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AusHeal Blog

September 2017 Nursing Team – D.R.Congo

 

Touchdown at Goma International Airport on Saturday 19 August began our introduction back into the hassles of entering DRCongo with Immigration border difficulties / dusty roads / people-people-people everywhere, women selling anything and everything on the sides of the roads…… from flour in open piles to fresh meat laid out on tables in the open /  bicycles being pushed along carrying heavy loads / chuck-a-doos (the local wooden push-bike) pushed along the roads with even heavier loads / women carrying/balancing bowls of goods on their heads / horns beeping / cars dodging motos and other cars / and general mayhem everywhere.

Then to the quiet and peaceful Maji Matulivu by the lake, where we were warmly welcomed ‘home’ again…. to unpack and settle in for the next few months. 

Nursing Team Arrives –

 6 AusHEAL Nurses from Brisbane arrived at Goma Airport to be met by similar hassles.  Sunday was their day to recover from the long trip before starting work early on Monday morning 28 August with attendance at the Nurses 7.30am meeting.

 

An orientation tour of HEAL Africa followed. Interpreters were allocated to each of the nurses, then all went to meet local staff in their various departments. First impressions from the AusHEAL Nurses included:

  • The Hospital is big & progressive but lots still to do.  Wards lacking resources (including privacy)
  • A lot happening in the Hospital
  • Small ICU for the number of hospital patients and staff – no space / no room to ventilate patients
  • Super impressed – cleaner than previous visits
  • A lot more equipment now in some areas
  • Big hospital but space can be a premium for patients

Thursday, the AusHEAL Nursing Team was invited to meet with the Provincial Minister of Health (North Kivu Province). He warmly welcomed our team to Goma and expressed his appreciation for the efforts made to come to teach and train HEAL Africa staff. 

COSECSA surgeon training continues –

4 HEAL Africa COSECSA Trainers (together with the HAH CEO) travelled to Kigali for a ‘Train the Trainers Course’ conducted by the College of Surgeons of East, Central and Southern Africa (COSECSA).  All believed the course was worthwhile. Each of the Trainers gained official registration from the College.

New Buildings –   

At the end of Chapel on Friday morning, the HEAL Africa CEO, Dr Justin, announced to the staff the plans to build a new Women’s and Children’s Pavilion on the Hospital site as well as a new building dedicated for the care of fistula patients. This will build the capacity of the hospital to treat the ever-increasing numbers of women and children who need to be hospitalised.

Equipment –

The CT Scanner is still not in working order, however our visiting AusHEAL Radiologist will next week be bring further replacement parts. Radiology staff are trusting it will very soon be functioning well.

The Oxygen Plant donated and transported through AusHEAL has arrived at HEAL Africa Hospital. It awaits a visit from an Engineer from Australia to install and connect it.

 

Amidst the difficulties, challenges and sad medical conditions we encounter here, we continue to thank God for the opportunity and privilege to be involved in this

April 2017 Update

NEW BRISBANE TEAM ARRIVES in GOMA 

On 2 April it was good to welcome Paul & Lyndee Bakes, Brian & Vanessa and Ben to HEAL Africa Hospital after considerable issues with obtaining their visas. (not due to the helpful Congolese authorities but due to difficulties with a major courier company) The visas arrived about 45 minutes before team members left their homes for the Brisbane airport departure.

Bakes Team welcomed to HEAL Africa Hospital

The team has been involved in planning the site for the AusHEAL Oxygen Plant, soon to be shipped from Perth Australia to D.R.Congo. They are assessing other building projects and becoming involved in a number of community projects. Paul and Lyndee will stay on in Congo for at least a further 10 weeks as Paul assists with the IT network at the hospital and Lyndee teaches English.

ECG Dots

The team was able to bring over a supply of  ‘ECG dots’ to use with ECG recordings and anaesthetic procedures. These were supplied though the Mater Health Service technical team and will allow for ECG tracings to be performed on equipment sent over last year by AusHEAL.  Dr Muller, HEAL Africa Hospital Emergency Department Director, was delighted to receive them. Such simple things make a big difference for patient care and staff morale.

Dr Muller excited to receive ECG dots

Dr Neil Wetzig and Surgery

Dr Neil has continued with clinical work, in particular as one of the HAH staff general surgeons (Dr Luc) has gone on a ‘cleft lip and palate surgical outreach’ to a western province in DRCongo. Activity is ongoing at the hospital.  In the last 3 weeks there have been sad cases with times of overcoming adversity.

  1. A major triumph saving a young woman referred from another health centre in Goma DRCongo, who was comatosed with life-endangering low haemoglobin (blood count) following a Caesarean section earlier that morning elsewhere. The woman’s womb had not been closed well after the caesarian section with resultant ongoing haemorrhage. Additionally, her baby had died!
  2. A 7-month old baby died from a treatable surgical condition. Specialist staff were not notified of the baby’s admission overnight. The relevant staff only became aware of this very sick baby when told by a medical student at the morning handover meeting. Urgent surgery was arranged but the baby died before an operation could be performed. None of the COSECSA surgical trainees were involved with this case. The unfortunate incident has been a significant teaching opportunity on communication essentials and protocols.
  3. In early March, a combined USA and Australian surgical team operated on a 3-year old boy removing a large facial tumour. He had previously had an eye removed for tumour. His facial reconstruction has gone well and he may go to Uganda for further treatment. The boy has however become attached to the ‘Talking Paul’ app on Dr Neil’s mobile phone. It was initially used to pacify his fears when he was about to have anaesthesia. Now on each ward round he asks Neil if he can play with it. He is such a happy character and so respectful as he hands the phone back when it is time to move on. His overall outlook is not good, but at least this brightens his day.

    Enjoying the mobile phone

    Doctor’s morning hand-over meeting

Neil has been involved with a number of other cases:

  • The care of a number of family members of HEAL Africa Hospital staff
  • A 25-year old woman with an unusual congenital abnormality on her left kidney. There was considerable pressure from some staff to ‘simply remove the kidney’. However, Neil was able to use this case as a teaching opportunity to sort through what the longer term consequences could be for such a young woman in a Congolese environment with only one kidney. Should the abnormal one be removed without at least an attempt to preserve it? She is still recovering from her kidney-preserving surgery and so far doing well.
  • A 19-year old woman was referred by MSF (Médecins Sans Frontières, Doctors Without Borders) from an outlying village with an ‘open abdomen’ after a Caesarean Section conducted in the local village by local staff and a second operation for severe infection. Exploratory surgery at HEAL Africa Hospital found that the infection had been due to the patients womb being sutured to her bladder. Neil reports seeing similar cases such as this from outlying areas. The patient underwent a further operation.  She is now doing well, as is her baby who she is feeding.

