Saturday, September 29, 2007
Three Promises
I am normally very careful about making promises and I am certainly not given to making them when I am a visitor in another country. I learned early in life about the value of promises and yet while in Goma with Global Strategies for HIV Prevention I made three promises: one to John Bizi, one to Joseph Ciza and one to myself.
John Bizi
John Bizi is a very busy man at HEAL Africa; he is in charge of keeping the medical equipment in working order. This is no easy job. The equipment he has to work with comes from other’s cast offs from all over the world. The equipment that finally makes its way to Goma often arrives incomplete or without operating instructions and it is John’s business to try to figure out a way to make it work. He is gifted and tremendously skilled but some things are just too difficult without written instructions. This patient and generous biomedical engineer had one request of me and that was to encourage someone with a background in medical equipment to volunteer in Goma for a couple of weeks and work with him. I promised him I would put the word out. As we said our farewells he prayed for me, for my health for the journey home, for my family waiting for me and for God to send me back.
Joseph Ciza
I first met Joseph Ciza in Nigeria last November and spent 2 weeks with him in PMTCT training for Global Strategies for HIV Prevention. Seeing him again in his homeland of DR Congo was truly joyous. He is an amazing man of courage and compassion and his journey with God and HEAL Africa has led him into the tremendously dangerous work with the rebel armies of North Kivu province. Before we arrived in Goma he had held a 3 hour workshop with rebel soldiers on the topic of human rights and gender-based violence. I have never known a person like Joseph. We visited his home and met his wife and children and heard about his dreams for the future. My promise to Joseph was a silent one. I promised to pray without ceasing for his safety and the wellbeing of his family.
Me
As for my last promise, it was to myself. I didn’t know it then but it would be a promise that would be made easier by the movement of this people and place into the far reaches within my core. It’s almost like there has been a stretching out of memory deep within, making itself right at home in my heart; faces, stories, need, pain, joy, suffering all mixing into a poultice that covers me like a balm. So my promise is this: to remember all I have seen and all I have met and to give those memories feet.
Laura
Monday, September 17, 2007
Who Is...
First Presbyterian Church of Berkeley
Saturday, September 15, 2007
Morning in Mugunga Camp
Just 10 kilometers outside of Goma thousands of people are fleeing the fighting in the surrounding regions and are setting up camp in places like this. Click on the links below the photograph of Mugunga Camp to see a series of images capturing the growing tragedy of internally displaced people on the move in North Kivu (the provence where Goma is the capital). If you'd like to read a first hand account of what's happening in Mugunga click HERE for a post by Eric Nguyen who is in Goma right now building on the IT / networking efforts of Melissa Ho who was a part of the August Goma Team from First Pres. The estimate of the number of people who have fled their homes because of fighting between rival militias and the Congolese Army is now running as high as 600,000 people. The combatants include Laurent Nkunda's Congolese Tutsi militia who are fighting the Interahamwe (Rwandan Hutu rebels in the DR Congo since 1994), other warloards and the DR Congo Armed Forces. 18-19,000 UN Peacekeepers are in the Congo trying to create pockets of safety so that humanitarian workers can reach these people.

