How our second fistula campaign came to be in Vanga. It shouldn’t have happened. But God broke down the barriers one by one. This blog meanders but stick with it and I promise you will be amazed as well. God cares about the details.
Shortly after Whitney’s birth, as we were contemplating our last few months in Africa for this season in our family, Dr. Tim Rice made an interesting proposition. If you don’t remember Tim, you probably haven’t been following our journey, but I’ll remind you. Tim is the Saint Louis University doc that I first went to Congo with in 2012. For 2.5 yrs, our families were inseparable. We went to language school together and then were in Vanga, DRC until our family moved to Togo. We’ve stayed in close communication, and their family has visited us in Togo, Kenya, and on brief stays in the US. Tim’s proposition was for our family to make a stop in Vanga “on our way” back to the US.
|Whitney had never been to Vanga|
Tim, now the medical director at Vanga Hospital, had a critical conversation with Dr. Paulin Kapaya, a urologist living and working in Kinshasa at St Joseph’s Hospital. Dr. Paulin had received part of his medical education in Vanga, and he had been part of the fistula team led by Dr. Delores back in the summer of 2016. (Read about that in my blog “Realizing the dream.”) Tim and Paulin met and discussed the plight of women in that area of Congo, along with the capacity of Vanga Hospital to potentially become a center for fistula care. Many women had been transferred, at great expense and inconvenience to families, to get fistulas repaired in Kinshasa at St. Joseph’s. The alternative was to repair these childbirth injuries during local fistula campaigns. Considering the success of the first campaign, it was certainly possible to do it again in Vanga instead of continuing to pay for them to travel to the capital.
|Rivers are a major means of transportation|
Dr. Tim’s question to me was whether we could make it a priority to come to Vanga in order to be part of the surgical team for a fistula campaign. At the same time, our family could come back to a much more peaceful setting (than when we left) and see our beloved househelp, the midwives we had taught, the maternity nurses, the students and doctors who are our friends, the place where Zack was born, and the place where part of my heart will probably always stay. It seemed like a pipe dream, but we promised Tim to check on the possibility.
Samaritan’s Purse gave us the approval to travel for the fistula campaign. Step one of many completed. We needed to get our Congo visas. They are notoriously difficult to obtain. Normally, they must be applied for in one’s passport country. Living in Kenya, this would mean sending our passports by mail to the US and back. Also, they may or may not approve a visa, and the reasons for refusal are not often known. The time it takes to obtain the visa is not consistent. It is a reminder of just how difficult it can be to live in Congo and dealing with the uncertainty of a process.
As I described in my blog about Whitney’s surgery, her paperwork and documentation all needed to be in order prior to our quick trip to the US for my younger brother’s wedding in October. We absolutely did not want to miss that wedding because her passport was in the mail or waiting on the DRC visa in Washington DC. We were thus unable to apply for the visas until after our family’s October trip. There was a short window between the October trip and her original surgery date, and this was the window we needed to apply for the visas.
I prepared all the documents, gathered the passports, wrote down the address for the US embassy, looked up the DHL office location, hired a taxi driver for the day, and headed to Nairobi with Whitney on a mission to get our visas applied for. There was a slim, minute chance that I would be able to apply for the visas in Kenya because we were Kenyan residents, but I wasn’t holding my breath. We drove to the central business district to a nondescript office building, and I let the taxi driver know that I would call him once I figured something out.
The DRC embassy was on the 12th floor. Other than a large Congolese flag, it was hard to know that I was in the correct place. A small waiting room with one desk was on the right, and two or three locked doors flanked the small hallway. That was it. The process was unclear, but that isn’t surprising. I sat down with Whitney and waited for someone to come to the desk. A business woman entered and took her place behind the desk and I waited for the other people in the room to make a move. They sat there. Finally, I went up and presented my documents. She looked at them and said, “Oh, these are the wrong forms.” Face palm. That’s five copies of unnecessary paperwork. Sigh. She looked at the baby in my arms and offered to help me fill a couple of them out. One of the other ladies in the waiting room offered to hold Whitney. I started working on filling out the exact same information (in the same order too) on a form that looked very similar. Sigh.
