A tale of three trucks

When we were with Christine's sister, and her husband Jim, recently, we realized that we hadn't given you feedback on the 3 trucks - and the amazing stories surrounding each and every one of those trucks! These stories are a testament to the prayers of God's people (you!), so we wanted to share them. 

In our last blog we mentioned the 40 foot container truck going from Nairobi (Kenya) to Bunia (RD Congo). Shortly before the truck reached the border our country director shared a local news story with a photo of about 500 trucks stuck on the road between the border and Bunia!! So we were really praying on this side as well! The truck arrived at the border post without problem, and we wondered how the passage to Bunia would go. We didn't hear anything for a couple of day, and then we heard that the truck had arrived in Bunia! We have no idea how the passage to Bunia transpired, but we are so grateful that it arrived without major incident! We don't think it got stuck at all!

The truck going to Butembo had its own challenges. It made it to the border without any problem. But after being cleared the clearing agent told us that customs was requesting an armed escort for the truck as some trucks had been attacked on that road, merchandise stolen and the trucks burned. When we talked with the head of the base, he hadn't really heard of armed escorts of trucks. Armed escorts are a big issue for humanitarian aid (and they are systematic, in Somalia, for instance). So there was discussion with headquarters about whether or not we should accept this request (part of the equation in taking a decision had to do with whether or not the requesters could do the hijacking if we didn't accede to their request). Finally HQ said we could go ahead with the armed escort, and the truck arrived safely in Butembo. 

Unfortunately, that was not the end of the Butembo story. As there were no customs officials who came from the border with the truck, the local customs officials in Butembo sealed the warehouse into which we put this medicine and would not allow Medair to use the supplies. This was obviously a challenge, and it took us another week to get the warehouse unsealed. We had to bring customs officials from the border to unseal the warehouse. 

The third truck was sent to Goma. It was the first to arrive at the border, and all seemed to be progressing well. The customs clearing process had nearly finished when Phil got a message from the customs clearing agency saying that customs was requiring that another government agency sign off on the duty free exclusion. He said that it could take a month to get that approval! Phil was super busy when he received this email, but he felt an urge to simply send the clearing agent this verse: "I am sending you out like sheep among wolves. Therefore be as shrewd as snakes and as innocent as doves." (Mt 10:16, NIV). About an hour later Phil got an email back from the clearing agent saying, "God has answered your prayers. The file has just been validated. We're finalizing the OCC formalities, then we'll take the truck out." We got the truck the next day and unloaded it into our warehouse. 

So you see just how important your prayers are! In fact, the clearing agency said that it was a miracle that our 3 trucks were cleared so quickly, because it has been taking up to 3 months to clear cargo! Phil contacted a colleague from Médecins Sans Frontière (MSF) who confirmed with him that they are spending at least 3 months to clear cargo. Thank you for your constant prayers (even when we are unfaithful in reporting back 😓). 

This week the new Deputy Logs Managwer shared this image with me: 

Maybe this is an appropiate way to end the stories of the Lord bringing us our 3 trucks of supplies from Nairobi!

In our Advent devotional this week, this was said: "When we cry out to God just as Jesus did in the Garden of Gethsemane “God take this cup from me” (Luke 22:42) our voice joins the chorus of the fellowship of the afflicted." This really resonates with us. In this season when we await the coming of the baby Jesus again, we are thankful to be able to be your voices joining the fellowship of the afflicted in Eastern Congo! 

The Father showed us the way - He gave his Son with us to share in our afflictions. May the Lord use us all to walk along with the afflicted in this Advent season! If you desire to do that through Medair, you can make a donation at medair.org. 

Praise:

1. Since Rudi his green card, he and Annika will be spending Christmas in Albania with Rudi's family. It has been nearly 5 years since Rudi has been home to Albania. He lost his grandfather during this time. So we are thankful they can be with family in Albania together!
2. Presidential campaign season has been relatively calm thus far. It is likely to be highly contentious when the results are announced (if the election isn't delayed) on the 15th of January. 
3. For good time in Tanzania with Christine's sister and husband. We got to visit the hospital where Christine was born, the market she remembers as a kid, and other notable landmarks. 
4. For awareness-raising during the 16 days of activism against violence against women (which will be the subject of another blog). 