In an email this past Thursday (2 days ago) Lyn Lusi sent the photograph above and writes,
This is what happens to civilian victims of conflict: the UN negotiated a 'humanitarian corridor' to go up to Masisi centre and Jospeh Ciza (the Head of nursing at HEAL Africa) took the ambulance and emergency medical supplies. In Masisi hospital, he found this poor man who was shot last Saturday (six days ago!). The staff there had no dressings or supplies of any sort. Ciza brought him back to HEAL Africa in the ambulance. Despite the appalling smell, he does not have gangrene, thank God. Please pray for his recovery. This man is the lucky one. What about all the others...?
The rainy season is starting and at elevations above 5000 feet (Goma is at 1500 meters, around 4500 feet) it is getting wet and cold.
Please pray for peace in eastern Congo.
Tim
Friday, September 14, 2007
Eve Ensler Discusses Her Experience in Congo
In this August 27, 2007 interview Eve Ensler discusses her experience in eastern Congo. The city and the hospital she visited in Bukavu in May 2007 are on the south side of Lake Kivu. Goma, the city where our teams worked in August and September 2007, is on the north shore. Warning: This video contains disturbing verbal descriptions of sexual assaults.
Wednesday, September 12, 2007
September 7, 8 and 9
Thursday night was exceptionally stormy; it rained hard with thunder, lightning, and wind all night. It was nature making all the noise however not fighting. But the UN helicopter gun ships returning over the lake at dusk from the west drove home the point that this is a part of the world in conflict. Friday morning in Goma seemed just the same as other days, the streets had the same amount of activity and work at the hospital was unchanged. Goma seems safe but with this wet weather the conditions for the people displaced by the fighting another 2000 feet up in the hills must be very difficult.
Goma is on the northern tip of Lake Kivu, a huge lake which is part of a chain of lakes that run north-south through central Africa. It is about 5000 ft elevation, so it gets chilly at night. Just north of the city is an active volcano that still glows red on clear nights. In 2002 lava flows from this volcano destroyed much of the city, including the HEAL Africa hospital. Some of the city burned, like the hospital, and the rest was covered in many feet of lava. Most of the city rebuilt on top of the lava, but there is a section of the main street where the buildings remained intact, just buried. They just built another floor on top of the old second story. That section of the city looks eerily like the inland part of Banda Aceh where the main force of the tsunami wave had spent itself but as it receded it left behind a thick, black layer of mud from the ocean bottom. Most of the roads are still an obstacle course of jagged lava rocks. If I ever give up medicine and settle here I am going to open an auto tire dealership.
The hospital is a series of mostly small buildings, the largest 2 being the central hospital rooms for mostly pediatric and gynecological patients and the OR building. Across the street is the chapel, a row of buildings that include the pediatric HIV clinic, and the Jubilee Conference Center. It is a beautiful building with rich hardwood details and on the second floor a view which is the best in town of the perfectly shaped cinder cone of the volcano.
The house where the Luci’s live (Joe is the chief surgeon and Lyn is the program administrator) is where we all stay. It is right on the lake, west of the main town. It is a huge home with spare bedrooms galore for all the visitors; a large common dining/living room; a beautiful garden; and a covered porch by the lake where we have many of our common meals unless it is pouring rain. To sit under the porch watching the light change and the kingfishers dive for food and to listen to the waves or the rain on the metal roof and to realize that I am in Central Africa, in a place so troubled by violence, 9 times zones away from home is surreal at best.
