The music that welcomed us to the Congo

I wish I had a longer clip to post. This is a small sample of some of the praise and worship music played at the welcome ceremony in the Congo. The people sing with all of their hearts. The music blends one song with another to make a continuous song of praise to God. If someone can understand the dialect they may correct me, but when we were there I was told that they were singing: "There is only one God and Jesus is the Lord". The people gathered in a circle, and clapping and singing. There were some in the middle of the circle playing drums. Others played shaker boxes (tin with bb's) to the beat. There was one lead singer that sang with an amplifier speaker... all together made a spectacular sound. The fun part I don't have on video (others on the trip do), was after watching some saw me tapping my foot and pseudo white-guy dancing and pulled me to the middle of the circle to play one of the shakers. They also pulled Pastor Baker into the circle and thankfully he danced more like a mzungu than I did (again thats a video I don't posses)... They do say its always easy to spot a mzungu during singing. They are the ones not moving :)







The second video, you will also see Fred do what he did best on the trip: gather children to hand out candy...

I hope you enjoy the small samples, I plea to my fellow travellers to post some pictures, stories and maybe some video of the white men dancing. I hope to soon get copies of all of their pictures so I can share more of the trip experience with you. Don't forget to leave a comment every now and then.

Our Travels - How did we get there

As we left for the trip, my lovely wife posted our itinerary of travel on this blog. To reach our final destination it took almost 4 days to get there, and 3 days to get back. Now that it is all done it is hard to believe we really spent a week of the trip traveling.


We first set fourth at Chicago O'hare to fly to Washington DC. In DC we scrambled to reach the Ethiopian Airlines gate in which we got our first taste of how things flow in Africa. Unbeknownst to us the airline had a very restrictive carry on bag rule. Ironically many of us looked online to see if they had a posted policy on carry on's... but no one found it. They allowed two bags, and each had to be under 15lbs's. Well that is what the sign said. But depending on the gate agent you happened to meet, some people had a 20lbs limit, yet other agents didn't bother to check. There was a scale at the gate, but some would use it, others just picked up the bag and sort of guessed if it was too heavy or not. One of our team members had a rolling small suitcase that in all American carriers would have no problem, but the gate agent tried to charge her an extra $135 because it was 25lbs! Thankfully pastor was ready not to be swindled and talked him down to $50, and they checked her bag. The other snafu was they required all of our bag tag's to ensure that they made it on the plane... some people lost them and had to trek back to our gate where we arrived and have them reprinted... After our sub par American meal (at least we didn't have to insist on bottled water) we boarded our flight to Addis Abba via Rome to re-fuel... At Rome we sat on the jet way for about 4 hrs while they found a "part" before take off. As you can see Pastor and Bonnie came prepared for the long overnight flight.

One part that wasn't too much fun in Rome, while they looked for the mysterious part, the flight attendants weren't allowed to serve water or any snacks... so we got to sit and wait. Laura hypothesized that they were waiting for the pilots to get over a hang-over :) Here is a view of the Sahara Desert from the airplane.

We eventually arrived to Ethiopia with all 19 of our bags (Praise God for that), and made our way through customs and eventually to our hotel for the evening. Thankfully the hotel provided a meal, and a place to lay our heads for a few hours until we departed early the next morning. This is a view of Addis Abba from my 10th floor hotel room balcony. It rained the night before. Not quite like the Chicago skyline. The next photo is a an interesting tree outside the Addis airport.


The next day brought another fun adventure in travel. As we boarded our plane destined to Kigali, there was an announcement overhead telling us they were having difficulty on the left side of the plane with the cargo door. Interestingly on the right side of the plane a hydraulic lift truck could easily be seen wedged under the wing, with many men in suits, white coats, technician outfits, and security officials all milling around the truck. Some were even taking pictures of the wing... I took a picture of my own. (notice how the tall posts are up almost all of the way? There's no OSHA in Africa)

Thankfully they eventually announced that we needed to change planes. Now instead of a half full plane, we moved to a smaller plane that was full and with no assigned seats... it was a chaotic scene when everyone was trying push to the front of the line, yet again in Africa no common rule such as a line, if you want to be in front you push to the front... We eventually arrived safely to Kigali Rwanda a couple hours late but Thank the Lord all of our bags made it.