Neil continues to be involved in meetings with HEAL Africa staff e.g. focussing on exploring further ways of Australian support for development of  additional community development programs. elections are scheduled later in 2017. Hope remains for opportunity in DRCongo for growth and development.

AusHEAL: Australians advancing healthcare in the developing world

 

 

Aussies to Goma in 2017

AusHEAL representatives David and Heather Kelly arrived in Goma D.R.Congo from Brisbane on the 15th February such that David could resume oversight of some of the HEAL Africa Hospital administration, mentoring the Chief of Operations, as well as his continuing involvement on the HEAL Africa Assemblie Generale, the Board for HEAL Africa Hospital (HAH) and external Community Projects. Heather is resuming her English lessons with various members of the staff.

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David & Heather Kelly

On 25th February Dr Neil Wetzig, Director of the AusHEAL Congo Project, also returned to Goma from Brisbane to resume the ‘on the ground’ partnership between AusHEAL and HEAL Africa Hospital.

Stability:

Having come through a period of uncertain security in 2016, Goma is currently peaceful albeit still coping with political uncertainty.

International Co-operation

An American surgical team from Wisconsin (pictured below) arrived for a two-week visit on 27th February. Neil has therefore continued with clinical activity (though less operating time) to allow the visiting team to teach and train the local surgeons and COSECSA Trainees. (College of Surgeons of East, Central & Southern Africa)

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Neil (2nd from left) with US Surgical Team: Greg, Marc, Ed & Chris

It has been encouraging to see the USA team embracing the basic surgical training program at HAH. Their interaction with the COSECSA Trainees has been of great benefit. This was demonstrated on Thursday 9th March, in an additional training session, when all the visiting surgeons formed a panel to answer Trainees’ questions.  Subjects included not only clinical problems, but also the craft of surgery, the responsibility of surgical care in DRCongo, and the significance of the current group of Trainees being the vanguard of improving surgical care in their resource-poor country.

COSECSA trainees, staff and visitors

COSECSA trainees, staff and visitors

Staff Presentations to Heal Africa Board

The annual HEAL Africa Assemblie Generale Meeting was held from 1st to 3rd March, a good productive time. Australia has two representatives on the board: David Kelly from AusHEAL and Lindsay Thitchener from Sonic Healthcare.A new board member, Dr Bill Clemmer (a long term USAid Program Manager with extensive experience in DRCongo and South Sudan) was welcomed.

HEAL Africa Assemblie Generale

HEAL Africa Assemblie Generale

On the first day, HAH staff presented the previous year’s activities in both the hospital and the community development programs to the Board in a public open session. While this was a long day, Neil and Heather were able to attend . It was a wonderful opportunity to observe the breadth of HEAL Africa’s activities in both the medical field and in community development.

Medical Care at HAH

A few facts gleaned from the presentations the medical care are as follows:

  • The hospital is expanding its capacity from 197 beds to 203.
  • The current hospital staff includes 14 specialists, 13 ‘other’ doctors, many on training programs, 82 nurses, 14 paramedical staff, together with 15 in administration. 42% of the hospital staff are female.
  • Consultations at the hospital rose from 22,576 in 2015 to  27,443 in 2016. There were an additional 17,244 consultations for preventative measures such as HIV follow-up & nutritional care.
  • 5,102 operations were performed by HEAL Africa staff in Goma in 2016.
  • 1,828 pregnancies were delivered. Questions had been raised about the 39% Caesarean section rate. It was explained that HAH deals with many of the difficult cases on referral from other hospitals.
  • There were no cases of maternal mortality for patients treated within HAH.
  • Sadly, presentations of victims of sexual violence rose from 347 in 2015 to 393 in 2016 -having fallen dramatically from 768 in 2010 to 271 in 2013.
  • Outreach surgeries by Heal Africa staff visiting rural centres increased from 719 in 2015 to 825 in 2016 – 28% were orthopaedic procedures, 53% gynaecology (mostly fistula and prolapse repairs) and 18% for general surgery. The latter mostly being for cleft lip and/or palate repair.
  • Activities of the Laboratory and Radiology departments, income generating for the hospital, continue to increase.

Daily Life at Heal Africa Hospital

David has spent the past week ‘tying up loose ends’ from the Assemblie Generale, while Heather has continued English lessons. Neil has been working alongside the USA surgeons, helping to deal with decisions regarding difficult cases.

Examples have been:

  • The sad case of a 3 year-old child with necrosis (death) of much of the tissue on the right side of her face, the result of a severe infection. She was eventually offered palliative care after extensive consultation with colleagues both in the USA and Australia.
  • Another notable case was the resection of an enormous left facial tumour. Surgery involved 4 surgeons and was a great USA/Congolese/Australian team effort.

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December 2016 Update and Farewell

SECURITY in D R Congo:    

Saturday 19 November passed peacefully – perhaps because the President appointed a ‘Prime Minister’ 3 days earlier.  It seems though, the date everyone is anticipating is 19 December.   Most ex-pat NGOs and non-essential UN staff are being told to leave DRC by 15 December.  There is not only the youth movement who post anti-government twitter-feeds regularly – but now also a movement called “Bye-bye Kabila”, who are calling for a peaceful protest march on Friday 25 November.  We have not been aware of any related anti-government incidents in Goma though there have been a couple of incidents of lawlessness.

 

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Mt Nyiragongo volcano, overlooking Goma, continues to please photographers with its array of cloud formations – and keeps on smoking from its crater!!              

HEAL AFRICA  HOSPITAL (HAH):  

Some of you will have read this on Neil’s Facebook post, but for those of you who do not follow Facebook……the following is Neil’s account of one Diverse Day…….

“…. I sat in the morning chapel service and watched a little guy at the front who lives in poverty, dancing for joy with the choir.  Then I received a text message “Abdominal ballistic trauma in Operating Room now”.  Four hours later after successfully repairing the liver, spleen, stomach, small bowel, colon and left kidney in a young male, I determined that Anton Kalashnikov who invented the AK47 rifle, has a lot to answer for!  I returned to our office to find a flat-bed funeral truck bearing a coffin and 30 or so relatives of another patient leaving the hospital.  The next task was to help the newly returned Emergency Department physician, Dr Muller, put into action plans to improve his poorly resourced department. Then further planning and communications re AusHEAL work in 2017 and, finally,  home for a well-earned shower and clean-up.  Such a diverse day!”       

The patient with the gun-shot wound did well following surgery. We were hopeful of a full recovery….. unfortunately, when we arrived in Mombasa later in the month we received news that he had died after we left.