Prayer: 

1. For elections to come off peacefully on Dec. 20 (this might take a miracle!)
2. For us to be able to get other needed supplies from Nairobi to Congo - and cleared!
3. For peace for Congo during this period of elections. 
4. For Medair to be able to continue to stand in the gap with the afflicted, the harassed and the destitute

More on the humanitarian air bridge - making pesto!

 

We wanted to simply send you this article about the air bridge: Medair Germany Air Bridge article - your browser should ask you if you want the article translated into English. Google does an admirable job in translating such an article. 

The rains have started!

I also want to ask that you be in prayer for 3 trucks that are going from Nairobi directly to our three bases in Bunia, Butembo and Goma with (as always) much needed medical and nutrition supplies! As you can see in the photo the rains have started in Eastern Congo, making reaching those we serve more difficult. This is one of our vehicles that went to take supplies to a health facility. On the way back, they struggled to make it through the mud. 

The truck going to Bunia is a truck with a 40-foot container on it. The road between the border and Bunia is really problematic - there have been a lot of vehicles getting stuck. So this is the one which really needs your prayers!

Yesterday we did something we have never done before in Congo - we made pesto! We had planted basil plants some time ago, but have only now gotten to actually making some pesto. Raising basil to make pesto was one of my favorite activities for the 7 years that we lived in the States and had a garden. I have fond memories of spending much of an entire day making pesto and freezing most of it (we enjoyed it well into the Winter - maybe even the 

spring)! We didn't make nearly that much this time, but it is a wonderful taste from home (borrowed from Italy)! We don't talk a lot about our life here in Goma. but this gives you a snapshot of one non-work activity!

Praise:

1. Rudi got his SS card and green card in the last 10 days - got it in record time!
2. Again, thanks for the arrival of supplies from Europe!
3. For our children doing well - one just got over COVID (which seems to be surging in the US)
4. For Christine getting a new Community Engagement Manager (Joel DJONGA), and Phil getting a Deputy Logs Manager hired (Aimé KUMBOKO). Please pray for these new staff! They should both help us to be able to get more done!

Prayer: 

1. For safety for Medair staff working in locations where the security situation can change rapidly
2. For our 3 trucks to be able to make it through customs quickly and move on to their respective bases successfully!
3. For Christine and other staff involved in writing project proposals for new funding for next year. Part of working in humanitarian aid is that project funding cycles are 1-2 years, which means proposal work is fairly continuous. 

Supplies from heaven....well, from Europe (but if feels like they have come from heaven to me)!

 Greetings from Goma!

We have just returned from time with the kids in MN (and just in the knick of time since Rudi & Annika have already moved to GA where Annika has started her Master's in public health and Nathan & Anna move to Boston at the end of the month so Anna can start her MDiv). Leaving only Lydia and Bri in MN. We left the States on Thursday. 

On Thursday I got the above video (showing them unloading Medair's supplies from the plane), and the

Ready to Use Therapeutique Food (RUTF) on its
way to our warehouse

following images, from my Senior Logs Officer, Jean-Louis MUSIMBI. Before I left, the coordination logs team was working on ordering supplies from Europe! We don't generally do this, except for urgently needed supplies that we can't find anywhere (because the shipping is so expensive)! But on Thursday the 3rd European air bridge flight arrived in Congo (to help humanitarian aid organizations get much needed supplies to the people we serve). These flights were arranged by the European Humanitarian Organisation. As it turned out there was not as much demand for this flight, so Medair was able to ship some very heavy nutritional inputs that normally are not accepted on these flights! I am, as they say, over the moon. 

Besides the RUTF, we were able to get therapeutique milk and resomal, all three used in the treatment of malnutrition (which we see too much of in displaced persons). These products are super dense and heavy, so when I left we were unsure that we would be able to get any of these products on the flight. In the end we were able to ship all three! 

