Parting the Waters for a Fourth Fistula Campaign

 Preparing in earnest amidst uncertainty

Planning a fistula repair surgical campaign in the era of COVID was ambitious. While it is essential to plan quite far in advance, making announcements about the free surgery provided in remote villages only accessible by motorcycle or on foot or by boat, it is also very difficult to know for certain that all the pieces will be able to come together to be successful. At any moment, we had to both continue these preparations and realize that one misstep or change in protocol could cause it all to be for nothing. Just a few of the pieces were my ability to get time off work in the US, the availability of the Congolese urologist in Kinshasa and his willingness to travel, negative covid tests at multiple junctures, the recruitment of the patients, and the procurement of the necessary materials. It was especially hard to hear that 12 (TWELVE!) women had come to Vanga for the fistula campaign which was cancelled in May 2020 due to COVID. I can only assume that they had no communication about the global pandemic and the impossibility of travel at that time. It breaks my heart. I hate that women are suffering from constant urine leakage and childbirth injuries, much less that they had made such an effort to get to the hospital only to find everyone masked with precautions in place and no possibility of a cure at that moment. I prayed that these women would have the courage and faith to return amidst uncertainty.

Ladies gathered, waiting for the surgical team to arrive

We had been tentatively planning this since November, even as cases in the US were rising rapidly and no vaccine had yet been released, and it seemed like it may not happen. Even by the end of January with a significant delay in the documentation from the Congo side, I was skeptical that my visa would be back in time to be able to go. My other proposed teammate was forced to back out, and I was getting discouraged. However, I had peace to continue pursuing the visa just in case, so I sent all the documentation and my passport to the Congolese embassy in Washington D.C. on a Thursday morning. We were startled with a knock on the door on Saturday morning, and my heart sank as I saw the familiar envelope in the USPS worker’s hand. I must have forgotten some postage. But when I touched it, I only felt a passport. I ripped it open to find my passport with a visa stamped inside!! It was unreal, especially when it has taken months sometimes, and caused cancellations of other trips. One day. Perhaps I am one of only a few that were crazy enough to apply right now.

Ryan brought me to the airport. My superman has been so supportive. 

Another snafu

Travel to Kinshasa was uneventful other than a 2 hour unexplained delay in Togo. Having a negative covid test was certainly helpful. Masks were required except when eating. When we got off the plane in Kinshasa, we descended the steps, our temperature was taken, and we were herded into a crowded bus. The bus took us a short way across the tarmac to a temporary tent that had been set up. This was also crowded, but the process was to get our official covid test registration paper. After that bottleneck, we were led to a second tent where there were health workers in full PPE to take the mouth or nose swab. It was very efficiently done at that point. I exited that last tent and found myself outside in the dark, without clear indication where to go next. The building with lights on was a few yards away, and I remembered it was where our bus normally dropped us off for customs. Normal procedures here, stamping passports, etc, but NO line. Next was the health stop where they normally check for our yellow fever vaccination card and take our temps. It was all about covid now. No one checked for my yellow fever card. 

Ahh COVID

A prearranged taxi driver helped me get a luggage cart. We waited for luggage. In Africa, many people wrap assorted packages with rolls of plastic, like Saran wrap. This particular flight from Togo had more random balls of plastic than traditional suitcases. The result was that the normal luggage carousal was not well suited for rolling plastic balls. It became quite comical for me to watch as the conveyer belt spitting the luggage and plastic balls became clogged with the balls of plastic. Everything would stop. They’d extract the balls from the conveyer and restart, only to have the next round of balls clog it up again as they rolled cattywampus down the belt and encounter a normal suitcase. Eventually, they took the plastic balls to the overweight baggage area and the process normalized. All my bags arrived.

As we approached the place where they run our luggage through the machines one more time, to extract taxes where appropriate, I was bracing myself. Last time I brought an electrocautery machine into DRC, I was taken aside to a separate room and questioned. At that time, I had offered to give the machine to them if they wanted it as I was not trying to sell or gain anything from it. I had simply told them I was using it for the surgeries I was undertaking. They had let me go. This time, to my great relief, the passenger just before me in the luggage line made quite a stink about something, and they quite ignored my bags as they went through. We picked them up and got out the door without incident.

A beautiful place to rest

We drove through Kinshasa toward the house where I would be temporarily staying until I flew to the village. I noticed many people rushing about, more hurriedly than normal for this time of night. Then I saw groups of policemen and barricades. My taxi driver informed me that our plane had been 2 hours late, and thus we were fast approaching the curfew of 9pm set by the government. They were closing the highway as we were driving, right behind us. We passed at least 5 roadblocks being put up, and I found out that we would have been stopped and proof of flight required to get through. I was so grateful to avoid that step and additional time on the road, but I realize that my driver then was forced to sleep in his car as he could not return back to the airport through the barricades without a passenger. 

I had a day to rest and enjoy reconnecting with long-term missionaries at their house. The flight to the village was scheduled for the following day. The urologist, Dr. Paulin Kapaya, was prepared to leave as well, with a negative Covid test in hand. However, the MAF (Mission Aviation Fellowship) pilot for our flight to the village received a positive covid test the evening prior to our flight. We scrambled to decide what our options were. We could attempt to drive to the village, but it was too late to arrange for this. The simplest solution was to take another test and hope the first was a false positive. Due to the number of patients waiting for us, we could not afford to be delayed longer, so we also made preparations to drive. We would arrive exhausted and worn out, and thus, the road was not an ideal option. In the end, we received word of a negative test from the pilot, and we were able to get on a flight only 1 day delayed.

Just after landing, this was our crew. Top right: Vanga Hospital is close to the river

Moses

After touching down on the grass runway in our tiny, 4 seat airplane (including the pilot!), we were met with the usual crowd of village children and hospital personnel. However, there was not the usual Landcruiser. They informed us that the road had washed out. Good thing we hadn’t attempted the road! 

We then walked from the runway to the hospital, and a half a dozen people carried our suitcases and packages on their heads to help us. We went by the hospital, where there were joyous reunions and smiles all around. (The urologist was born in Vanga, went to nursing school there prior to med school, and still has family there. Likewise, I had lived in Vanga with our family for over a year.) 

The fistula patients and the family members who accompany them were waiting for us. During our introduction to the patients in their local language, I kept hearing the word, “Moses.” Indeed, like the Lord parted the water of the Red Sea for Israel to cross over on dry land, it felt like the Lord had parted the waters of Covid restrictions to make it possible for our team to arrive.