 

HATSHEAL Africa Training Scheme:

The inaugural meeting of the HATS Management Team was held on Monday 21 November, presided over by the Dean of HATS, Dr Luc Malemo.  Ten departmental heads of various training programs at HAH were informed of the renewed emphasis being given to ‘training’ within the organization.  Teaching and Training in all HAH services and departments will lift the standards of the organization and contribute towards improved healthcare at the hospital and the community services it provides.

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Inaugural HATS Management Team meeting

SHORT-TERM DEVELOPMENT GRANTS:

  1. HAH Dentist, Siva, who has been mentored and trained by AusHEAL team dentist,  Dr John Yared, spent 18 days at the large dental unit at Kijabe Hospital in Kenya. He was sponsored by an AusHEAL Short-Term Development Grant. Siva was able to observe how work was organized and performed in Kijabi, as well as learning about root canal treatment and the use of dental braces.
  2. Following discussions with the Chiefs of Nursing about selection of suitable nurses to receive an AusHEAL Short Term Development Grant (STDG), Orthopaedic Officer, Katembo, who works in the operating theatre, was awarded a grant to visit a Nairobi hospital to observe and learn the necessary skills for new procedures now being undertaken at HAH (knee and hip replacements).

 

SURGICAL TRAINING  –  COSECSA (College of Surgeons of East, Central and Southern Africa)

Tests & interviews were conducted for the 5 College Trainees at HAH to assess their progress with the COSECSA Membership Training Course.  Lack of proficiency in English is a major hurdle contributing to difficulties in comprehending the clinical texts they are studying. They are showing good improvement in this area.  All agreed the training program was quite heavy, but realised the opportunity they have been given.  The trainees reported learning many new things with resultant improvement in the care and management of their patients.  All 5 are keen to continue.

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3 COSECSA trainees waiting for their interviews

This week, the 5 COSECSA Trainees and 4 of the HAH Trainers  are in Mombasa, Kenya (together with Dr Jo Lusi, founder of HEAL Africa) attending the COSECSA Annual Scientific Conference.  Not only is it beneficial for the HAH doctors to be exposed to a wider experience of surgery in Africa and attend the scientific presentations, but equally important for the COSECSA College to witness the enthusiasm and commitment of the first Membership Training Program established in D R Congo.

 Dr Kinyoma (Trainee); Dr Luc (Director of COSECSA, HAH), Dr Kahuko (Trainee), Neil (awarded a COSECSA Fellowship ‘by election’) and Trainees Drs Severin, Francisca and Jacques.

Dr Kinyoma (Trainee); Dr Luc (Director of COSECSA, HAH), Dr Kahuko (Trainee), Dr Neil (awarded a COSECSA Fellowship ‘by election’) and Trainees Drs Severin, Francisca and Jacques.

 

Dr Muller

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Dr Neil and Dr Muller with defibrillators for the Emergency Department – thanks to the MATER HOSPITAL in BRISBANE Australia who sent over a container of equipment.

Congratulations to Dr Muller on his Graduation in Emergency Medicine in  Dar es Salaam in early December.

 

GLOBAL SURGERY:

Neil attended the G4 meeting in Washington DC on 10-11 November. The G4 Alliance for Global Surgery, Obstetrics, Trauma and Anaesthesia care is seeking a way ahead to provide access to safe, affordable surgical and anaesthesia care for 5 billion people worldwide who do not have such access. He was representing HEAL Africa Hospital. Of the 83 organisations represented at the conference, only 12 were from Low and Middle Income Countries – therefore the importance of being there as a voice for the truly neglected surgical patient, as well as for HAH and its work.

Neil had opportunity not only to highlight HEAL Africa Hospital but also stress to those present the need to include more representation from LMICs.  It was an interesting time to be in Washington so soon after the Presidential election and to be briefed about the potential impact that will have on US relationships with the rest of the world.

 

A SMILE COSTS NOTHING ……

On a previous trip, we (Neil & Gwen Wetzig) kept acknowledging a female security guard at the hospital gate – but, there was not much response.  We kept smiling every day and said “Bonjour”.  Slowly there was a little response.  On this trip there has been a great response – hellos and smiles and even calling each other by name. To top it all off – her son was a patient at the hospital. – Now there is a very happy security guard who smiles and greets us enthusiastically!

For a few weeks we greeted a young disabled girl with hydrocephalus (maybe aged 10-11 years) who just sat on some steps as we walked past every day.  We would greet her but there was no response.  We kept saying “Jambo” and waving and smiling. Gradually, after many days she began responding.   Then she began waiting for us. Then she initiated the waves and smiles and called  “Jambo” out to us.  Then one day, she was gone! We just hope that for those few weeks we were able to bring some small amount of joy to her days.

One day we found a young boy in a wheelchair sitting in the doorway of a room at the bottom of the steps we use to go up to the AusHEAL office.  His leg was pinned and in plaster.  He was perhaps about 8 or 9 years old.  The first day we said hello and smiled, but there was no response – then again the next day but still no response – then a few days later a little acknowledgment – then half a smile – then a “jambo” response!

By the time we left there were big smiles and ‘jambos’ and ‘bonjours’ every day and a very warm and hearty response from him every time we passed. One day he was crying and Gwen stopped beside his wheelchair.  What could she do????? Nothing much – so she prayed… and touched him on the shoulder and continued on.  When she returned about 15 mins later, he was happy again and smiled brightly!  Gwen also had the opportunity when seeing him wheeling himself out of the outpatients building, to offer to push his wheelchair back to his room.  He agreed – what a precious moment in time.

One day there was a young girl walking through the hospital wearing a T-shirt that said    “Use your Smile to Change the World.”  No one of us can change the whole world – but we CAN change someone’s world…. sometimes!!!

 

November 2016 in Congo

Greetings from eastern Democratic Republic of Congo – a nation that does not stop for a horse race…  does not have to vote in the USA elections nor choose whether to stay within or exit from the European Union….. but a nation that wants to be democratic, could be a republic, wants to have new president elections ….. but still is… Congo!!

 

SECURITY in D R Congo:

Things have currently remained relatively calm around the country as far as we know.  As the country approaches November 19th the tension is likely to rise.  Probably the most significant date is going to be December 19, when constitutionally the leader is supposed to step down.

Goma has been quite calm.  There have been the usual incidents of gunshot wounds and accidental injuries but to date none related to the security situation.  Today we noticed a group of young people gathered at one of the universities here, so perhaps they are gearing up for the next round of protest marches.

 

MAJI:

One night as we were seated at the dinner table at Maji (our accommodation), in walked a new guest . As he began to speak it was obvious he was an Aussie! He was with the TEAR Australia Fund, staying at Maji on and off for a couple of weeks.  The Tear Fund office is located immediately next door to the Maji property.  It is rare for another Aussie who is not connected to our regular AusHEAL, Sonic or WorldShare teams to visit Goma.