The rest of the (second) team from 1st Pres- Art, Bridget, and Laura, left Friday morning. I miss them but there are other wonderful people to be in community with here. Besides I get to move into Art’s room where there is hot water. My work started with a talk at the General Hospital and another case presentation. This time a 9 year-old with chest pain who as far as I could tell had no evidence of a cardiac problem. It was the 4th time she had come in to the hospital for this in the last few months. The last time they had started her on digoxin. I tried to suggest that there were other reasons for chest pain in a 9 year-old with a normal cardiac exam, like living in such a stressful place, and maybe they should see how she did off digoxin. I then worked with Dr Vindu in the Pediatric HIV clinic the rest of the morning and early afternoon.
Saturday was a short morning pediatric HIV clinic but after clinic I went over to the hospital and the general pediatric clinic. There Dr. Denise and Dr. Amani, 2 other young MDs interested in pediatrics told me that before inpatient rounds that they had to tell the family of an 11 year old boy who had been losing weight that he is HIV positive. They wanted to translate my “consultation” with the family. Then they told me it was not part of their culture to just tell the family. I then said maybe I should learn how they did it so maybe they should tell the family and someone could translate for me. They said no they would rather I go ahead with the consultation. It was the mother and paternal uncle whom I told. The mother obviously got the implications for not only her son but herself and her other younger children. She made the comment that there was once a rumor that her husband had a second wife but she didn’t believe it. The family is not from Goma so if they wish to pursue treatment they would have to make a decision to relocate because we would have to see him regularly. We will see the family on Monday in clinic. Inpatient rounds included the 8 year-old boy with an abdominal infection from Thursday. We had expanded the antibiotic coverage by adding Flagyl, for anaerobic bacteria, and he was now without fever and had a much improved exam.
The rest of the day was spent relaxing; the highlight was a group of us visited a chimpanzee rehabilitation center about 100 meters down the road from the house. There were 3 baby chimps playing around the grounds. I am not sure that playing with humans is the best way to “rehabilitate “chimps but it sure was a trip to hold them.
Sunday was a day of rest. There was a beautiful sunrise over the lake silhouetting the mountains of western Rwanda behind it. We had a leisurely breakfast and then went to church. There is a chapel at the hospital where there is a 7:30 service in Swahili, which is mostly attended by the hospital patients, and a 9:00 service in French, which is mostly attended by the hospital staff. Everyone in their festive Sunday best filled the chapel and its annex to overflowing with prayer and song. Prayer and song that comes from a community that struggles in a physical environment of hardship that is beyond my understanding. The sermon was “Persevere- we are here because of the endurance of Another”. It was a moving 2 hours, especially during the prayers, even though I understood few of the words. The tradition here is for everyone to join in with their own prayer as the minister prays. As the mixture of languages and voices being raised in praise grew louder and louder I thought again, as I did at the beginning of this e-mail, of thunder. But this was the thunder of a glorious, bright, Sunday morning, a morning to celebrate The Light.
Blessings from Goma,
Randy
Monday, September 10, 2007
Another perspective - and technical update :)
For more info and updates, check out his blogs here:
http://mindtangle.net/2007/08/30/live-from-goma/
Melissa
Saturday, September 8, 2007
What I Received From the People of Goma and Central Africa

