Mundele - my month in Congo
During August 2015, I had a new name - Mundele. It means white person in Lingala, the language spoken in Kinshasa, a city of 10 million people and capital of the Democratic Republic of Congo (DRC).
Everywhere I went, I would hear the word coming from all directions, usually from people who simply wanted to say Bonjour! to me. Most looked at me with amused curiosity. From the very young, I would sometimes get stares or an excited version of Mundele turned into an original song. The vast majority simply wanted to say hello, look you in the eye and smile. They were friendly and welcoming.
Here's a slideshow of city photos of Kinshasa:
Everywhere I went, I would hear the word coming from all directions, usually from people who simply wanted to say Bonjour! to me. Most looked at me with amused curiosity. From the very young, I would sometimes get stares or an excited version of Mundele turned into an original song. The vast majority simply wanted to say hello, look you in the eye and smile. They were friendly and welcoming.
Here's a slideshow of city photos of Kinshasa:
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Culture shock
On the Human Development Index, Canada is number 8 and DRC is number 186 - out of 187 countries. Being there drove home to me that the things I have taken for granted every day of my life. I believe the majority of Canadians share these expectations, but I believe that the vast majority of people there would not expect to have:
While I lived in RDC in first world conditions, every day I saw homes smaller than a Canadian bedroom, without beds. Electricity is available to a few - and even then there are frequent power outages. Running water is available to a few, with frequent stoppages that mean you still have to go to a communal well at times. I believe many people eat one meal a day - supper - and then perhaps save a little for the following breakfast. While there may not be much obvious starvation, there is undernourishment.
In a word, there is almost none of the infrastructure we have in the first world. Most roads, even in the capital, are unpaved. The main means of public transit are mini-vans, usually with 20+ people on four benches where three rows of seats used to be. There is one highway in the country from Kinshasa to the port city on the Atlantic coast. Travelling east into the country by land is an odyssey. Banks have only restarted following years of civil war.
Publicly funded health care and education are practically non-existent. Most education is private, in schools that are small and informal. Most health care is delivered through small clinics and a small number of hospitals. People have to pay, unless it’s subsidized. Foreign governments or charities fund much of the health care and many schools.
The needs are enormous, almost overwhelming. What’s available to meet those needs feels grossly inadequate. It will take decades to change things - and that’s only if everything goes well.
Below is a slideshow of Lakunga, the place on the outskirts of Kinshasa where I stayed, as well as some of the places I visited in and around Kinshasa:
On the Human Development Index, Canada is number 8 and DRC is number 186 - out of 187 countries. Being there drove home to me that the things I have taken for granted every day of my life. I believe the majority of Canadians share these expectations, but I believe that the vast majority of people there would not expect to have:
- a bed
- electricity - available 24 hours a day
- running water with all that comes with it - toilets, cooking, washing, bathing
- three meals a day
- either food in my home or financial means to buy some at any time
While I lived in RDC in first world conditions, every day I saw homes smaller than a Canadian bedroom, without beds. Electricity is available to a few - and even then there are frequent power outages. Running water is available to a few, with frequent stoppages that mean you still have to go to a communal well at times. I believe many people eat one meal a day - supper - and then perhaps save a little for the following breakfast. While there may not be much obvious starvation, there is undernourishment.
In a word, there is almost none of the infrastructure we have in the first world. Most roads, even in the capital, are unpaved. The main means of public transit are mini-vans, usually with 20+ people on four benches where three rows of seats used to be. There is one highway in the country from Kinshasa to the port city on the Atlantic coast. Travelling east into the country by land is an odyssey. Banks have only restarted following years of civil war.
Publicly funded health care and education are practically non-existent. Most education is private, in schools that are small and informal. Most health care is delivered through small clinics and a small number of hospitals. People have to pay, unless it’s subsidized. Foreign governments or charities fund much of the health care and many schools.
The needs are enormous, almost overwhelming. What’s available to meet those needs feels grossly inadequate. It will take decades to change things - and that’s only if everything goes well.