 

TRAINING at HEAL Africa Hospital (HAH):

Dr Luc Malemo (Director of Surgery, HAH) has been appointed the new Dean of HATS Heal Africa Training Scheme, with Dr Neil Wetzig as the Deputy Dean.   HEAL Africa’s vision was originally to train Congolese doctors in-country.   However this changed for a number of years to allow specialist training in other African countries.  HEAL Africa has now established a solid basis for the future direction of the hospital and its leadership as these specialists have returned to work here. Therefore, a group of potential trainers has been established locally.  Many of the returned qualified  specialists will train others in their areas of specialty, all under the HEAL Africa Training Scheme H.A.T.S.

Dr Luc, Dean of HATS with Dr Jo Lusi, Founder of HAH

Dr Luc, Dean of HATS with Dr Jo Lusi, Founder of HAH

SURGICAL TRAINING

COSECSA (College of Surgeons of East, Central and Southern Africa): Following the very helpful COSECSA course recently in Kigali on Basic Surgical Skills, the 5 surgical Trainees from HAH attended a weekend course (again in Kigali, Rwanda) on Surgical Physiology.  Each Trainee was partnered with a Trainee from Rwanda and together they presented on a topic.  During the following week back at HAH, Neil had one of the Trainees with him on 2 occasions while seeing a patient.  HE questioned the trainee about a particular situation, and on both occasions each Trainee thought through the question and answered correctly.  Both Trainees were delighted to be able to say, “I learned that at the weekend Physiology course in Kigali.”.

 

SHORT-TERM DEVELOPMENT GRANTS:

While discussing with the Chiefs of Nursing at HAH about selecting suitable nurses to receive an AusHEAL Short-Term Development Grant to visit a hospital in another African setting, the Chiefs shared the following:

  • “Visiting AusHEAL Teams from Australia (Doctors + Nurses) give us innovations and we use them to improve.”
  • “Your Teams know us better – they know our strengths – and know where we need to improve.”
  • “AusHEAL Teams ‘adapt’ training to our level.”

It is encouraging to see both the improved level of nursing care at the hospital and the way in which the nurses benefit from the visits of the AusHEAL Nursing Teams.

 

WELCOME BACK Dr MULLER !!!

After 3 years of AusHEAL-sponsored specialist training in ‘Emergency’ in Tanzania, Dr Muller has now qualified and returned to HAH eager to make its Emergency Department efficient and well-organised; together with training its staff to be capable, competent and caring.  Dr Muller is the first fully-trained Emergency Specialist in the whole of D R Congo.

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Dr Muller being welcomed by Dr Neil

GLOBAL SURGERY:

This week Dr Neil Wetzig is visiting Washington DC to attend the G4 Alliance Board Meeting.  The G4 Alliance is a global alliance to look at strategies to improve Surgery, Obstetrics, Trauma and Anaesthesia care in the developing world.  Neil represents HEAL Africa Hospital on this Board. He is passionate about representing and advocating for the real needs ‘on the ground’ in these 4 areas of unmet medical needs in countries like D R Congo.

 

MEDICAL:

One of the reasons that Neil is passionate about Global surgery is because of what we see ‘on the ground’ at HAH as poor surgical outcomes.  In the last fortnight two major surgeries each lasting 6-7 hours have been conducted to ‘re-arrange’ the abdomen and bowel of 2 women who had surgery, complicated by more surgery in a peripheral centre.  Referral to HAH was arranged due to continuing bowel motion leaking from their abdominal wounds. Both women are now doing fairly well.

Another case with similar complications, though in a male, is planned for the week after Neil returns from Washington.  Such complex cases continue to be good opportunities to work alongside the HAH surgeons, and to work as a team.

In a further surgical case Neil operated with one of the HAH surgeons on a 30-year old woman from a remote island in Lake Kivu.  12 years previously she had had a caesarian section for the delivery of her first child.  The baby tragically died. During the operation the mother’s ureter (tube from the kidney to the bladder) was sewn into her vagina.  She has leaked urine ever since. Her husband left her, and she then had no chance of ever falling pregnant.  It is satisfying that some dignity has been restored to her life (albeit 12 years too late) when her ureter was able to be re-implanted into her bladder – and now she is ‘dry’.

 

REMINDER of HOME ….

We have always believed there is a special ‘synergy’ between Africa and Australia,   not just in the way people get along, but also in the vegetation (many gum trees) and flora (hibiscus, bouganvillea and beautiful bottlebrush trees).  We have one of these outside our room at Maji. Also, we can walk out of our AusHEAL office at the Hospital and look down on another bottlebrush tree and feel not so far away after all.

bottlebrush

bottlebrush

October 2016 Update from Neil & Gwen Wetzig

SECURITY in D.R.Congo:

It continues to remain safe in Goma currently, though the 19th of each month could be disruptive. An activist group has been cleaning streets dressed in white to show they want a ‘new’ country. The police have stopped some. Civil disruption has been reported elsewhere with reports of young people being shot in Butembo after protests. (300kms north of Goma). In Kinshasa, the capital, protesters have been reported shot by police.  As Dr Jo Lusi (founder of HEAL Africa) said recently, “Every day we remain ‘extremely curious’. “. 

Road Re-Surfacing:

Those reading this who have been to Goma will be surprised (and thrilled) to know that the main road from Maji, where we stay, along past Le Chalet and up to the main junction, is being resurfaced with bitumen. This past week work has been done on the section along and outside Maji. Detours around the road works are so narrow and bumpy, making the current drive frustrating. Equally, the entrance to the hospital itself has been moved and remodelled in an effort to make the hospital flood proof after the inundation and damage earlier this year.

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Sights on Goma roads: the things that are carried on motos

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Sights on Goma roads: loads pushed on a chugadoo

Education & Training:

[i] SURGICAL TRAINING

AusHEAL supports basic surgical training under COSECSA (College of Surgeons of East, Central and Southern Africa). Much of this training is conducted within HEAL Africa Hospital by the HAH Surgeons. Such training is the first of its kind in D.R.Congo. The 5 HAH trainees are required by the College to attend courses over the border in Kigali (Rwanda), in association with the Rwandan Surgical Society.

Trainees went to Kigali on Tuesday and Wednesday this past week to attend the first course on ‘Basic Surgical Skills’. The event created anxiety as a number of the trainees had not ventured outside Congo before.

