Democratic Republic of Congo, Day 1

I'm a few days late in posting, but rest assured, I did write this post on the day it should have been published (which in this case was Monday, March 11). Here it is:

After a long day of traveling yesterday, we arrived in Kinshasa around 10 pm local time. By the time we got to the hotel (which is very nice, by the way), it was almost midnight, and I went to bed right away. Because I was tired from a very long day of traveling.

My room in the Flueve Hotel

Today started by formally signing into the embassy and receiving the RSO (Regional Security Office) brief. Since it is the Democratic Republic of Congo and there are a number of security concerns, we listened carefully for anything of note. Before the mission, we received a warning of anticipated protests at the return of the defeated presidential candidate (who declares that he was actually the winner and has a following that does the same), but that didn’t happen. What we did note was that police officers are known to be corrupt, believed to be due to low pay and low training, and are to be avoided at all costs, as all they usually want from westerners is bribe money. We also learned that photography was illegal until recently, and still is in and around government facilities, and is still frowned upon, so if I don’t give very good pictures from this trip, that’s why.

The first real meeting of the day was with the AFRICOM training advisor and the Deputy Chief of Mission, where we learned that the Ministry of Defense (MOD) is not organized well, but the medical corps is better than most departments within the MOD. The key issues all revolve around logistics, because things are too expensive, too difficult to get out of Kinshasa (due to lack of roads in most of the country), and hoarding is an issue.

Following the embassy, we headed out to the MOD, where we first met with COL Kambale, the Director of Military Cooperation. He didn’t have too much to offer. The second meeting was with COL Louis Kakudji Ilunga, MD, the Deputy Surgeon General. He identified four disease surveillance programs within the MOD: malaria, HIV, TB, and cardiovascular disease. I don’t know how robust these programs are (with the exception of the HIV program, which is funded, monitored, and run by US DoD programs), but if the MEDRETE happens, these will be the areas that we focus on. Pretty much, all I learned is that their disease surveillance is low, consisting of monthly reports of disease counts. This doesn’t really mean much, because I don’t think that they follow trends or even take into account denominator data of the overall population (troops, dependents, etc) who are at risk.

The final meeting of the day was with the medical director of Clinique Kinoise, the first public hospital in DRC, built after independence in 1966. It is currently in very poor shape, with a roof with structural problems, electricity that is unreliable, and no running water. It is a 300 bed facility with 4 ORs, but there are around 3 surgeries/week, approx. 10 inpatients currently, and an average of 15 patients seen in the outpatient clinics daily. The medical director does have grand plans for the hospital, all of which would require significant donor equipment and funds, and is unlikely to be maintainable without significant outside assistance. It is unlikely that we will use this at the clinical site for the MEDRETE, because there’s really not much to see or do, with such a low patient count.

Clinique Kinoise. Lovely, isn't it? Oh, and there's no elevator, in case you were wondering.

In all, pretty long and exhausting day, and I was glad to be able to get back to the hotel to go for a run (on the treadmill) and sit by the pool to work on my sunburn (because it would be embarrassing if I returned to Savannah without any color to me).