Below is a slideshow of Lakunga, the place on the outskirts of Kinshasa where I stayed, as well as some of the places I visited in and around Kinshasa:
The needs and challenges today
The greatest risk for such a long-term development is the democratic infrastructure, very much a work in progress. DRC’s history does not inspire confidence on this front. Close to 100 years of brutal colonization resulted in millions, if not tens of millions dying. That gave way to independence in 1960. Soon after, the head of the army led a coup, beginning a dictatorship that would last until 1997. It was brutal, autocratic and corrupt. Beginning with pillaging by the army in 1991, the deterioration of the country accelerated. A civil war ensued, the first of a steady stream of uprisings over the last 20 years, estimated to have left more than five million dead, mostly in the eastern part of the country. In 1997, the dictator was overthrown, the rebel leader took his place, only to be assassinated in 2001. His son, Joseph Kabila, took over. During his father’s rebellion, Joseph led child soldiers. He remains in power today. He has brought a measure of stability and rebuilding. The big question is whether he will give up power peacefully. He has won two presidential elections (both considered to be fixed) allowed in the constitution. He recently tried to change the constitution to allow himself to be re-elected. Although he failed, there is an expectation he will try again.
Other scars of the years of violence are particularly evident in the east of the country where most of fighting took place and continues. There remain 1.5 million displaced persons within the country. The region is known as the rape capital of the world. Central government control is limited and both the army and militias are essentially a law unto themselves. Even the president admits there is problem of rape in the army. This fuels the growth of Kinshasa with people coming there because of its relative security.
The violence continues, unfortunately it is the most visible form of political expression, usually pillaging or uprisings of a secessionist or tribal tendency. Unchecked, they have led to civil war and brutally repressed localized incidents - both of which bring extremes of sexual violence as well.
Why do you want to go there?
In the weeks before departing, when I told people I was going to Africa, they were excited for me. When I said I was going to DRC - most people had not heard of it. When I told them about the country, inevitably I was asked why I would go to such a place. Given what I have summarized above, it’s a fair question.
The reason for my trip was to visit the Monkole Hospital for Mothers and Children in Kinshasa. It was started in 1991 by members of Opus Dei, a personal prelature of the Catholic Church. I am also a member of Opus Dei, and a board member of LINCCO, a Canadian charitable organization helping Monkole.
I went to DRC to meet the people who run Monkole, particularly the Nursing School attached to it, Institut Supérieur en Sciences Infirmières, for which LINCCO has provided funding over the years and is currently funding an expansion to offer a Master’s in Nursing, the first in the country.
Here's a gallery of photos Monkolé and ISSI:
The greatest risk for such a long-term development is the democratic infrastructure, very much a work in progress. DRC’s history does not inspire confidence on this front. Close to 100 years of brutal colonization resulted in millions, if not tens of millions dying. That gave way to independence in 1960. Soon after, the head of the army led a coup, beginning a dictatorship that would last until 1997. It was brutal, autocratic and corrupt. Beginning with pillaging by the army in 1991, the deterioration of the country accelerated. A civil war ensued, the first of a steady stream of uprisings over the last 20 years, estimated to have left more than five million dead, mostly in the eastern part of the country. In 1997, the dictator was overthrown, the rebel leader took his place, only to be assassinated in 2001. His son, Joseph Kabila, took over. During his father’s rebellion, Joseph led child soldiers. He remains in power today. He has brought a measure of stability and rebuilding. The big question is whether he will give up power peacefully. He has won two presidential elections (both considered to be fixed) allowed in the constitution. He recently tried to change the constitution to allow himself to be re-elected. Although he failed, there is an expectation he will try again.
Other scars of the years of violence are particularly evident in the east of the country where most of fighting took place and continues. There remain 1.5 million displaced persons within the country. The region is known as the rape capital of the world. Central government control is limited and both the army and militias are essentially a law unto themselves. Even the president admits there is problem of rape in the army. This fuels the growth of Kinshasa with people coming there because of its relative security.
The violence continues, unfortunately it is the most visible form of political expression, usually pillaging or uprisings of a secessionist or tribal tendency. Unchecked, they have led to civil war and brutally repressed localized incidents - both of which bring extremes of sexual violence as well.
Why do you want to go there?
In the weeks before departing, when I told people I was going to Africa, they were excited for me. When I said I was going to DRC - most people had not heard of it. When I told them about the country, inevitably I was asked why I would go to such a place. Given what I have summarized above, it’s a fair question.
The reason for my trip was to visit the Monkole Hospital for Mothers and Children in Kinshasa. It was started in 1991 by members of Opus Dei, a personal prelature of the Catholic Church. I am also a member of Opus Dei, and a board member of LINCCO, a Canadian charitable organization helping Monkole.
I went to DRC to meet the people who run Monkole, particularly the Nursing School attached to it, Institut Supérieur en Sciences Infirmières, for which LINCCO has provided funding over the years and is currently funding an expansion to offer a Master’s in Nursing, the first in the country.