Neil had travelled to Kigali a day ahead of them for a ‘Train the Trainers’ component of the course and to his surprise found it was being conducted by two Scottish surgeons from the Royal College of Surgeons of Edinburgh, along with the head of training in Rwanda. He was able to facilitate the attendance of the Heal Africa Hospital trainees and ensure that the Trainers were sympathetic to their difficult situation, particularly as in Congo English is not the first language.

It was a thrill to see the Congolese trainees perform so well at the course, be accepted by their Rwandan colleagues and learn a great deal of basic surgical skills.  It has boosted their confidence. It was helpful for the Congolese trainees also to see that the techniques that Neil has been discussing with them are actually not just confined to surgical practice of in the developed world but also regarded as essential by their African colleagues.

A second similar course on Surgical Physiology will occur in Kigali on the 23rd-24th October. In their weekly presentations at HAH the trainees have already been studying Surgical Physiology in preparation. Their initial fear of having to present course material has been allayed by meeting up with their Rwandan colleagues at the first course.

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For Neil, attendance at the Basic Surgical course in Kigali furthered his connection with surgeons from other nations who have a heart to improve surgery in the developing world. Surprisingly there was a unique connection with the immediate past president of the Royal Australasian College of Surgeons.   He was exposed to some unique and simple models for teaching basic surgery, applicable in resource-poor settings.  It also highlighted the huge difference in ‘development’ that is present between Rwanda and eastern D.R.Congo to him.”

[ii] ENGLISH

Gwen has begun English classes 4 times a week. 2 specific classes for staff from the Finance Department and 2 classes generally for remaining hospital staff. It brings much enjoyment not only to the students but also to Gwen herself.

Gwen teaching English

Gwen teaching English

[iii] OTHER TRAINING

After a number of years of sponsoring young doctors to specialise in other African countries, HEAL Africa Hospital is now well-equipped with trained specialists in most of its Departments. The focus of the hospital is being realigned to empowering training in Congo itself, Jo and Lyn Lusi’s original vison.

Consequently last week saw the establishment of a new training focus at HEAL Africa Hospital called  H.A.T.S. – Heal Africa Training Scheme. Training under the umbrella of HATS began in the following areas:  Family Medicine Program,  Surgical Training Program (COSECSA),  Orthopaedic  Officers Training Program (Nurses),  Neonatal Nurses Training Program,  Fistula Surgery Training Program,  Radiology Training, with the anticipation of  Maternity Training,  and probably Emergency Medicine training.

[iv] CHAPLAINCY

As a further part of the HATS program, a Chaplaincy Training School was launched on Friday 7th October also a long-held dream of Heal Africa founder: Dr Jo Lusi.  Twelve men and women from community villages and committees have begun Clinical Pastoral Training to enable a holistic approach in healing. The community leaders are taught to listen as people tell their stories and offer wise counsel.

It is still common in surrounding villages for people to believe in witchcraft and seek advice when ill from their local ‘healers’. Training chaplains will begin an approach to educate people in communities and villages about the benefits and value of seeking trained medical help from hospitals. Secondly communication networks between hospital and village will be fostered and strengthened.

It is the legacy of Jo’s late wife, Lyn, whose life’s work was to reach out with ‘love in action’ to the people in villages of eastern Congo by establishing local community committees to find solutions to, and help deal with, the many atrocities (social, health and spiritual) occurring in rural areas.

How things can change quickly:

Overnight a young moto (motorbike) driver aged 28 was admitted after having been knocked off his moto in a ‘hit and run’ incident. He had a very serious head injury, was unconscious and transferred to the Intensive Care Unit where he was put on a ventilator. A CT was indicated. As the hospital CT machine sent from Australia some time ago is still awaiting further funding to allow installation, the young man had to be transported by the HEAL Africa Hospital (HAH) ambulance to a private radiology clinic in Goma for the scan.

Unable to afford the private CT cost and ambulance fee, his family asked for contribution from family friends etc. At the transfer 30-40 fellow moto (motorbike) drivers congregated at the gates of the hospital to watch him being put into the ambulance. No doubt they had also contributed to his financial need.  This is a culture of community – not individualism.  They help each other out.

The CT scan was performed and the patient returned to the HAH hospital.  Sadly the results revealed severe bleeding inside the brain. Inoperable.  And now the family just waits……03-img_4109

As is often the way in Congo, rumours spread quickly.  A car came to the hospital and the moto drivers thought it was the vehicle which had hit their fellow driver. A commotion started at the front gate as many moto drivers tried to storm the hospital. They wanted to pull the driver out of the vehicle, beat him and burn the car.

In a matter of minutes about 5 heavily armed police arrived at the entrance and along with the hospital security guards managed to push the moto drivers back and disperse them. It turns out the driver of the vehicle was simply a friend bringing the patient’s wife to the hospital to pay the bill!  This story underlines Congo’s background: patients cannot often afford medical care, there is a tremendous community spirit, but rumours and misunderstanding can lead to rapid changes in the mood of a crowd. It reflects the edge the country is on with the current political uncertainty.

SURGERY :  A 12-month journey for a 9 year old girl……

A year ago Dr Neil saw a young girl who had accidentally drunk acid. It consequently destroyed her oesophagus and left her unable to swallow.  Her parents took her to 4 hospitals and used all their money on these visits but nothing was able to be done for her.  She was malnourished and her father pleaded with us to help her. As the girl’s weight and nutritional condition had greatly improved Neil was able to operate on her in March this year, performing oesophageal bypass surgery. It was major surgery, successful and she recovered amazingly well.

She attended an outpatient’s  appointment this month  for a clinical review and she is so well – no side-effects and eating and swallowing normally. Imagine the excitement when her father brought her to the hospital during this past week to greet us and to say how wonderfully she was doing. She is back at school as a normal student. This girl now has a future ahead of her.

AusHEAL through its AusHEAL Hospital Patient Fund provides funds to enable such patient’s surgery and subsequent hospital care.04-kitso-with-her-family

September 2016 Update

Technical:

AusHEAL Team Member, Paul Bakes (IT Systems Engineer) has been at Heal Africa Hospital (HAH) for the past two weeks, at the specific request of the CEO of the hospital. Paul’s task was to look at the problems HAH is having with QuickBooks, their accounting package.  The online version is unsuitable due to slow internet connection.   A solution to the slow internet connection is being sought urgently, as the HAH Board desires accounting to be online.  Other tasks Paul achieved were:

  • Installation of new internet server (proxy server)
  • Installation of backup procedure for the Patient Admin Software server
  • Installation of new backup server for the whole Heal Africa organisation
  • Measured and drew plans for additional levels of Radiology

Container: 

A container sent from Brisbane’s Mater Hospital via DHL had arrived before the Australian team.  Dr Neil Wetzig and Paul supervised an audit of the container’s contents. Some of the supplies and equipment were delivered to the appropriate departments under Neil’s guidance; the remainder being withheld, to be delivered gradually as needed to avoid overwhelming the recipients.