One of the more interesting parts of the trip occurred at the Kigali Airport. As we were getting our bags out to the parking lot where cars were waiting, there was another American in front of the airport who struck up some conversation with our team. He introduced himself as a senator, and as I looked closer you could recognize him as Bill Frist, the Senate Majority Leader 2002-2007! He is a cardiothoracic surgeon and was in Rwanda for a few medical missions as well as a relief group of retired senators. He was very nice and was excited to hear of our trip and was more than happy to have a couple pictures taken. Many thanks to his staff with him who took the pictures!



The last leg of the trip began the next day in which we drove the 6 hrs across the beautiful Rwanda country side, and through the Nyungwe rain forest to end up at the DRC border. Here you see the women carrying their loads on their heads, the typical busyness along the road, the rain forest, and last one of the huge tea fields seen along the drive.



Bukavu is the major city at the border. It is a sharp contrast when you cross the border. I find that words and even pictures have difficulty showing how poor this place is. The roads are mostly in shambles, dust coats everything, thick smoke lingers over all parts of the city. There is constant noise of people, cars, horns, people selling goods, and men / boys selling bottles of pop by tinking on the bottles as they walk around the city. Notice the thick smog of the sky, next notice the typical road of the "nice part of the city", the nice buildings of the city, and last a shout out to a friend of mine who works for food for the hungry (apparently doing some work in Bukavu).Crossing the border Katie snapped a quick picture of the bridge and the lake... a plain clothes officer saw this and confronted her. He tried to incite a crowd of outrage that she would even dare take a picture of the border. A nice welcome to the country. The provincial senator, a personal friend of our group, intervened and informed the man that she did not break the law and that he may be arrested for trying to incite a crowd. It was good to have powerful people going to bat for us. We otherwise were treated as celebrities everywhere else we went in the DRC. We stayed the night in the Hotel Residence. This was one of the best that Bukavu had to offer... at one time I am sure it was quite luxurious at one time, but has been run down along with the city. As it turned out our original reservation was to be at the Swedish Christian Mission compound, but they gave our reservations away without telling us (anyone recognize a theme here?). But speaking of pictures of questionable legality.... (the DRC military compound in
Bukavu)


Some slept well in the Bukavu hotel, some (i.e. me) did not sleep much at all. Early the next morning we finally set off in SUV's to Nyangezi. Again nearly no one in the car spoke as we traveled through Bukavu and the impoverished outskirts of run down wood shacks with tin roof's, people everywhere, and the bumpiest dirt road I have ever ridden on (puts the pink jeeps to shame). The roads were literally so bumpy you can only drive close to 5mph, and you get jostled out of your seat, head hitting the ceiling here and there.

The road is only 25km from Bukavu, but takes 1.5 to 2 hrs to get there. We were told there was going to be an official delegation of dignitaries to open the clinic and training center, and to welcome the mzungu to Nyangezi... (mzungu (miz-'un-goo) is swahili for white person). We saw that a photographer and videographer kept leap frogging our group... they would pull ahead and film us traveling on the road, then see him again pass us... then film again further along...

We arrived at Nyangezi and the locals were there gathered, singing praise songs to God. The music is wonderful... I will post a video of some sining soon. Alas we made it there with all of our bags, supplies, limbs, and minds. Needless to say we were ready to start our ministry to the people there.