As she was going through Whitney’s information, she noted that Whitney did not have a dependent’s pass that was valid for 6 months after our trip to Congo. I explained that we would be going on to the US and not coming back to Kenya. She said it was the rule. She went out to talk with her boss. I waited, praying fervently that there would somehow be favor. Her boss came in and talked with me, saying they could probably get visas for all of us except Whitney. Would I be willing to travel without the baby? They assumed not. And here I was stressed that our residency cards had expired, and we were all on residency extensions. But instead we were dealing with a problem with Whitney’s residency status. They went again behind closed doors to talk with someone else.
My hope dwindled. I continued to pray. I really didn’t want to be spending all this time in this office just to turn around and have to spend time and money finding the DHL office and sending our passports into the oblivion that is international mail. Yikes. They came back at one point and asked me for our old passports. More prayer. More waiting. Finally, the boss came back. She said, to my surprise, “Looks like you guys are still considered residents of Congo with your 5 year permits which expire in 2020. So we will allow your baby to come as well. Just go pay the application fee and the visas should be ready by Monday.”
I could hardly believe it!! Not only could we get this done in Kenya and not risk losing passports in the mail, but we also knew for certain that our applications were approved before we paid, and we could plan our trip for the fistula campaign with certainty. A minor benefit was that the visas would be ready in 3 days instead of the 10 days which is clearly written in multiple places as the processing time. I praised the Lord over and over again and still am in awe of this little miracle confirming our trip to Congo was in God’s will for us. Step two complete.
|Last school assembly at RVA|
In order to apply for a Congolese visa, we needed to have flights reserved coming and going to Kinshasa. Step three complete, or so we thought. We turned all our attention on getting through Whitney’s surgery and finishing well at the school, both monumental tasks which I tried to describe in my last blog. After the successful surgery and easier than expected healing period, we strove to say goodbyes well, packing up our lives into 4 checked bags (not counting some bags which others volunteered to carry for us at various times throughout the year). The night before we left for Congo, as Ryan was checking into our flights, he realized we had overlooked a crucial detail in our busyness. We hadn’t actually booked our tickets!
We are so thankful that Ryan was checking in online 24 hrs ahead of time and that the US is in the middle of a work day as we are going to bed. Though extremely stressful, on top of our baseline stress, after 4 hours we had confirmed tickets to Congo. Whew. Step three actually complete. Our flight to Congo was uneventful, other than seeing two men riding camels on the side of the freeway going north. We joked that they were going to find the Christ child as it was early December and they were headed in the direction of Bethlehem. 😊
|In Kinshasa seeing some of our best doctor friends, former neighbors in Vanga|
|Our kids got to know each other too :) Zack was born a month after their oldest|
We made it to Kinshasa. After a day of rest and reunion with several Congolese friends who had moved to the capital in our absence, we joined up with Dr. Kapaya and the Rices for the flight to Vanga. Grass runway, hundreds of kids, and a friendlier governmental process awaited us. Several midwives I had taught were overjoyed to see me. The reunions and memories they conjured were at once joyful, painful, sweet and healing. We walked the same paths we had walked before, showed the kids where Zack was born, where Sydney chased piglets, where Grandpa made the swing for Sydney, where we had pizza nights at the Brothers, where we sat on the porch swing overlooking the Kwilu, and of course, the Kwilu River where we swam most afternoons/evenings.
|Grass runway and Vanga village. Kwilu River and Vanga Mission and Hospital at the top|
|Greeted at the airport/runway by former midwife students :)|
|Greeting hospital staff on our arrival. Can you see that the sun is hot?|
|Swimming in the Kwilu again!|
|Aunt Kathy reading stories. Kids' happy place|
|Whitney learned to sit in Vanga|
|The Kwilu River. Upriver by several hours is the city of Kikwit.|
If I understood correctly, the UNFPA had allotted money for a fistula campaign in the nearest large city of Kikwit for the 2018 year. Nothing had been organized nor was this widely known when we started making plans for the fistula work in earnest in Vanga this fall. Health officials in Kikwit called St Joseph’s Hospital to find out Dr. Delores’s availability, only to be told that she was out of the country and Dr. Kapaya was her backup. They contacted Dr. Kapaya. He was already committed to the fistula work in Vanga, a non-governmental hospital with private funding separate from the UNFPA. They ordered Dr. Kapaya NOT to come do the fistula campaign in Vanga. He was called in by the provincial health minister and told, in no uncertain terms, that this would jeopardize their need for the fistula campaign in Kikwit. No fistula campaign. No funding from the UNFPA.