photo-1-unloading-operating-table-from-dhl-to-ha-ute

Unloading the container from the Brisbane Mater Hospital and DHL

photo-2-ute-outside-operating-theatre-complex

Container supplies being delivered to the operating-theatre-complex

photo-3-unloading-operating-table-from-ute

Unloading the heavy operating theatre table

Surgical:

  • Dr Neil has borne the whole surgery load at the hospital since Dr Luc left for the USA a few days after we arrived.
  • He continues to see complex surgical conditions, some that he has never seen before.
  • The other HAH surgeon, Dr Medard, has been on rural ‘outreach’ since we arrived and due to security issues where he was, no flight was available for him to return to Goma this past week.
  • He has now returned from the north west of Congo and has reported that there was a 500-bed hospital in Kananga, serving millions, but the hospital was filthy inside and there was no surgeon. The young doctors working there do their best with little to no training…… This is why the COSECSA surgical training program at HAH is so important – one of the current Trainees comes from that area!

 

Surgical Training:

The 5 COSECSA (College of Surgeons of East, Central & Southern Africa) Trainees are very keen to learn.  As well as researching and presenting on various topics (2 sessions per week) they are also taking English lessons (this 2 year course is in English).  Their presentations are improving and show not only good research skills but also an enormous amount of work being committed to this.  Trainees will attend courses in Kigali (Rwanda) this month.

photo-7-cosecsa-trainees-viewing-x-rays-of-small-large-bowel-obstructions

Dr Neil instructing the 5 COSECSA trainees

Scholarships for Specialisation:

  1. AusHEAL sponsorship for Dr Muller has provided for 3 years specialisation in Emergency Medicine. He has now completed his training and exams obtaining his Emergency Medicine specialist qualification. Dr Muller is expected back this week and will contribute enormous value to not only the Emergency Department, but to the whole Hospital.
  1. Dr Kigayi, also on an AusHEAL scholarship has completed his first year of Anaesthetic specialist training in Tanzania.
  2. Dr Barthelemy has been accepted into Nairobi University (Kenya) to begin specialist training in Obstetrics & Gynaecology (‘ObGyn’ here). This is a 4 year course and is being sponsored by AusHEAL.  There is a great demand for ObGyn services here in Eastern Congo, especially due to the need for fistula and prolapse surgery for women.
Dr Muller, AusHEAL Scholarship Holder in Emergency Medicine specialist training

Dr Muller – Emergency Medicine

Dr Kigayi - Anaesthetics

Dr Kigayi – Anaesthetics

Dr Barthelemy

Dr Barthelemy – Obstetrics

HEAL Africa Hospital News:

This week HAH received a delegation from UNICEF – a group comprising the Brazilian Ambassador to DRC who was accompanying Princess Caroline of Monaco (a UNICEF Ambassador).

We had the opportunity to talk with the Brazilian Ambassador for about 20 minutes.  He showed great interest in our work and training here, what AusHEAL teams had been doing over the years, and particularly in the current surgical training program.  He insisted on our meeting the Princess, so Dr Neil perfected in 30 seconds a summary of why we are living here and what we are doing here.  We are hopeful that there might be some UNICEF support forthcoming for Heal Africa Hospital’s work with children and women

Princess Caroline of Monaco with Neil & Gwen Wetzig

Princess Caroline of Monaco with Neil & Gwen Wetzig

photo-5-brazilian-ambassador-with-neil

Dr Neil with the Brazilian Ambassador to the Democratic Republic of Congo

April 2016 Update – Did today really happen ?

The fortnight after Easter at HEAL Africa Hospital (HAH) in Goma D.R.Congo was extremely busy and somewhat difficult for different reasons. Though the week commenced positively with the unloading of the CT scanner sent from Australia and moving it in to the new radiology building, a variety of difficult issues then arose.

CT scan being unloaded

CT scanner from Australia being unloaded

CT in place in radiology building

CT in place in radiology building – ready for installation

(1) DIFFICULT CASES:

Two white male patients with severe medical conditions presented separately to the hospital. Efforts to save their lives were unsuccessful. This is an unusual situation. On the one hand it indicates the standing of the HEAL Africa Hospital in the community is such that ex-pat patients choose to come here. On the other hand the loss of the two patients was quite distressing to all staff involved.

 GWEN WETZIG writes below regarding one of the difficult incidents and other distressing cases in what she titled: Did today really happen????? …..

“Yesterday morning I was sitting in our AusHEAL office located on the top floor of the Cinquantenaire Building at HEAL Africa Hospital.  My husband (Dr Neil) was with one of the Hospital Residents conducting a surgical outpatient clinic.

About mid-morning I heard a siren. It was getting closer …. and louder… As I predicted it entered the HEAL Africa gate closest to the Emergency Department.  From my office I have a ‘birds-eye’ view of this particular section of the hospital grounds. I was unable to see anyone actually being transferred from the ambulance to the Emergency room.  However, I texted Neil to suggest he might ‘just call by’ Emergency after he had finished in Outpatients.  This he did……Two young boys had been rushed in to the hospital with severe electrical burns – penetrating skin, fat and through even to muscle and bone!!  Neil commented that he had not previously seen such severe full thickness burns…. to arms, hands, legs, back and front of the chest and abdomen. He was surprised that both young boys even survived.  A bigger picture was revealed later.  Two brothers (aged 4 and 6) were standing on a balcony and the younger one saw a wire hanging down.  He reached out and grabbed it……. The current went straight through him – into his hands and up his arm.  His older brother ran and grabbed him around his body – at which time the current transferred to the brother and went through him and out his back.”   

Despite intervention on the day, surgery on the younger brother the following day revealed no blood supply through the arm which took the initial electric shock.  His arm was completely dead and had to be amputated through the shoulder. The electric current had also penetrated his abdominal wall and his liver. Furthermore, there was some ‘mishap’ outside resulting in shorting the theatre building such that the boys remaining burns were cleaned and debrided in the dark. Neil’s battery powered headlight was well used. The power outage meant that the older brother’s surgery had to be postponed, adding ‘insult to injury’ in the truest sense.

One of the burns cases

One of the burns cases

Gwen continues…….. “As if that was not enough trauma for today……. another siren was heard in the afternoon, to be followed by an ambulance racing into HEAL Africa Hospital Emergency Department.  Again watching from the third floor, but not being able to see clearly what was actually happening, I alerted Neil (who was in a meeting) to the fact that there could well be another need for assistance in Emergency.  Correct again!!”   

