military types who have spent years fighting in the bush. But from the second they are wounded, they are no longer combatants, but patients; and MSF treats everyone who needs help, regardless of how many shells they’ve fired.

The MSF ambulance on its way to pick up a patient in Nyabiondo Photo: Sandra Smiley/MSF

The ambulance continues in our direction, turns around on itself and stops. The driver jumps out and pulls open the back doors.

But it’s not the hard-boiled, wind-beaten soldier I’d expected that emerges from the vehicle.

It’s not a soldier at all.

It’s a kid – one who couldn’t be older than 15. He has a strong jaw but round cheeks, big hands but skinny arms: his face and body occupying that awkward space between child and adult. He is wearing a collared men’s shirt that hangs loosely from his teenaged frame. There are dark red smears at the shoulder, where a bullet has penetrated his flesh.

The soldier is helped into the second MSF ambulance.Photo: Sandra Smiley/MSF

As quickly as possible, the boy is bundled into the second ambulance. Armed with thermometers, stethoscopes and blood pressure monitors, nurses Astrid and Jacques take vital signs.

Soon, we are moving again, and Jacques radios the readings back to the emergency ward. He is speaking in the efficient and emotionless language of medicine: temperature of 37 degrees; respiration at 20 cycles per minute, blood pressure 120/60 mm Hg. The words he uses do not betray his concern for his patient. But his eyes do.

Simweray's medical history is taken by an MSF nurse in the back of the ambulance.Photo: Sandra Smiley/MSF

The boy’s name is Simweray. He is 13 years old. Last night, armed men entered his family’s home in a village about 30 kilometres from here. The men fired once inside. A bullet hit Simweray in the chest – but not before tearing through his brother’s skull and killing him.

Simweray's bloodstained hands grip the back of a seat in the MSF ambulance.Photo: Sandra Smiley/MSF

We arrive back at the emergency room. Simweray is rushed through the double doors into the ward, his vital signs taken and recorded again. He will be observed in the emergency room until the doctors and nurses are confident that his condition is stable, that there are no complications from his injury or the shock that followed. Then he will be hospitalised for a few weeks to receive medical and psychological follow-up care.

Later, I think about the bullet, recalling the yarns I’ve heard about steel hip replacements and dental fillings setting off metal detectors in international airports. Obviously missing a transcontinental flight is the least of this young man’s worries. But I’m curious: will the metal in Simweray’s chest be taken out or left inside?

Simweray arrives at the MSF hospital in MasisiPhoto: Sandra Smiley/MSF

I’m told that the highly specialised surgeons in Masisi could try to remove it. Doing so would mean the wound could heal completely, reducing the risk of complications in the future. But it’s dangerous to try to extract a foreign object from a part of the body that’s so full of organs, arteries and veins – it could do irreparable damage, even cause Simweray to bleed to death.

The risk of leaving the bullet in his body, then, is much lower than the risk of taking it out. He narrowly escaped with his life last night; the team does not intend to make him do so again.

The MSF medical team discuss treatment for Simweray.Photo: Sandra Smiley/MSF

So the bullet will stay where it is. As will Simweray’s memory of last night: of having his home invaded, his family threatened, his brother killed with the same weapon that would mark him for life. He will have to live with those physical and mental scars forever.

But he is not the only one: so many people – men, women, children – get caught up in the violence of this part of eastern Congo. They find themselves in the wrong place at the wrong time, and end up here, wounded in a hospital bed.

And I can’t help but wonder: will the metaphorical bullet ever be removed from Masisi’s metaphorical flesh? Will this conflict ever end, or will it remain beneath the surface forever?  Will the people of this area ever have the peace of mind and security they need to get on with their lives – for these wounds to fully heal?

Simweray lies in recovery at the MSF hospital in Masisi.Photo: Sandra Smiley/MSF