Travel Advisory

Two weeks before our scheduled departure for our fistula campaign, DR Congo made world news. Goma, a city in the East of Congo with significant international presence despite its troubled history, had been overtaken by M23, a rebel group widely-known to be backed by Rwanda. Many lives were lost, horrendous tragedies unfolded, and a world largely distracted by chaos in Washington DC and Gaza and Ukraine suddenly remembered this country. Eastern Congo is a sort of place where conflict never really ceases, much like some areas in the Middle East. There are large deposits of highly-valuable minerals sought worldwide. Tribalism is rampant. Sexual violence is common. Terrorism of innocent villages to pillage and feed scores of men who are fighting is the norm, unfortunately. While none of this is new, the capture of Goma and the sudden advance of M23 caused protests and some destruction in Kinshasa, the capital located far away in the West. A travel warning went into effect, and the level 3: AVOID UNNECESSARY TRAVEL soon shifted to level 4: DO NOT TRAVEL.

What to do? Preparation for a fistula campaign begins months in advance, and scores of women were preparing to walk, float, and ride dugout canoes, motorcycles and planes to get to Vanga. Some of them were likely already waiting. Although Dr Paulin performed over 70 fistula surgeries last year without me, he was counting on my support. Fistula campaigns can be brutal in terms of workload, and the reality of the situation is that postponing the campaign this year would mean cancellation. We did that in 2020 during Covid, leaving 12 women waiting for our arrival, and I did not want any of these precious women to have to wait indefinitely for a chance at a cure.

Anxiety set in for me. I do not take travel warnings lightly. Already, Dr. Tim and Kathy Rice were not able to host us personally this year due to an unexpected stay in the US for healthcare. On top of this, I felt the weight of responsibility of directing the GYN resident and the medical student on my team. So, I prayed for clear guidance. I consulted my African friends, especially those with government connections or impartiality (without any involvement in the campaign). We have contacts at the US Embassy in Kinshasa. Word on the street was that things in Kinshasa, through which we travel on our way to the village in Vanga, were completely calm and normal after the initial unrest. Calm but tense. No one could guarantee that chaos would not return at any time, thus the travel ban, but every contact consistently said that life was going on as normal “for the moment.”

As I went about those last two weeks, my shoulders were granite slabs I carried around. If we needed to cancel, earlier was better. If we were continuing, there were so many tasks and messages, packing and supply-gathering to do, and I felt completely overwhelmed. Should I take this lack of peace as a sign from God, or was this unusual anxiety a sort of resistance from an evil source? Evil would not want hope and healing to reach these vulnerable women. With one week to go, I checked in more intentionally with my US team. Their responses through text brought the clarity and peace I needed. “If you feel comfortable then so do I!” and “If the travel advisory stays at a level 4 then I can’t get elective credit for the trip but that’s not a big deal to me.” Wow. I was so grateful to have their resolute responses.

Somehow, in the midst of single parenting that last week due to a work conference for Ryan, we were able to pack eight of nine suitcases full of surgical supplies. Tuesday, the day before our departure, I drove to pick up one last stash of supplies for the final bag. As I was driving, I glanced up at the message flashing on the highway sign: “WINTER STORM WEDNESDAY. TRAVEL NOT ADVISED.” We were supposed to drive to the airport and fly on Wednesday mid-day, and the snowstorm was to hit 2 hours before our scheduled flight. Sigh. What’s next? Oh, the warning about possible Ebola, the warning about Monkey Pox… it’s no wonder people have a hard time working in Congo. Not to be deterred, we called our travel agent and changed our flight to 0-dark thirty, adding not only 6 hours of travel time, but also peace of mind.

It was with extreme fatigue, yet satisfaction, that we arrived in the village on Friday. Travel was as smooth as I have ever experienced in  the Kinshasa airport, navigating the city of 17 million, and the formalities for the regional flight to Vanga. We collapsed, exhausted, in the guestrooms of the empty house of Dr. Rice. This was after walking from the airport, taking a short tour, and greeting the very excited staff of Vanga hospital. Sleep came quickly and deeply. Finally, prior to sunset, we took the courage to venture out again. We needed to greet the women suffering from fistula who were waiting for us. We had barely rounded the corner of the building where they all slept when we were greeted by excited cheers. As they streamed out of the large simple cinderblock room and filtered in from gathering firewood for the evening meal, they broke out into a song of greeting, dancing, clapping, smiling. And I cried. I couldn’t help it. The granite slabs dissolved and became my shoulders again. This. This is why we came. These women were why “WE MUST TRAVEL.”