The stocks being offloaded into our warehouse

Besides these nutritional rehabilitation inputs (which we have been having a super hard time gettting - the global supply chain disruption continues), we also were able to procure a lot of essential medicines in the form of Interagency Emergency Health Kits. The contents of these kits were formulated by a consortium of humanitarian aid organisations, so they really respond to our needs on the ground. With these kits we will have not only essential medicines, but also some specialized medicines and medical equipment. As usual, we will supply these to health facilities with which we work in the emergency response. 

We thank the Lord who has helped us get these much needed supplies! Please celebrate with us these supplies which are truly heaven-sent! Thanks also for your ongoing prayers for the people we serve and for peace in Eastern Congo!

Tippy Taps......running water - well, kind of....

A young boy activating the
tippy tap with his foot

I, Christine, went out this week to Kibati, to see what the community engagement (CE) team has been able to achieve in one of the informal camps for displaced persons. The CE team works along side Medair's Water and Sanitation (WASH) team and the health team running the Cholera Treatment Unit (CTU), where people with cholera receive treatment. Cholera is a diarrheal disease where people can die of dehydration within 24 hours if not treated.  The CE team has been working at encouraging behaviours that help prevent cholera.  

We have already talked about the life-saving Oral Rehydration stations that the CE team has put in place in these different IDP camps where Medair is serving. We now want to introduce you to "tippy taps". Water in these informal settlements is a real problem. Kibati is on the side of a large volcano with no good source of water.  Many organizations are trucking water to the camp (including Medair). But good water remains scarce. At the same time, hand-washing is crucial to the prevention of cholera. Early in the cholera response, when discussing with displaced people about the importance of washing hands to prevent cholera, our teams were told that people were happy to wash their hands but had no water and no soap. So the CE team introduced tippy taps that are activated by a foot pedal. 

A young girl using her family's tippy tap

Having tippy taps is only the beginning of the battle. People have to believe that using them will help them to prevent cholera. When I got out to Kibati on Thursday, right away I went over to one of the shelters where a Tippy Tap was hanging. I asked the child there, 'what do you do with that thing?', she told me, 'I wash my hands', and proceeded to show me how she did so. I then asked, 'why do you wash your hands?', immediately she responded, 'to prevent cholera' as if it was something I should already know. It was really great to hear that response. I then talked to other children, asking questions about why and when they washed their hands. They enthusiastically showed me how they used their tippy taps at their own shelters as well as told me exactly when they needed to wash their hands (after using the toilet, before eating, when their hands are dirty). Hearing these answers from the children, who are often seen as change agents in communities (how many of us recognize that our kids are more willing to embrace change than we as adults?), was a confirmation that the hard work of the CE teams is bearing fruit. 

Tippy taps in front of every shelter!

 Fun fact: Tippy taps are considered an 'appropriate technology'  in settings where water is scarce. We had our own tippy tap outside our latrine when we lived in a village in Benin! 

Praise:

1. Annika and Rudi's wedding was a beautiful celebration on the 27th of May

2. For being able to get much needed essential medicines and nutrition supplies in over the last few weeks.

Prayer concern: 

1. Ongoing impact of these interventions after Medair and other NGOs withdraw from the IDP camps;

2.  IDPs are still not able to return home as armed groups are still active in their home areas. Prayers for peace and a resolution to the conflict

3. For safety for Medair staff working in locations where the security situation can change rapidly

A wedding, a graduation and housing

Annika and Rudi

Quite a lot has been happening in our family these days and we wanted to share a quick update.

A Wedding - Annika and Rudin will have their first little wedding on May 27th to be followed by a larger celebration at a later date. We are thrilled that they've made this decision. We first met Rudi at their graduation from Goshen College and he has become a very much loved member of the family. Phil and I had the opportunity to get to know Rudi's family in Albania, when we spent 2 months there in 2021. Annika moved to Akron, Ohio while Rudi was finishing up his Master's degree at Kent State, and both have been working for a local nonprofit Asia. In mid July they will move to Atlanta, as Annika will start her Masters in Public Health at Emory.

