Fieldset
A volcano, an amorous wife, and the two Constances: First days as a doctor in DRC

Sarah has recently started her first MSF assignment in the Democratic Republic of the Congo. She blogs about culture shock, naming babies and having a giggle with the locals...

I've just been startled by an extraordinary noise coming from my Congolese colleague's pocket. I still have to get used to African mobile ringtones; there may be some that are subtle or self effacing but if there are I haven't heard any.
 
I spent a few days in Goma, the capital of North Kivu, before transferring up the hill to the hospital here at Mweso. Goma lies at the foot of the Nyiragongo volcano and on the shore of Lake Kivu. The lake has large quantities of carbon dioxide and methane in its depths which are currently held down by the pressure of water, but which could bubble up and threaten the city were there to be further seismic activity.
 
The volcano last erupted in 2002 and there is still a plume of smoke coming from the crater; all of this gives an added frisson to the city's atmosphere.  
 
 
Photo of the volcano in the distance
Photo: Sarah Wookey / MSF.
 
Bustling and full of entrepreneurs at every level from selling litre bottles of kerosene at street corners to the provision of international hotels, Goma's streets are full of motorcyclists - it appears that you can have any colour motorbike you like as long as it's red, with a matching helmet. Functioning chin straps seem to be optional, however.
 
In the UK we have advertisements for slimming products and tanning preparations. In Goma the main street is decorated with advertisements for bodybuilding preparations and skin lightening creams. 
 
The trip up the hill to Mweso is about 100 km and took about five hours. The road is mostly unpaved and deeply rutted, winding its way up and around stunningly beautiful hillsides and crossing several rather thrillingly deep fords in the valleys. It would have been fabulous and probably faster on a mountain bike.
 
 

"If you need shit you ask me. I give you shit. If I no have shit I order shit. Shit arrive. I give you shit. If you know you gonna need shit tell me 'Stefan, I need shit'. In plenty time. OK?"

 
Upon my arrival in Mweso I was inducted into the etiquette of living with a small group of MSF workers who come from all over the world, in a compound in which we spend 99% of our off-duty time, and in which nothing flushes, where if I stream a video then you can't read your emails and where if someone eats all the peanut butter we have to wait a month before the next shipment.
 
My colleagues all took time out from their jobs to explain to me how their bit of the project works. 
 
Stefan, from Romania, in charge of supplies, described his job beautifully: "If you need shit you ask me. I give you shit. If I no have shit I order shit. Shit arrive. I give you shit. If you know you gonna need shit tell me 'Stefan, I need shit'. In plenty time. OK?"
 
There is a concerted effort from our manager to prohibit working on a Sunday, so we are taking turns in cooking national dishes. My attempt at an apple crumble was a pathetic failure after I realised, too late, that I'd used maize flour instead of wheat.
 
The white MSF workers are the only muzungos (white people) in Mweso, and we quickly get used to being the centre of attention when walking around town. I went for a walk last week with Norah, my Kenyan MSF colleague. She looked on in amazement at the group of 20 or so youngsters who were surrounding me, wanting to shake my hand, give a thumbs up, practise their French and try on the off chance for a biscuit (no way).
 

On congratulating the mother on the safe arrival of her daughter she invited me to name her. All I could think was to tell her the names of my three daughters and invite her to choose. 

The hospital at Mweso has been supported by MSF for nine years. Although I have only just arrived and am still getting to grips with my very rusty French, I am starting to get to know a bit of how the hospital works. I'm amazed by the amount of work that gets done, and to such a high standard, with the available resources.
 
 

I watched a caesarean section a couple of weeks ago. On congratulating the mother on the safe arrival of her daughter she invited me to name her. All I could think was to tell her the names of my three daughters and invite her to choose. Baby Constance's picture has now been swapped with that of big Constance in New York.

Photo of woman and her sleeping baby

DRC woman and her sleeping baby. Photo: Sarah Wookey/MSF.

I accompanied the neo-natologist on her ward round last week. One of the babies was due to be discharged after having been successfully treated for an infection, which had necessitated a prolonged stay at the hospital for the mother. I asked her via an interpreter what she was most looking forward to doing when she got home. She clearly decided that I needed to be impressed, and, rather primly, replied that she was looking forward to cleaning the house. After an exchange of raised eyebrows between us she promptly collapsed in giggles and declared that actually she was looking forward to sleeping with her husband again.
 
The hospital is held in high regard by the local communities; although there is instability in the surrounding areas exceptional efforts are made to enable patients to get to the hospital, which is the only one operating in the area.
 
A small boy with an injury was recently carried to the hospital by a series of porters. The journey took three days and went through several areas where there were different armed groups. At every crossover point those carrying the boy handed him over to another team who could carry him safely to the next stage.