Dr. Kapaya told the health minister that he had already committed to Vanga and could not turn his back on “his community.” This relational aspect is a much stronger component in Africa than it ever would be in the West. The health minister contacted St. Joseph’s Hospital to try to force his hand. St. Joseph’s then told Dr. Kapaya that he was not permitted to do this fistula work in Vanga. Dr. Kapaya solved this by taking a leave of absence without pay and carried a document that stated he was not getting paid by the hospital during this time. He kept it with him during the fistula campaign.
Officials in Kikwit also contacted other doctors at Vanga and told them not to do the fistula campaign. Dr. Kapaya was even told to gather all the patients who were planned for surgery in Vanga and transport them from Vanga to Kikwit. Money talks. The UN has money. Our private funding through donors was not nearly as profitable for the doctors or hospitals who have big organizations involved with their funding. There was an invisible war on, and it sadly had nothing to do with the plight of the women suffering from obstetric fistula. The love of money is the root of all evils, right? Well, evil did not have the upper hand. Dr. Kapaya was faithful to his word to Dr. Rice and to Vanga, and we went ahead with the campaign in Vanga despite the obstacles!
|Papa Modja, nurse anesthetist and head of the operating room,|
consults with Dr. Paulin Kapaya and me as we get a game plan for the week.
The women came from far away villages. We transported 4 of them by airplane, and 6 came by motorcycle from a remote hospital. They had suffered from urinary incontinence for 3 months up to 40 years, and some had previously had attempted repairs 2 or 3 times. It was a busy week. In all, we operated on 32 patients with incontinence or prolapse, 26 for true obstetric fistulas. It was a great atmosphere and we had camaraderie. He was a urologist and I am a gynecologist. He preferentially operated on the abdominal cases and I did the vaginal cases. The tables are in the same operating room, so he would come and verify my work or make suggestions on difficult cases, but I was working primarily with my assistants as he worked on the most complex cases, some involving ureteric reimplantation or flaps. It was a great confidence boost for me as I’d been out of practice for many months after Whitney was born. Fistula surgery is technically difficult on any day. Praise God for His guiding my hands.
|Dr Paulin Kapaya|
|Whitney got plenty of time in the operating room as |
I needed to feed her regularly while operating all day.
Mama Lutti, our previous Congolese nanny, easily got into the swing of things again with the kids, falling in love with Whitney immediately. Zack and Sydney enjoyed romping around outside in the sand and mud, climbing on the huge fallen tree and playing with Aunt Kathy’s legos and reading books. Ryan mostly hung around the house with the kids but took them exploring several times. We got out on the Kwilu River with Tim’s awesome powered dugout canoe a couple of times, and at the end of the busy fistula surgery week, we had a picnic at Lunungo Beach.
|Whitney trying Tata Mbuta's pizza. He was our cook and now the Rices employ him|
|Chilling with Mama Lutti|
|Outdoor bathtime because it was hot!|
|Making sugar cookies!|
|Picnic with the fistula team at Lunungo Beach|
I was called to the hospital at night a couple of times during the week for catheters that had fallen out, but other than those couple of concerns, our patients did great. They stayed in Vanga for quite a while, getting fed through the nutrition center to help their healing tissues. We tried to avoid a long motorcycle drive back to the villages by providing transport in a vehicle, and just this month we heard back from the women who had been transported by plane. “The women, when they arrived back at Kikongo, were very, very excited by the results and immediately headed back to their villages to celebrate their recovery.”
|Rounding on patients post-op|
|Dugout canoe with an outboard motor|
|A perfect getaway on the Kwilu!|
|Getting ready to fly out|