D&Y,  Anna, Lydz and Bri celebratring with Nathan

Nathan and Anna

Graduation - for the past two years Nathan has been doing a Masters in Development Practice. On May 13th he graduated from the U of MN's Humphrey School of Public Policy. As many of you know, Nathan is well known for 'collecting surrogate parents' in the absence of his own. Nathan invited our dear friends Dan & Yvonne to his graduation, and they so willingly came to support and encourage him, as they did so often while we all lived in South Africa. Nathan and Anna will move to Boston the end of August so that Anna can start her Masters of Divinity studies at Boston University. 

Housing - affordable - For the past year and a half Lydia has been working for Urban Home Works, a nonprofit focused on providing safe and affordable housing and encouraging home ownership opportunities for low to moderate income families. On the personal home front, Lydia and her partner, Bri, asked us if we'd be willing to have them move into our home (affordable), which we've been renting out, and test out their home renovating and design ideas. Bri works as an HR Coordinator in a company that provides HR Services to organisations looking to outsource this support.

 

Lydia and Bri

            

    Today, the 24th, Phil and I start the long trip back to the US to join the wedding celebration this weekend. We'll be in Akron for about 2 1/2 days before heading back to Kigali to recover for a couple of days before heading back to work commitments.     

We are looking forward immensely to this special occasion this weekend and the opportunity to be together as family as we welcome Rudi officially into the LD clan. We would love to stay longer but will have more time with family at the end of July when we'll have a month of leave. 

We ask for your prayers as we travel. And most especially we ask for your prayers for Annika and Rudi, as they make this commitment to each other in the very small gathered community of family and close friends. Yes, Rudi's parents will be coming from Albania!  A&R have chosen Micah 6:8, as their couple's verse, and were quite surprised to see a banner with that verse on it, hanging on the wall of the church where they will be married. Apparently it had been hidden behind something else. A beautiful confirmation for them of the verse they make their couple's verse as they embark on a lifetime together.                                                                       

What if you were an internally displaced person?

What is it like to be an internally displaced person (IDP) in Eastern Congo? Are IDPs like you and me? Do they have the same hopes and dreams that we have? Do they hope that their children will grow up to change the world? We love this story written by the Medair Comms Officer, Daniel: Vainqueur must live! The name of the child, who was treated in a Medair facility, is Vainqueur in French, which translates to winner, conqueror or overcomer! He has already had to overcome a number of things in his short life, due to ongoing conflict in his country. This story brings out the aspirations of his mother, Aline, for her children. 

The Bushagara IDP camp where Medair provides Health Care
@Daniel WAKANDU, Medair

The article contains this picture of the one-of-its-kind IDP camp in Bushagara. Officials in charge of managing the large influx of  IDPs saw the deplorable conditions in the informal camps where Vainqueur and his family were living. They planned this organized camp and then relocated IDPs from various informal camps. The health sector then chose Medair to provide health services in the camp. Bushagara is about 10 miles outside of Goma. 

Life in this and other camps isn't all rosy. Medair also supports a health center in Kibati. The blog post we wrote on the 9th of November described people fleeing to Kibati, where we have been working since that time. Last weekend, gunfire was heard right next to our cholera treatment center, on the outskirts of Kibati. The government staff, as well as the IDPs receiving treatment for cholera, all fled. Thankfully the fighting ceased, and the landlord of the treatment center got community members to protect the facility from looting. Those who fled returned over the next 2 days to finish treatment. This is the fragility of the situation that most IDPs live in. 

When we meet together as the Goma team on Tuesday evenings for devotions, we always look back at our prayer concerns from the previous week. Here are some of the answers to prayers we have had over the last while: 

A gathering with IDPs, to listen to their concerns and see how Medair
can best support them. 

1. Access to more sites here in Petit Nord Kivu (the province Goma is in) due to the security situaton improving;
2. Protection of the health center in Kibati;
3. Successful evacuation of Medair staff from Khartoum, given the situation in the Sudan;
4. Nutrition supplies being released from customs so that they can be used in our projects;
5. A Medair staff member successfully returning from his work site (Pinga), where he had been stranded due to insecurity stopping UN helicopter flights; 
6. Safety of Congolese staff who found themselves in a very insecure situation in Ituri province; 
7. A truck leaving Goma with supplies, passing through Rwanda and Uganda, before successfully reentering Congo to take supplies to our Butembo base; 
8. Provision of essential medicines, which are banned from importation into Congo, but which are in short supply within the country.

