Sunday, June 25, 2023

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

Monday, May 22, 2023

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.
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.                                                                       


Sunday, May 21, 2023

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'. 

Wednesday, March 1, 2023

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

Tuesday, February 28, 2023

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

Sunday, January 22, 2023

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

Sunday, January 8, 2023

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