Denise

War is hell. On Schoolchildren.

War is hell on schoolchildren. The decade-plus of war that has killed nearly six million citizens of the Democratic Republic of the Congo and destroyed the country's industry and infrastructure has also destroyed the hopes of a generation of children that they might get an education and with it, an opportunity to help their country break its cycle of poverty and self-destruction.

In 2005 it was estimated that 4.6 million Congolese children were not being educated, either because their parents could not afford school fees and supplies, or because armed conflict had caused the suspension of educational services in their towns and villages. Data compiled in 2007 estimated that 3% of D.R.C. citizens receive a university education, 30% a secondary school education, 46% only a primary school education, and 21% no education at all.

Travel around the D.R.C. and you see children everywhere. In the IDP (internally displaced person) camps, you are followed everywhere by a crowd of kids. In part this is curiosity; how strange the mzungu are! In part it is hope; can the mzungu help us? In part it's boredom; doing anything is better than doing nothing.

Of course, children also work to support their families. They collect water and they help their parents in the fields in times peaceful enough to permit people to cultivate their fields. The above photographs taken in and around IDP camps near Rutshuru in North Kivu show children collecting water and observing the mzungu photographer.

I brought my "A" game and was, I'm sure, at least as entertaining as usual, but I can't claim my visit was an adequate substitute for a good education.

Movie Night in the Congo

One morning on my way back from the hospital in the North Kivu town of Rutshuru, I passed the above-pictured cinema and wondered what was playing and how movies are shown. [Regrettably, the scene had passed from my mind by the time I walked to the Medicins Sans Frontieres residential compound where I was staying and could have asked. Also regrettably, there was no chance at all for me to go to the movies while in the Congo; MSF operations everywhere I stayed outside of Kinshasa and Bunia (in Ituri province), where there is a large United Nations peacekeeping force headquartered on the outskirts of town, observe a curfew from nightfall for security reasons.]

It's almost impossible to imagine that there's a film projector involved; far more likely is that the cinema owners possess some sort of projection television (if reasonably wealthy), or even simply show DVD movies on a medium-sized (by developed country standards) CRT television.

Discovering this photograph yesterday among the thousands I shot in the Congo, I was prompted to wonder about the typical Congolese (i.e. ex-Kinshasa) moviegoing experience. [If any readers of this blog have first-hand knowledge, I'd be very happy to hear it.] How much does it cost to go to this cinema, I wonder (around $0.10-0.25 is my guess)? What movies are shown? French movies, I presume, dominate, and probably the major Hollywood blockbusters, subtitled in French, are shown as well. [Cost aside, language would be a bar to moviegoing for the average Congolese, who speaks little French and no English.]

What about locally produced movies? After all, Nigeria has a thriving video production industry; what about the Congo?

Well, I did some research, and it seems the 12 years of war that have killed nearly six million people has also dampened enthusiasm for producing films in the country. There are a few well-known (to cineastes) Congolese directors, but they live and work overseas.

In any event, the history of film production in the Congo is brief. During the Belgian colonial period (until 1960), Congolese were not permitted to watch foreign films at all, ostensibly because they were unable to differentiate between fact and fiction and therefore might develop mental problems (reminding me that China banned "Babe", a live action film about a talking pig, on the grounds that because pigs can't talk, people might become confused), but in fact to limit exposure to (and questions about) the more egalitarian ex-colonial world. The Belgian colonial administration did, however, see the utility of the film medium as a communications tool, and it established a Film and Photo Bureau to produce educational and propaganda films for the local population. And inevitably, in training locals to assist with the production process, the seeds of a local film industry were sown.

Not until 1987, however, was the first Congolese feature film produced, Mwenze Ngangura's "La Vie Est Belle". Although I haven't see either that or his "Pieces d'Identite", which won several awards, Ngangura remains the Congo's best-recognized film director.

Readers who live in the New York City area may be interested to learn that the Maysles Cinema is screening a "Congo in Harlem Film Festival" this month until October 24. On the schedule is Ngangura's "La Vie Est Belle" (October 23); the documentary "Reporter", chronicling New York Times correspondent Nicholas Kristof's efforts to raise global awareness about the war in the Congo; and "Pygmy Thrills" (October 20), a 10-minute short (shown with another film) filmed in the 1930s by Eugene Castle and a film Werner Herzog cites as his impetus for embarking on a film career. Unfortunately, you've missed Raoul Peck's "Lumumba", which was shown on October 2.

One Among Many

As I've written before, I spent a day while in Rutshuru (where Medecins Sans Frontieres shares the administration of an excellent hospital with the Ministry of Health) riding with Didier Kaubi, a Congolese nurse who has been working for MSF for three years.

Our first call-out (pictured above is the ambulance leaving the MSF residential compound – the service starts at 0800 and that's when the call came in) took us to a small health clinic in the tiny village of Kinyandoni, where we found a mother and her badly burned 18-month-old son Elie. Elie had fallen into the cooking fire, which in huts with only a few square meters of floor space, is easy to do.

Didier spoke with Elie's 24-year-old mother Antoinette, who has three other children at home, and put a line into Elie's arm to administer a pain killer and Ringer's lactate solution, which comprises sodium, chloride, potassium and lactate and is used to rehydrate children who have suffered burns or blood loss.