Some Reflections on Goma by Ryan Irmer (that's Mount Nyiragongo, the volcano that destroyed major portions of Goma in 2002, in the background):
I didn’t know what to expect when I made the decision to join the group led by Tim and Bridget to Goma, DRC. I remember hearing stories, looking at pictures and videos from my wife, Amelia’s, previous trip to
Thursday, September 6, 2007
More Images from Goma
Picture Captions:
Above: Children at HEAL Africa's school
Below:
(1) Ryan, Dan, Naomi, Paul and Sarah's bag (attached to Sarah) in Kigali, Rwanda on Sunday just before Dan found out that the clothes he is wearing in this picture would be the only clothes he would have until Thursday.
(2) Dan working out in Goma.
(3) Coach Irmer. Doing a little scouting??
(4) Naomi (who preferred "motos" to cars and vans).
(5) Melissa (when she was not climbing on top of one of HEAL Africa's buildings).
(6) Sarah and Stewart with matching, very cool, bracelets.
(7) Harper and Bridget who put it all together for us behind the scenes.
Wednesday, September 5, 2007
Two Updates from Goma
Dr. Art Ammann, the president of Global Strategies for HIV Prevention (the partner organization we went to Goma with) has been in
First – some news has been reaching the
Although we departed
We came as the second group – primarily an assessment overview team. Morgan Davis, the chair of the Global Strategies board of directors, and his wife Sandy, Congressman McDermott and his wife Therese from Washington State, Laura Sera, a nurse from FPCB and myself (Dr. Ammann). Assessments ranged from investigating the hospital needs to nursing educational needs and orphan programs. For everyone except Congressman McDermott and I, it was their first eye opening trip to the
The workshop for prevention of mother to child transmission of HIV finished with the support of the local Ministry of Health, a necessary requirement. The 24 nurses and 3 doctors have been certified. We are optimistic that our programs will move forward even in the face of rebel activity.
The third team is the medical team. Dr. John Schmaelzle, a urologist, arrived yesterday. It was also his first trip in the
Laura Sera is connecting. We hope to encourage a volunteer nursing program. She is meeting with nurses going to the nursing school, conducting training sessions with the nurses at
Next week is a full schedule of surgery, seeing patients, teaching and meeting with key individuals who we work with to manage our programs. These meetings are key as they are the individuals who keep things going when we are not here.
Bridget Nolan as been responsible for all of the coordination of all three teams – a daunting task. We are appreciative of her skills and patience in carrying out the complex logistics of travel, accommodations, water supply , medicines, meetings, phoning, and emails. With over 25 people ranging from pastors to nurses, doctors, internet experts, business men and a congressman, over a 4 week period she is challenged daily.
Pray for strength for the people visiting, and for safety and wisdom. Pray for the people here who are encouraged by those who came but must remain under difficult circumstances.
Sincerely -
Arthur J. Ammann, MD, President
________________
When Jesus saw the crippled man lying by the
We were reminded of the man who waited by the pool of
It was also Randy Bergen’s first time in the
Laura Sera continues to connect in Goma. She is giving her second lecture right now to the nursing staff and tomorrow will be working in a well baby clinic before going to meet with the local nursing school. Her trip and the contacts she’s made have reiterated the important need for continuing education for nurses and their enthusiastic response to a nurse educator like Laura coming to teach new skills. Many sentences with regard to Laura start with “When you come back…”
From Laura…
Children have a hard life in
I have also been talking with a young boy at
We finish our stay in Goma in several days. The commitment of these people is extraordinary. Their needs sometimes so great that we don’t know where to begin. We pray for our health care workers who attended our workshop who must now return to there homes in rebel held regions. Joseph Ciza, an amazing nurse called in advance and talked to one of the rebel leaders to request that our health care workers be kept safe. This area of the
Sincerely -
Arthur J. Ammann, MD, President
Monday, September 3, 2007
Children of Congo
Lumo
Don't miss the nationwide broadcast of "Lumo" on PBS beginning September 18. This is a documentary about the work of HEAL Africa told through the experience of one woman.
PBS Press Release: In eastern Congo, vying militias, armies, and bandits use sexual assault as a weapon of terror. Lumo Sinai was just over 20 when marauding soldiers attacked her. A fistula, common among victims of violent rape, rendered her incontinent and threatens her ability to bear children. Rejected by her fiancé and cast aside by her family, she awaits reconstructive surgery. "Lumo" is her story, tragic for its cruelties but also inspiring for the struggle she wages and the dignity she displays, with the help of an extraordinary African hospital, to overcome shame, fear and the affliction that robs her of a normal life.
The Goma Team along with Global Strategies for HIV Prevention will host a special preview presentation of this important film on Sunday, September 16 at 7:00 PM at First Pres in G 202. Our full team report about our time in Goma will be presented on October 14 at 12:15 PM and 6:30 PM in G 202. Our church serves a lunch and a dinner every Sunday, so pick up a meal for $5 and head on over to the presentation. The meals are served in Westminster Hall and the report will be made on the second floor of Geneva Hall on the campus of First Pres. Berkeley.
See an excerpt of "Lumo" online by clicking HERE. Select PREVIEW once at the Goma Film Project's website. If you live in the San Francisco Bay Area you can watch "Lumo" on KQED Channel 9 on Tuesday, September 18 at 11:00 PM.
Images from Goma