Here's a gallery of photos Monkolé and ISSI:
The needs and problems of RDC can feel overwhelming, but Monkole shows you can still hope. Started as a small medical clinic in 1991, it has grown by leaps and bounds - with no signs of stopping. It is now a 100 bed hospital in a new building - with empty space to grow. Monkole serves 85,000 patients annually with 5,000 inpatient admissions. Its budget is 4.5 million Euros, of which 90 per cent comes from foreign sources.
The nursing school started in 1996, now with 50 graduates every year and a residence for the students. LINCCO is helping ISSI set up its Master’s in Nursing Program, the first in the country. It’s taking time to get traction, but that has never stopped them in the past.
When I interviewed Marcia Restiffe, the School Director, she underlined that training nurses saves lives. In a country where the health care system is so minimal, it’s easy to see that the front line primary care that nurses provides makes a huge difference in people’s lives.
A related key program at Monkole is continuing education for health care professionals. Unfortunately in DRC, once a health care professional graduates, there is no system to keep their skills up to date. Monkole has a vibrant continuing education program for doctors, nurses, lab technicians. While it’s easy to focus on buildings and equipment, the need for well-trained personnel is as much a need. Without competent personnel, the buildings don’t really help.
Getting back to the health care needs of DRC, they are on a scale that is hard to imagine. The following compares some key indicators:
DRC Canada
Population (millions) 67 35
Life expectancy (years) 53 82
GDP/capita (US dollars) 680 42,000
Total government expenses on health/capita (US dollars) 26 4,800
Maternal mortality rate per 100,000 births 540 12
Under age five mortality rate per 1,000 births 102 5
These stats underline the importance of Monkole’s focus on maternal and paediatric care. The high maternal mortality rate is a result of absence of pre-natal care. That’s one focus of Monkole.
For pediatrics, one of Monkole’s specializations is orthopaedics. A common birth defect or deformity that develops is curvatures of the legs. The causes are either congenital or malnutrition that means the bones remain soft and bend. One of the physicians at Monkole specializes in correcting these deformations with amazing success rates. The ‘before’ photos are truly hard to look at.
Two other endemic diseases that affect children in particular are malaria and sickle cell disease, which are inter-related. Everyone gets malaria in this part of the world. It can knock out an adult for days. For a young child, it can be fatal. Proper treatments is necessary, potentially requiring hospitalization and medication. Sickle cell disease is potentially a result of a genetic resistance to malaria. In places like DRC, an estimated 2 per cent of the population have it. While more people are living longer, it requires ongoing medical attention and treatment but it is fatal over time.
For these and so many other services - HIV, tuberculosis - those affected are usually not in a position to pay for long-term, ongoing treatments. Monkole is a life-saver for them. People who can pay are asked to do so, but the vast majority pay a token amount.
With an inadequate national health care system, Monkole is a point of hope. It is exceptional in the DRC, but hopefully it is an exception that will become the rule some day. They are certainly working with other health care providers to raise standards and their nursing graduates are valued wherever they go.
Conclusion
In the weeks following my return, I bought a second hand book form the 1920s called ‘If I lived in Africa’. From today’s perspective, it’s cringe-worthy in its condescending view. But the title makes a point. Because I don’t live in Africa, my projection of how people should feel in the face of their material situation isn’t fair, it's what I would feel coming directly from Canada. And yes, I could never imagine myself living in their conditions, but regardless of my projection, they get on with their lives. As one of my colleagues put it when I described my trip, they are just as unhappy as we are. While not a very hopeful observation, there is some truth in it. They certainly have to face death, hardship and suffering on a more frequent basis than us, but that doesn’t stop them from living and trying to enjoy life just as we do.
I read Ghana must Go by Taiye Selasi while I was there and it gave me some insights into their mindset. While set in a different country, there was a passage that helped me potentially understand how they view the world. It’s a flashback scene of one of the main characters in his village as a youth as his sister is dying: ‘The calm eyes of a child who had lived and died destitute and knows it, both accepting and defying the fact. With precisely the same heedlessness the world had shown her, and him, all dirt-poor children. The same disregard. Looking back at a world that considered her irrelevant with a look that said she considered the world irrelevant too. She’d seen everything he had - without seeing herself undignified, unimportant or small.’
Upon my return, I have been asked half-jokingly if the trip was life-changing. At the risk of disappointing people, I would say it was not. Nevertheless, it was certainly an incredible life experience. There has been a change, and I think it is a deeper commitment to help. I will continue to work with LINCCO, hopefully a little harder. I knew the impact it had before going, but now I have felt it in a much deeper way.
And if you want to help, here are two small things you can do. LINCCO has an e-newsletter that comes out three times a year. Send me your email and I will add you - [email protected]. You will see our progress helping Monkole and our other projects.