You can see that we rely on the Lord's providence on a daily basis for all that we do here (even if we don't find the time to always communicate these prayer concerns to you). We are humbled by the expressions of concern and prayer that we get from you through social media or email. And it means all the world to us that you support us, our colleagues, and our programming in prayer! Thanks from the bottom of our hearts!

Just one last story before we leave you. This morning one of the Medical Supervisors, who's currently in a very difficult to reach remote location, sent a photo and a caption to show that he was hiking 20 mins to the top of a hill to find cell phone coverage to check in with the team and send in weekly statistics. Our staff out in the field, are doing their best to support health facilities, in locations where other organisations do not go, demonstrating Medair's vision to 'reach the most vulnerable'. 

Update on Annika

Hello all,

A quick update on Annika. After being admitted to the hospital last night Annika was very relieved to not be put on a heparin drip (blood thinner) but rather was able to continue on the anticoagulant medicine that her regular doctor had prescribed to her earlier in the day. Her care team decided that she would not need surgery to remove any of the clots - they seemed to be in positions that were not so dangerous and with the medication would dissolve on their own over the next 3-6 months. She will be discharged this afternoon and will see a haemotologist as soon as she can to see if they can figure out what provoked these clots. It seems that she must have had clots for quite awhile as in the bottom of both lungs there is tissue that has died due to lack of blood flow. The pulmonologist assured Annika that the pain in both those spots would go away as the tissue regrows.

Lydia arrived safely from Minneapolis last night and has joined Rudi, Annika's boyfriend, in making sure Annika is getting lots of loving care. She is in much better spirits today and very relieved that she will not need surgery.

Thanks for the many many messages and prayers for Annika. She is really feeling loved and held up by all of you around the world.

Christine

Personal (Annika) and professional pain mixed

Today we got the news that our daughter, Annika, has blood clots both in one calf and in her lungs. As we speak, she is being admitted to hospital for these conditions. 

Annika was healed miraculously while we were ministering in South Africa. And we know that the God who healed her at that time has not changed an iota. As you can imagine, this is a difficult time for us, as parents, to be far from her. Lydia and Nathan are looking at how to surround Annika with the love of our family at this time. And Annika's boyfriend, Rudi, is with her. We are looking at the possibility of whether Christine can return to the States. But this is complicated both by the flights disturbances I have mentioned below, and visa considerations. 

It has been over a month since we last wrote. We wish we could say that things have gotten better for people in Eastern Congo, but that is simply not the case. One of our goals has always been to work ourselves out of a job. Unfortunately Medair's business is booming right now. We are adding new emergency responses every week in order to respond to the movement of people. We have health centers which we were supporting (as we have written about) which have been overtaken by the fighting, looted and everyone has fled. And so we are trying to support health facilities in the new areas to which the health staff have also fled, along with the displaced persons. 

It is disheartening to see the suffering. 

Along with the ongoing displacement of people due to fighting, in the last 2 weeks a UN helicopter was shot at, the pilot died immediately, and the co-pilot had to crash land the helicopter. We are thankful that there was not more loss of life, but the family of the pilot is is grieving this loss. On Sunday another helicopter was shot at, prompting the UN to cancel all flights. No one was hurt. Flights (at least of planes) have restarted again. But this helicopter on Sunday is one that our staff would use to return from a field location where there is currently no road access. So Medair is having to evaluate what to do about these staff at this time. 

We really appreciate your prayers at this time. The One who hears the groaning of our hearts when we don't have words to pray, hears your prayers. And we are thankful. 

Phil & Christine

A new emergency response in Bushagara

 As the fighting rages on, Medair has been asked by the health sector to provide health care in a newly set up camp, outside of Goma, for displaced persons (IDPs) from Rutshuru territory. These are families who have been living in more informal housing (like we have talked about in previous blogs) right along the main highway into town. Some are being moved into this camp, which has been set up with better shelters, more space and a safer environment. 