Neil reports …….”This time it was a South African man aged 62 from a mining company in a village some way from Goma. He was brought to the hospital first by helicopter and then by road in an ambulance. An anaesthetist from the UN Hospital was sent for as the HAH nurse anaesthetists were having difficulties. Neil assisted with the resuscitation while the UN doctor was awaited. The man had probably suffered a severe heart attack and after all was done in the Emergency Department that could reasonably be done, he passed away.” 

Resuscitation in the Emergency Department

Resuscitation in the Emergency Department

And there’s more from Gwen ……….

As Neil was recalling to me the events of the day; he received word that there was a 26-week pregnant woman in the maternity department with a bowel obstruction. She could not be taken to the main operating theatre as the power had not yet been restored so she was taken to the maternity ward emergency theatre. The findings were 2 separate examples of a very uncommon surgical condition called “intussusception” where one part of bowel slips inside another and can, as it did in this case, lead to strangulation of the bowel.”

The highlight of the week was the discharge from hospital of Kitso, the little girl who underwent successful oesophageal by-pass surgery exactly 3 weeks earlier. Her recovery has been remarkable.

Kitso able to eat normal food 3 weeks after surgery

Kitso able to eat normal food 3 weeks after surgery

(2) DIFFICULT NATURE:

On Thursday night the 31st of March and into the early hours of Friday, a large thunder storm occurred – not uncommon for this time of the year. However the rain was heavier and more sustained than usual. Staff arriving at the hospital the following morning were shocked to find the hospital flooded. Almost a metre of water had run through the operating theatre, wards and radiology building leaving a field of thick mud throughout.  Electrical equipment including radiology equipment and ultrasound had been partly submerged. All, a devastating blow to the staff.

Mud in the operating theatre

Mud in the operating theatre

04 Flood level at front gate

Flood level at hospital front gate

Although officials from the local authorities came to the hospital, little assistance from the government was available for a clean-up and return to work. Neil wondered if the UN would help and spoke to Dr Jo Lusi (Founder and Legal Representative of HEAL Africa) who liked the idea. After some difficulties getting through the security cordon the hospital executive eventually met with the UN Director of Civil Affairs who arranged for engineers to visit the hospital and assess the damage. They declared the hospital a ‘disaster’ and sent fresh water, firemen to hose paths, cleaners and an electrician to check the power. Meanwhile the HEAL Africa Hospital technical team set about pulling electrical equipment to pieces, drying and reassembling it in the hope it would work again. Damage was estimated to be close to US $700,000 damage. Insurance does not exist in D.R.Congo!  In what is a sign of Congolese resilience and effort, the surgical block was able to re-opened, wards and radiology areas were cleaned and some of the flooded electrical equipment was thought to be functional. All within 48 hours!

012 UN officals inspecting the Radiology Department

UN officals inspecting the Radiology Department

Recovery ward after cleaning 48 hours after flood

Recovery ward after cleaning 48 hours after flood

At the end of the week PAUL BAKES, AusHEAL team member from Brisbane, arrived. A timely visit. With his IT and electrical expertise he will be able to assist with the recovery and oversee repair of equipment and software problems that have occurred. He was accompanied by cinematographer Nick Paton and Jason Elsmore. Nick is doing some filming in preparation for the 2016 AusHEAL Fundraising Dinner to be held on Friday 27 May in Brisbane. Jason is the Senior Pastor at Gateway Baptist Church in Brisbane coming to assess the work and meet and encourage the people AusHEAL has been involved with over the last 10 years at HEAL Africa Hospital.

Whereas Paul will remain at the hospital for a further 3 weeks the remaining team members left Goma Wednesday to wind their way back home. 

Nick Paton filming a story

Nick Paton filming a story

March 2016 Update

Much has occurred at HEAL Africa Hospital in the past 2 weeks.

David and Heather Kelly departed on Thursday 17 March after 2 months service. David has been working alongside hospital administrative staff including Dr Justin (HEAL Africa CEO) and Mr Patrice Mulamba (Chief of Operations). He has been able to give guidance not only in hospital administration but also to the many community development projects associated with HEAL Africa outside the hospital. Heather continued her English teaching classes up until the day they left and one of her classes sang a song for the hospital staff in English.

David and Heather Kelly about to depart from HEAL Africa Hospital

David and Heather Kelly about to depart from HEAL Africa Hospital

Gwen Wetzig has also been teaching English to the staff of the Finance Department. It not only improves their English but provides practical training in communicating with English-speaking partners of HEAL Africa regarding financial reporting etc.

Gwen Wetzig teaching English to the accountantcy staff

Gwen Wetzig teaching English to the accountantcy staff

Dr Neil Wetzig continues to be involved with surgical patients with complex and difficult conditions referred to HEAL Africa Hospital (HAH). He sees the results of young doctors newly graduated in DRCongo and sent to rural centres to staff a hospital or medical centre on their own with little to no practical experience. They can operate in difficult conditions and frequently without appropriate knowledge or skills. Even a Caesarean section to deliver a baby can be poorly performed. Should complications ensue there are difficulties.

This month a 12 year old girl was treated at HAH following surgery at an outlying peripheral medical centre. Her chance of survival currently is low even with the resources and expertise at HAH. Her problem emphasizes the need for appropriate rural surgical and obstetric/gynaecology availability. Patients with obstetric fistulae as a result of poor child birthing or sexual violence are being referred to HAH with increasing frequency.

A fortnight ago a 9 year old girl underwent major surgery by 2 HEAL Africa Hospital General Surgeons and Dr Neil to bypass her narrowed oesophagus (swallowing tube). She had accidently drunk ACID about 12 months ago severely burning her inside. (Water bottles in Congo are regularly used to store many different fluids without labels.)  The young girl had been unable to eat solid food since swallowing the acid and had visited 4 different hospitals to seek care before coming to HAH in September last year.  As an essential first step a feeding tube was surgically inserted into her stomach in 2015 to allow her nutrition to be improved before major bypass surgery this week 6 months later.

young girl prior to her bypass surgery

Young girl prior to her bypass surgery this month

She has recovered well from her procedure. An x-ray taken 9 days after surgery confirmed all the internal joins were healing well. Hopefully she will be able to eating solid food in a few days.

9 days after major bypass surgery

9 days after major bypass surgery

Bypass surgery, although complex and long, provides an excellent training opportunity for HAH staff at different levels including the operating theatre, intensive care unit and general nurses. AusHEAL has been able to fund this surgery and the young girl’s hospital expenses as her family were unable to afford it. Money well spent, not only because of the young life saved but also because of the training opportunities outlined above. This is about providing ‘sustainable change’ in the medical area which is AusHEAL’s ethos.