I want to try to explain what it is like to be in developing countries.  The airports have the wealthier people and they are in the the most variety of dress.   They range from completely western to their own traditional costumes. For example, a man was wearing the red checked head scarf  like Arafat wore.  In Addis Ababa, Ethiopia, we only went directly to the hotel, Le Leopold, and their level of comfort was very nice.  They had individual bathroom hot water heaters which I had never seen.  Then we flew to Kigali, Rwanda, and that night we stayed in a place like a motel but run by a Presbyterian group.  Each bed had mosquito netting over it. Hot water was delivered in the morning by large yellow plastic jugs, with a few bugs in them.  Even without bugs, the water was only for bathing, not drinking.  Drink bottled water only.   Then we were driven over a very hilly road, for 5 hours, weaving to avoid the many people walking along the road, and also to avoid the potholes.   The first time I really felt like it was "third world" was at the border, leaving Rwanda.  We were out of the van, on bare dirt, next to a lot of people who looked poor, were staring at us and weren't even smiling. We were mzungos, white people. You will surely read about Our Own International Border Incident going into DR Congo, from the perpetrator or someone else, later.  Then we went to Bukavu, DR Congo and our rooms, at another church-run stop over, had been given away.  So we went to the Bukavu Hotel which had seen better days.  You could see they started well with nice tile and a glass walled elevator, for example, but apparently were not able to keep up repairs.  The staff was speaking French.  I didn't like it that a little old man was carrying our 50 pound bags around but that's how he makes a living.  In the morning we were driven over a very bumpy dirt road for 1 1/2 hours and finally arrived at Nyangezi.  We were driven into what you might call a compound though I think the barrier between it and the town was a one pole fence.  But the people, including the kids, had apparently been told to stay out of the Poll Clinique compound.  And the people who were there officially, such as the family members caring for the hospital patients, stayed in their own area, mostly by the outdoor kitchen provided for them.  So, whenever we proceeded from our rooms,  we knew we were stared at.  Now for the poverty part.  Even the hospital staff asked us for things, anything.  "We are so poor and life is very hard."  We soon learned that the gesture of moving the hand from the mouth and then the abdomen meant, "Give me something, anything."  The patients did that often.  When we ventured from what I am calling the compound,  there were little boys who surrounded us and gestured for:  anything.  Fred had been in countries like this before and he had brought about 500 pounds (it seemed like), of candy, so he made a lot of kids happy. We'll write more later.  Rachel L    

The Poll Clinic - Nyangezi DR-Congo

For those who are curious of what this clinic is like in Nyangezi (ne'on-gez-zee) allow me to explain how it came to be and what my role was there on the trip. I first must explain how it came to be. Our connection to this place is a man named Florimond Kabanda. In the '90's he had strong presence in the government as a human rights advocate. As the war loomed in Rwanda and spread over to the Congo some weren't too happy with his influence and there was a plan to assassinate him. Enough people got word to him a long story short he was whisked out of the country by the US and was relocated to Grandville MI. Already a Christian he went to work and earned his doctorate in psychology at GVSU, and also got a masters in divinity from Cornerstone University. He eventually started the Congo International Ministries (CIM), an NGO, that established itself in Nyangezi.

CIM set up a community type center in Nyangezi, and worked with the local government to provide some vital services to the area. The big project was to build a training center for to be used to help strengthen the Christian church in the region, the medical clinic, and Florimond has many future plans for the area such as establishing a university in the area and there was talk of opening a medical school in the area... In Africa I learned they like to make many big plans, and see what can come to fruition..

The Poll clinic is named after a generous family in West Michigan. They worked with Florimond early to get it started and worked to arrange to get modern equipment there. They do have an autoclave, a transabdominal ultrasound, basic surgical equipment, an OR table and the typical attachments, a basic lab with microscope and various equipment, a pharmacy with many types of antibiotics, OTC drugs, creams, and some IV/IM meds with various uses, and power is provided via generator and water by faucet (i think by well?).

The outside view of the Poll Clinique.














The building has an OR, a prep room for the OR, a treatment / exam / labor and delivery room, an interview room, patient waiting, a pharmacy and dispensary area, and then there were three patient rooms with multiple beds.

The view of the OR.... yes small but it works. For those curious, they use Ketamine for anesthesia and titrate to sleep but breathing. Archaic yes, but don't have anything else! Anyone want to donate an anesthesia machine?











The autoclave... small but gets the job done...