Needless to say, there was a lot that needed to be done in order for Medair to begin providing health care to these IDPs. Tents were provided by the World Health Organization. The ground had to be leveled in order to put them up. Drainage

had to be dug so that water didn't run through the two tents (it is raining every day here). Supplies (like chairs, desks, cabinets, office supplies and health supplies) had to be procured and delivered to the site. Staff needed to be allocated to this new site. Medicines from our stock, as well as from the medicines which just came into Congo from Nairobi (which you prayed for) are being used to stock this new health center. Oral Rehydration Solution (ORS) stations need to be set up here. And there needs to be awareness raising among the families being moved here so that they know the health facility exists, what services it will be offering and how they can benefit from those services. 

One of the prelimary tasks, which one might not think, about is the digging of a latrine. This is important for any health facility. But it is even more important for a facility which is targeting cholera prevention and treatment. The challenge in this location is that it was covered by lava from the Niyragongo volcano eruption in May 2021. So the digging of a latrine is really a challenge! On Friday this digging through lava rock was ongoing!

In our last blog we talked about the training of community health workers (CHWs) in Kibati for the cholera response. The training targetted 2 important pieces: cholera symptons, prevention and treatment at the cholera treatment center and how to run the SRO points.  Rutshuru is one of the agricultural centers for Eastern Congo. Residents had herds of cattle (which they had to leave). This is the territory from which Goma received much of its vegetable supply. The people are enterpreneurs, and very industrious. This article talks about the refugees making charcoal to sell in order to provide for their families - and the long term effect that could have on the area. 

During the training of the CHWs in Kibati, it suprised Christine to hear that they were serving a glass of milk during what we would generally call "tea break." Because these people had cows, they really prefer milk over tea and coffee. This is their preferred drink. So Medair provided milk for their, err,

A Medair ORS (SRO in French) station in Kibati 

"milk break"  (ask us sometime about production of gouda-like cheese in this area). IDPs are people like you and I, with their drink preferences, livelihoods that supported their families until they had to flee their homes (and those livelihoods) and hopes for the future - the difference is that many of these things have been put on hold by the fighting from which they now flee. 

For Christine, one of the tasks that occupied a lot of her time this past week was assuring the supplies needed for the ORS stations in Kibati for which the CHWs were trained to run. These stations will not only provide life-saving ORS to persons dehydrated by cholera, they serve as referral points to identify people needing to go to our Cholera Treatment Center (CTC). And CHWs continue with raising awareness of how people can prevent cholera. 

All these things are keeping us both busy! Thanks for walking alongside us as Medair walks alongside these people not only having to flee fighting, but also facing a cholera epidemic caused by the conditions in which they are living. We had hoped that the epidemic was subsiding earlier last week. But it is stubbornly persisting. 

Praise:

• For staff at all levels (at the bases and in the field) who largely gave up time off during the holidays and continue to work 6-7 days/week in order to care for IDPs
• Phil seems to have finally had healing from the sinus infection - and the asthma that it provoked is much better. We both walked to or from work a couple of times this past week - a good sign for him.
• Medicines and medical supplies were flown by helicopter this week to a health center in the IDP camp in Rhoo. Because of the fighting there is no way of reaching this area by road. This was a significant logistical challenge greatly aided by advocacy from the funder, ECHO. And these supplies will bring much needed relief to the IDPs there. 
• For the safety of staff working in the field, where security is uncertain and monitored constantly by Medair. 

Prayer:

• For the staff in Kibati treating cholera in the CTC and the team which will work in the community preventing cholera - for efficacy in their work and protection
• For ongoing wisdom for Christine as she provides leadership to the community engagement teams in all 3 locations - connecting well in communities is key to acceptance of Medair's presence as well as long term sustainability and ownership of this work
• Medair had a new project approved in the last couple of weeks which will see nutrition work extended to all health facilities in a couple of health zones. We will need to procure nutrition supplies urgently for this project - and the global supply chain for these supplies has been extremely contracted for the last year. We need a miracle!
• For a peace based on justice in Eastern Congo, and with its neighbors.
• For Medair to be able to respond safely to care for people who are suffering - particularly safety for our national staff who work in areas where the security situation can change rapidly

Straddling two different worlds - and trying to make sense of it

Happy New Year and Best Wishes - this greeting has been common as we returned to our work here in Goma on January 2.