And you can also go through the rest of my website and consider purchasing some of my art. All the sales go to LINCCO.
Thanks for reading!
The nursing school started in 1996, now with 50 graduates every year and a residence for the students. LINCCO is helping ISSI set up its Master’s in Nursing Program, the first in the country. It’s taking time to get traction, but that has never stopped them in the past.
When I interviewed Marcia Restiffe, the School Director, she underlined that training nurses saves lives. In a country where the health care system is so minimal, it’s easy to see that the front line primary care that nurses provides makes a huge difference in people’s lives.
A related key program at Monkole is continuing education for health care professionals. Unfortunately in DRC, once a health care professional graduates, there is no system to keep their skills up to date. Monkole has a vibrant continuing education program for doctors, nurses, lab technicians. While it’s easy to focus on buildings and equipment, the need for well-trained personnel is as much a need. Without competent personnel, the buildings don’t really help.
Getting back to the health care needs of DRC, they are on a scale that is hard to imagine. The following compares some key indicators:
DRC Canada
Population (millions) 67 35
Life expectancy (years) 53 82
GDP/capita (US dollars) 680 42,000
Total government expenses on health/capita (US dollars) 26 4,800
Maternal mortality rate per 100,000 births 540 12
Under age five mortality rate per 1,000 births 102 5
These stats underline the importance of Monkole’s focus on maternal and paediatric care. The high maternal mortality rate is a result of absence of pre-natal care. That’s one focus of Monkole.
For pediatrics, one of Monkole’s specializations is orthopaedics. A common birth defect or deformity that develops is curvatures of the legs. The causes are either congenital or malnutrition that means the bones remain soft and bend. One of the physicians at Monkole specializes in correcting these deformations with amazing success rates. The ‘before’ photos are truly hard to look at.
Two other endemic diseases that affect children in particular are malaria and sickle cell disease, which are inter-related. Everyone gets malaria in this part of the world. It can knock out an adult for days. For a young child, it can be fatal. Proper treatments is necessary, potentially requiring hospitalization and medication. Sickle cell disease is potentially a result of a genetic resistance to malaria. In places like DRC, an estimated 2 per cent of the population have it. While more people are living longer, it requires ongoing medical attention and treatment but it is fatal over time.
For these and so many other services - HIV, tuberculosis - those affected are usually not in a position to pay for long-term, ongoing treatments. Monkole is a life-saver for them. People who can pay are asked to do so, but the vast majority pay a token amount.
With an inadequate national health care system, Monkole is a point of hope. It is exceptional in the DRC, but hopefully it is an exception that will become the rule some day. They are certainly working with other health care providers to raise standards and their nursing graduates are valued wherever they go.
Conclusion
In the weeks following my return, I bought a second hand book form the 1920s called ‘If I lived in Africa’. From today’s perspective, it’s cringe-worthy in its condescending view. But the title makes a point. Because I don’t live in Africa, my projection of how people should feel in the face of their material situation isn’t fair, it's what I would feel coming directly from Canada. And yes, I could never imagine myself living in their conditions, but regardless of my projection, they get on with their lives. As one of my colleagues put it when I described my trip, they are just as unhappy as we are. While not a very hopeful observation, there is some truth in it. They certainly have to face death, hardship and suffering on a more frequent basis than us, but that doesn’t stop them from living and trying to enjoy life just as we do.
I read Ghana must Go by Taiye Selasi while I was there and it gave me some insights into their mindset. While set in a different country, there was a passage that helped me potentially understand how they view the world. It’s a flashback scene of one of the main characters in his village as a youth as his sister is dying: ‘The calm eyes of a child who had lived and died destitute and knows it, both accepting and defying the fact. With precisely the same heedlessness the world had shown her, and him, all dirt-poor children. The same disregard. Looking back at a world that considered her irrelevant with a look that said she considered the world irrelevant too. She’d seen everything he had - without seeing herself undignified, unimportant or small.’
Upon my return, I have been asked half-jokingly if the trip was life-changing. At the risk of disappointing people, I would say it was not. Nevertheless, it was certainly an incredible life experience. There has been a change, and I think it is a deeper commitment to help. I will continue to work with LINCCO, hopefully a little harder. I knew the impact it had before going, but now I have felt it in a much deeper way.
And if you want to help, here are two small things you can do. LINCCO has an e-newsletter that comes out three times a year. Send me your email and I will add you - [email protected]. You will see our progress helping Monkole and our other projects.
And you can also go through the rest of my website and consider purchasing some of my art. All the sales go to LINCCO.
Thanks for reading!