So my day was a relatively simple one. I was the first western physician to come and work there. Basically I helped with the normal activities of the clinic. When I arrived they already had some surgeries scheduled... various things such as hernia repairs, appendectomies, oophorectomies.... My first surgery was a c-section the second day we were there... It serves as a good example of my role there. They did all their c-sections with a vertical incision (old) and it was a challenge for me to do a pfannenstiel incision (bikini cut). The medicine practiced in much of Africa is 50 years out of date... They prepped the belly with rubbing alcohol, didn't place a foley... The doctors assumed that I did general surg cases in the US too (like they do in Africa) and it wasn't towards the end of the trip that they realized I specialize in OBGyn cases... oh well.

They have 3 doctors on staff there. Two are relatively new med school grads, and one (part time) is a surgeon for the last 25 yrs. I found that my role was to teach a lot of basic clinical medicine, and challenge many of the old or out of date methods of medicine practiced there. The big frustration I had was that many of the surgeries that were done were really not necessary... but I found the mind set there was if you don't actively do something you are doing nothing... where in the US surgery is often a last resort. So in a place where resources are scarce, it did not make sense to waste them on unesessary things that could potentially hurt, kill, or just not work. One example was a scheduled appendectomy on a old man. When they were getting him ready for surgery I found that he didn't look painful, had a soft belly, no pain on palpation, no rebound tenderness, no other symptoms other than having some abd pain a day or two prior (i.e. not an appy...). When I challenge the surgeon (the older) he chuckled and still went on and removed the mans normal appendix....

Other than surgery the clinic operates like a walk in clinic. Patients bring a small booklet with scribbles of medical information. They come with rashes, infertility, pain, seizures... whatever the ailment. They come in, we talk and do the exam, then decide if they need reassurance, meds, or in some cases discuss surgery. Some patients they would schedule for ultrasound to evaluate pain. One of my other frustrations was they thought that the transabdominal ultrasound was a great diagnostic tool... so they used it to look at the gall bladder (ok), the uterus and ovaries (not very good use, but acceptable), but also for gastric ulcers (not a use), or for other abdominal pains (again not a great use). We brought a number of meds a supplies with us on the trip. We had some limited abilities to admit (if there were spaces open). They did very little prenatal care, but if someone came in in labor they would manage that and do the delivery. At night time the doctors were all gone, so the nurse there for the night watch then would do the delivery.

I did a couple deliveries while there. I had to challenge the doctors again as they routinely cut episiotomies on most deliveries, and employ the use of fundal pressure to speed the delivery. This is dangerous and potentially can cause nerve injury for the baby... This is how they were taught to do things... They did stop, and hopefully will continue to not do that any more... The mother of that baby named her little boy Brad :)

A picture of the medical record....











They see a great variety of problems in the population. Somethings we had to just realize that we didn't have the abilities to take care of things. Things such as a 6 year old with status epilepticus and likely brain damage (lost speech weeks before)... all we had was phenobarbital, and she already had failed that treatment... So the only solution was to plead to a higher power and see if there was another way to get her a CT and a way to talk with a neurologist. If any readers out there know anyone who can help, I have her information.

It was a blessing to be able to minister with my training. The two younger doctors are Christians, and all the people in that region and country could use your prayers. I will post other topics as time allows this week. Other team members had drastically different roles in our ministry to the people of Nyangezi.

First Post - We're home!

Hello all. We officially have made it back to US soil safely, however, our bags have been mixed up between DC and Chicago. I will be working on a series of posts this week with pictures and stories. I think I will open the blog to the other team members to post as well so this blog can paint a whole picture of our trip.

Speaking for the team I think that each member had a different experience and all contributed in their own way. All in all, we all came with a commitment to serve Christ, and we all served in our own unique way. Overall I had a lot of frustrations with many things. Frustrations with old school medicine, lack of resources, and with cultural norms...