Singing carols around the family puzzle

In thinking about the last couple of months it feels like we are straddling two very different worlds.  We spent the month of December in the very different world of the US where together with extended family and friends we celebrated my dad's eternal homecoming, where various members of the family picked up COVID19, where we adjusted travel plans to Ohio to beat the snowstorm to enjoy immensely time with our kids and their significant others over Christmas and where generally we were able to 'let go' of the realities of life and work here in the DRC for a full month. It was healing despite Phil catching COVID19 as well.

IDPs chased from their homes by the fighting

When we left the DRC the 1st of December to fly to the US, Medair's team in Goma was gearing up to support the health centre of Kibati on the outskirts of Goma, an area which had received a massive influx of IDPs (internally displaced people) fleeing fighting from an armed group.Upon returning we learned that an outbreak of cholera was officially declared mid-December in the IDP camps around Kibati. Medair worked hard to set up a CTC (cholera treatment center) which has been operational since the end of December.  Integral to any cholera treatment response is prevention. As the person managing community engagement efforts, my teams' efforts are critical to prevention at the community level. In wanting to prevent any disease it's important to to look at motivations and barriers to doing things like handwashing with soap - which is key to preventing cholera transmission. This meant doing a quick evaluation, so on my first day back on Jan 3 I made a trip out to Kibati, to meet with leaders to set up the evaluation. I would have loved to have taken photos to document and share what I was seeing, but did not feel comfortable doing so. All along the road, from the outskirts of Goma to where we reached the health centre in Kibati, IDP informal shelters lined the road. This was a distance of several miles.

The CTC being constructed. 

Last Thursday I conducted a 1 day training for the team using a rapid assessement tool used to orient hygiene strategies in humanitarian emergencies. Friday the team went out and spent several hours listening to people's stories, video recording how people wash their hands and leading focus group discussions looking at people's perception of their risk to getting cholera, their motivations behind prevention and to understand who they listen to in their community and how they hear information. 

All this data was then inputed into a software program which gave recommendations for our prevention strategy. We know already that most people do not have easy access to a handwashing point (let alone water for other purposes), that "site chiefs" are important community leaders, that people really want to be good parents and make sure their children stay healthy, and that they had 'normal' lives back home in the communities from which they fled (had work of some sort of work, had homes, had roles in their community, had friends and family, had hopes for the future). 

The CTC during Christine's visit the day after our arrival

By midweek we hope to have started implementing our prevention strategy throughout the different IDP camps which will include working with community health workers to raise awareness about cholera, holding community meetings, setting up ORS points (oral rehydration solution which treats the dehydration from cholera which can kill people within 24 hours left untreated) and implementing the recommendations from our quick evaluation. 

Upon returning we also learned that the shipment of medicines that Phil has been working to get from Kenya finally arrived in Bunia - 3 containers of much needed medicines. 

And back in the US, snow continues to fall, at least in Minnesota. It is a bit discombobulating to straddle two such different worlds. Yet we know that wherever we are, people face challenges and have hopes for good lives. In this new year of 2023 - may the Lord grant you meaning and all good things. 

Praise:

• Most of the last prayer concerns have been answered! Medicines arrived, guidance on interventions to respond to, customs convention signed the day before medicines arrived at the border from Kenya.
• For wonderful family time in the US and a really special Memorial service for my dad

Prayer:

• For Phil, who is recovering from a sinus infection
• For the staff in Kibati treating cholera in the CTC and the team which will work in the community preventing cholera - for efficacy in their work and protection
• For wisdom for Christine as she provides leadership to the community engagement teams in all 3 locations - connecting well in communities is key to acceptance of Medair's presence as well as longterm sustainability and ownership
• For quick resolution to the last hurdle for the 3 containers of medicine - negotiations with the equivalent of the FDA over how many samples they need to take
• For a peace based on justice in Eastern Congo, and with its neighbors.
• For Medair to be able to respond safely to care for people who are suffering - particularly safety for our national staff who work in areas where the security situation can change rapidly