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