Below is a picture of our team on one of our last days in the DR Congo. We all were blessed to have the opportunity to serve. We also continue to pray for a different team from Jenison Bible Church that is now landing and getting settled in Russia, to help the believers there with construction and refurbishing their churches. Pastor and Bonnie Baker left us in Addis Abba to head to Russia to meet with the team. We all thank you for your prayers and support on this trip, and hope our posts can inform you about the work and the mountain of problems in Africa.

below: Before leaving Bukavu, posing with Senator / Pastor David, who was invaluable member of the ministry. His influence inspires and in some ways protected us in different situations (Katie :) ).

above right: Me with two of the three doctors of the clinic, and Georgette. Dr. Bora (left), Georgette, and Dr. Roy. I worked closely with Dr's Bora and Roy in all aspects of their clinic work . Georgette is a pastor's wife, who was available to help translate into swahili for our nurses.

As they say in Congo: Mongarrebe Jema - have a good night

LANDED!

They are back on US soil!!! I just heard from Brad! They landed in DC! HURRAH! HURRAH! HURRAH!

A Letter

Thank you to all of you who've commented, sent emails, called, made me feel like I'm not walking this alone. Part of me wants to delete my previous post so it's not just out there for everyone to see how truly mixed up I can be sometimes... but I have found that in the cyber-world, it is easy to make yourself appear like you've got it all together- and sometimes it is good for everyone to see how human you really are. I didn't win any gold medals for faith performance today. But God is still gracious... and long after I had assumed that the African crew would be in bed (after 12:30am their time!), Brad sent a long, newsy email! I will copy it for you here- maybe you will be as encouraged as I was to hear from him in his own words.

From Brad: titled "After all, it's Africa"

So I've learned manythings in the past few days! I wanted to write to let you all know we are back in kigali safely. Its been a long travel day. First I should say that the mission trip was very successful and all involved have really felt they were able to make a difference. We all have found that africa is layer upon layer of problems on problems. There is jsut so much that is to be done, and then even more problems will arise. I had a great deal of frustration with one of the doctors at the clinic, but despite that, I was able to plant some seeds to help them practice better medicine. I'll post more later. Today we traveld from bukavu to kigali rwanda. AS you will all hear there are no such things as plans or an itinerary in AFrica. We had a long bus / van ride to kigali and got to our hotel to find they gave most of our hotel rooms away to others. I guess unless you come and pay in cash early, reservations are more like well.. eraseable? So we had to wait with our grumpy taxi drivers for about 2.5 hrs to make sure we had a place to lay our heads. So we found a nicer western style hotel that ate a bunch of our fun money, so no safari tomorrow... but instead we aer going to go to the genocide museum, and more tourist shopping for coffee, etc. (rwandan coffee is really good i have come to find. ) Then we get to start the long journey home tomorrow, I'm ready to go.

Medically I never felt pushed to do anything i wasn't qualified for. I did do a couple anterior colporrhaphy's for women with pretty severe bladder prolapse. And I didn't see a single fistula... but i know they are out there. My biggest task was to really challenge the way the african doctors are taught how to practice, and practice clinical medicine. They don't have the complete care and well RESOURCES to be up to date on many things, and many decisions become knee jerk. It was difficult to deal with old ways of things that in the US have been out of date or old ways of doing things for quite some time. By the end of my time I had the two full time doctors of the clinic excited for all the ways they were learning to treat patients. They also learned many new surgical techniques in my time there. The others in my team were really effective in reaaching out to the community and other areas around Nyangezi. the funny thing is that white people visit so seldom, we were treated as very important dignitaries anywhere we went. I had some meetings with the minister of health, and the lead health inspector for the region to give them my opinion of how they can improve things there. Pastor had a huge turnout for is theology teaching, some of the pastors at his conference walked over 600km (2 weeks) to attend. The people in nyangezi felt very blessed to have the mzungu there. The DR congo was excited to. They had an official government ceremony to welcome us to the area, and to declare fulll opening to the shiloh center. It was on the national news, newspapers, and the television news for a number of days. Florimond our host was going to try to gather newspaper clippings and TV recordings for us all.

I will call when we are stable on US soil sometime on friday! Thanks for praying for me and the team... keep it up for a few more days now! WE also have a team now heading to Russia from our church to do more ministry work, so if you remembers them in your prayers I wold appriciate it! But it is late here... 1235am on the 31st... so its time for bed. I look forward to seeing you all soon!

Love brad