Then we all piled back into the vehicles and drove Elie the 10 kilometers to the hospital, where Didier handed him off to the doctor in charge of the pediatric unit. [I've included a shot of the Lund-Browder chart for estimating the extent of burns in children, allowing for the varying proportion of body surface in those of different ages.]

Elie was a brave little soldier, and I hope he's recovering okay.

Mobile Clinics ... Mohammed Goes To The Mountain

During my short time in the Democratic Republic of the Congo (DRC) I visited nearly a dozen Medecins Sans Frontieres-operated and -supported clinics and hospitals in Kinshasa and North Kivu and Ituri provinces. I spent a day with a nurse providing ambulance service to the area surrounding a rural hospital, and I visited a mobile clinic operated by MSF out of its Kabizo clinic.

MSF operates mobile clinics in the DRC (and elsewhere) in large part because there is next to no public transportation in that country.Most people, if they need to get to a hospital or clinic, walk there. That may take hours, or it may take days. The government-run rural health clinics in the DRC are for the most part extremely basic, short on medicine and equipment and trained medical personnel. Basic supplies such as rubber gloves can be hard to find. As a result, where MSF can provide regular support to local clinics, the quality of medical care in those communities is greatly improved. If the mountain won't come to Mohammed, Mohammed must go to the mountain.

The mobile clinic I visited in Upper Tongo is held twice a week between 0800-1500, with two doctors/nurses treating around 100 patients a day for the complete range of Congolese ailments – malaria, cholera, measles, diarrhea, respiratory infections and malnutrition. Patients with urgent medical problems, e.g. gunshot wounds, will find a way (motorcycle taxi, MSF ambulance) to get to the nearest hospital (in this case, Rutshuru, a few hours away from Tongo by car). Around 50 percent of patients at the Upper Tongo clinic are internally displaced people (IDPs), and there are around 3,000 IDPs in the region immediately surrounding the village.

In the last photograph above, the girl with the cast on her left arm is named Solange. She broke her arm while fleeing an attack by armed gunmen on the fields her family was working and had the cast put on at the hospital in Rutshuru. She lives in Tongo with her parents, five sisters and brother, and was at the clinic to have her arm checked by the doctor. She was a cute and very self-possessed little girl, and I hope her arm is healing well.

[In the third photograph are a couple of guys from MSF's Kabizo operation. On the left is Gaspard, the administrator, and on the right is Jean, the assistant logistician.]

Probably the only Kindle in the Congo

Met a doctor the other day in Rutshuru. Her name is Shelly and she's working at Rutshuru Hospital, which MSF operates in conjunction with the Ministry of Health. I caught Shelly reading on her Kindle, and I wondered to myself if it was the only Kindle in the country ...

Jeff Bezos, if you're reading this, can you provide any Amazon e-book sales data for the Democratic Republic of Congo? And FYI, Shelly told me that in exchange for a few hundred dollars in book credits, she's willing to serve as a “See a Kindle in Your City” representative in Rutshuru.

Denise

I met Denise (pictured) a few days ago in Rutshuru Hospital, in North Kivu. She'd been in the hospital for around a month, after having been shot during a truck jacking. In the D.R. Congo, there is very little long distance transport (short distances ... of up to 20 kilometers) are nearly always covered on foot), and the long distance trucks (nearly all old and decrepit, with tires in even worse condition) double as "buses" for people needing to travel farther than can be walked in a half day or day. The passengers ride on top of the load (I'll post on this separately), clinging on as best they can over unpaved, rutted roads. Injuries (and presumably deaths) from falls are not infrequent. The truck jackings are an even greater risk, of course, and though the bandits could easily order the passengers off the load, they frequently don't bother, perhaps finding it easier to clear a path to their objective with bullets.

Denise was shot in the leg, and the round (almost certainly a high-powered round from an automatic rifle) shattered her tibia. When I saw her, she had an exoskeletal brace (don't know the technical term) holding the two main pieces of bone together, and she had months/years of bedrest and rehabilitation ahead of her. She managed to show a beautiful smile, though, if a bit of a sad one ...

Also pictured, with Denise's x-ray, is Dr. Willy, in charge of medicine at Rutshuru Hospital. In the comprehensive tour he gave us of the (very busy) hospital, Dr. Willy seemed to know nearly all of the patients by name, and had a kind or playful word for nearly everyone.

Ace Reporter Ayako Tsujisaka Contemplates A Big Change

Had a bit of fun snapping Ayako and Dr. Richard after our tour of the Rutshuru Hospital operating theater ...

If only I had 10 years to spend getting my medical degree ...

Spent a day a few days ago getting the tour of the MSF hospital in Rutshuru from medical director Dr. Willy (not pictured). The hospital there (about which more later when I have more time) is full-service, from maternity services to trauma treatment. [A day later, given a chance to chase an MSF ambulance, I watched/helped nurse Didier deliver a child burn victim (cooking fires are open, and children are often burned) and three maternity cases to the hospital.]

In this photo is Dr. Richard, who gave us the tour of the hospital's operating theater. I had a chance to imagine myself starring in a medical drama (since a TV offer seems more likely than my getting a medical degree). [Yes, I chose the cap purposely.]