BASIC SURGERY TRAINING

A new surgical training programme in basic essential and emergency surgery has been commenced at HEAL Africa Hospital this month to begin dealing with unmet needs for surgical expertise in DRCongo.

As referred to in the previous blog this programme is in conjunction with COSECSA: the College of Surgeons of East, Central and Southern Africa. At the end of 3 years 5 new trainees at HAH will sit a written and practical exam in an endeavour to gain ‘Membership’ of COSECSA. This is only the second time this English based course has been conducted in a French speaking country. A further year has initially been added to the usual 2 year training program to allow additional English training at HAH. Staff surgeons conduct the programme involving 2 formal training sessions per week together with ‘on the job’ training and mentoring.

AusHEAL is contributing to the establishment of this course both financially and through the oversight of Dr Neil Wetzig who has been given the title of Consultant and Advisor of Surgical Training Programmes by HEAL Africa Hospital.

Booklet received by COSECSA trainees at their first lesson

Booklet produced by the University of Queensland received by COSECSA trainees at their first lesson

This is a unique and new programme for DRCongo. HEAL Africa Hospital is leading the way. Dr Jo Lusi, the founder of HAH, will soon travel to the capital, Kinshasa, to inform the Congolese Minister for Higher Education about the course.

The COSECSA trainees (back row) and trainers (front). Dr Jo Lusi is centre of the front row.

The COSECSA trainees (back row) and trainers (front). Dr Jo Lusi is second from the left in the front row.

 

2016 BEGINNINGS

Currently there are 4 AusHEAL personnel at HEAL Africa Hospital (HAH) in Goma, D.R.Congo:

DAVID & HEATHER KELLY:

They have been in Goma since late January.  DAVID mentors the administrative staff across the whole organisation of HEAL Africa. He is also part of the HEAL Africa Assemblie Generale (AG) (HEAL Africa Board) whose Annual General Meeting took place from 2-5 March. He has had much responsibility in helping the Congolese staff prepare for the meeting while HEATHER has been busy teaching English to HAH staff and medical students. A complete new intake of medical students commenced at the hospital a few weeks ago.

HEAL Africa Board. David Kelly front row, second from the right.

HEAL Africa Board. David Kelly front row, second from the right. Lindsay Thitchener (from SONIC) is the other Australian on the Board – back row, second from the left.

 

NEIL & GWEN WETZIG:

NEIL & GWEN arrived back in Goma  on 27 February. Although not part of the Assemblie Generale they have enjoyed meeting some of the board members from Africa and the USA. They had a busy week of settling in and establishing contacts with staff and patients at HEAL Africa Hospital. As there was a team of 4 American surgeons at the hospital NEIL kept a low profile surgically to allow them to complete their programme.

USA Surgical Team 1

Visiting USA Surgical team at work

 

NEIL with members of the visiting USA surgical team

NEIL with members of the visiting USA surgical team

NEIL, GWEN & HEATHER did have the opportunity to sit in on the public reports to the Assemblie Generale presented by hospital staff. It provided interesting insights into the whole organisation. Time was also spent with the new CEO of HEAL Africa-USA (the USA charity supporting HEAL Africa Hospital) to discuss how a more co-ordinated international approach can be achieved.

HEAL Africa Hospital (HAH) has been assessing the establishment of a ‘Basic Essential and Emergency Surgery Training Programme’ in conjunction with the “College of Surgeons of East, Central and Southern Africa” (COSECSA) in an effort to meet the huge un-met surgical need in D.R.Congo. NEIL spent much of the first week preparing for this. He also gave a presentation on the proposed programme to the HEAL Africa Assemblie Generale, who then agreed to proceed with it. This has meant a large amount of work for NEIL, who will now facilitate the actual course and meet with the HEAL Africa Trainers on staff and trainees.  Five inaugural trainees in the new basic essential and emergency surgery programme at HAH have been registered online with COSECSA, not easy considering the poor internet connectivity.

Dr Neil & Dr Luc (Hospital Director) with inaugural COSECSA Surgical Programme trainees

Dr Neil & Dr Luc (Hospital Director) with inaugural COSECSA Surgical Programme trainees

AusHEAL has taken on the sponsorship of one of these trainees. Future blogs will outline this new thrust into wider provincial surgical, obstetric and anaesthetic needs.

It was good to welcome POTEAU back to HEAL Africa Hospital. Poteau is a staff nurse-anaesthetist, who has been sponsored by AusHEAL for 2 years of additional training in paediatric anaesthesia in Kinshasa, the capital of DRC. Anaesthetising children has a higher level of risk in comparison to adults, requiring special expertise and experience. It is envisaged that Poteau’s return will enable him to pass on his newly acquired skills and knowledge to the remaining nurse-anaesthetists.

Another significant experience during the first two weeks was to present to Dr ALBIN (HAH Physician) the first of a series of teaching CDs on echocardiology, arranged by AusHEAL Brisbane team member Dr DARRYL BARSTOW, (Cardiologist) and sponsored by AusHEAL.

Poteau, returning nurse-anaesthetist with Neil

Poteau, returning nurse-anaesthetist welcomed by Neil

Dr Albin receiving Echocardiology CD's

Dr Albin receiving Echocardiology CD’s

GWEN has prepared for English classes she is to hold with the Finance staff at HEAL Africa Hospital as well as spending time receiving the many HAH staff and adherents welcoming them back and ‘bring greetings’, so important in this relationship-based culture.

The clinical work increased for NEIL after the USA team departed. Patients were seen and triaged with some scheduled for surgery. The work of establishing the new surgical training programme continued, involving meetings with both trainees and HEAL Africa Hospital staff trainers so that they understand the course structure and curriculum. Other HAH staff were consulted to achieve as much co-ordination as possible within the hospital.

GWEN has been put to work minuting some of those meetings. She & HEATHER have continued to teach English. They participated in the significant International Women’s Day celebration conducted by HEAL Africa Hospital on 8 March. All female staff were given a holiday and encouraged to join the celebrations.

Heather Kelly at International Womens Day

Heather Kelly at International Womens Day

Gwen at International Womens Day

Gwen at International Womens Day

DAVID meanwhile has been following through with many of the decisions made at the HEAL Africa Board Annual General Meeting.

The work of HEAL Africa Hospital is enormous. Both Irish and USA guests who work for outside organisations have arrived at Maji Matulivu (where AusHEAL team members stay) in these past weeks. They constantly tell us of the great developmental work that HEAL Africa Hospital is involved inning created. US-AID recently assessed one (HAH) Project in the area of support for victims of sexual violence, judging it to be one of the most sustainable projects they have seen in the region. It is a privilege for AusHEAL to partner with HEAL Africa Hospital in its medical work.