Children at Femmes Plus, a ministry to widows, their children and AIDS orphans supported by HEAL Africa . When Ryan Irmer pulled out a soccer ball these kids went nuts!



Paul Yeager leading a training seminar for doctors, nurses and staff of HEAL Africa about providing pastoral care to patients. That's our friend Pastor Samuel doing the work of translating.

On the right is Stewart Lunanga, another one of our translators, who made it possible for people to understand our sermons, receive our pastoral care and benefit from Ryan's coaching tips on the basketball court. He speaks English, French, Swahili and German. He would like to go to college and study engineering (he's interested in hydroelectric power generation). He is a great guy.

Melissa Ho with women from the Grounds for Hope community. They cheered when SHE got up in front of them to preach a sermon! They passionately worshiped God in the face of great disappointment.


Here are some children that we met in the pediatrics ward at HEAL Africa.


Here's the view from the outdoor eating area where we had breakfast and dinner together at the Lusi's home and guest house on Lake Kivu.

Tuesday, August 28, 2007
Lost in Translation
Dan and I were invited to lead what turned into a prayer retreat with these men and women. After discussing the format with Pastor Bolingo, the chaplain for HEAL Africa, we decided to walk the committees through the Lord's Prayer, praying the prayer as we went. "Lord, in Goma, in eastern Congo, may you character, your heart, your Name be known. May your kingdom come and let your will be done in this city, in North Kivu, in the hearts and lives of the Congolese, the Interahamwe, the other rebel forces. Give to the people all that they need to be your people. Grant to them the grace to receive forgiveness and to forgive. And when they are tested protect them from the Evil One who wants to get them not to trust you." It was a remarkable experience to think through the prayer and pray through the prayer with these courageous men and women.
There was a moment of comedy while I was teaching the fourth petition, "Give us this day our daily bread." In an attempt to lighten the mood a little bit I decided to tell a story that had been pretty funny when I told it in Berkeley. I did not get the same reaction in Goma, at least not at first. Instead of smiles and laughter I got furrowed brows and anxious glances at Pastor Bolingo. In a somewhat weak attempt to get people to think about our uncontrollable wants and desires (in relationship to our prayer for daily bread) I told the story of what happened in July when I was car-camping with a group of young adults in Lake Tahoe. A HUGE bear got into the church van in the middle of the night and started eating a cheesecake that we had mistakenly left in the cooler which was inside the van. How that happened and how I got the bear out of the van is another story.
All of our teaching to the Nehemiah committees was translated from English into French (one of the languages of the Congo). As I told the bear story I was met with blank stares. Fortunately, Paul Yeager interrupted my teaching to inquire whether they knew what a bear was? Maybe the fact that they had no reaction to what I was saying was because they didn't understand how big and intimidating a bear living in the Sierra Nevada mountains of California can be. It soon became clear that it wasn't because they were unfamiliar with bears. It was because the translator thought I said "BEER", not "BEAR". So my story, when translated into French, was about a HUGE BEER in the back of the church van and the BEER was eating cheesecake. No wonder they looked at me like I was psychotic. Once they understood that there was a BEAR in the back of the van they were with me. That was a talk that was almost lost in translation.
Peace,
Tim
Saturday, August 18, 2007
Pictures... and some technical stuff...
(from Melissa)
Check out my photos from Goma on flickr, including some pictures of our adventures putting up the wireless routers to link the hospital to the learning center (and Internet room and library) across the street.
I'm so incredibly blessed to be here at the end of a very busy three months in Africa. Where
most of the time I'm very occupied by my various research projects and consumed by the need to produce publishable data, here I have the freedom to just do whatever's needed. But more importantly, I'm getting a chance to do what I love as part of my church. It's so exciting to work with everyone on this team, to see another member preach at morning chapel every day, and to see God at work in this place, using our variety of gifts and skills to really serve HEAL Africa and to learn about how we might be able to continue serving in the future. Tomorrow/Sunday we're splitting our resources - our team will be preaching at three different churches after we attend the 7am service at HEAL Africa together.Internet access is mostly okay - it works best in the mornings and in the late evenings, whereas it pretty much grinds to a halt in the late afternoons. During the day most of us just use the Internet room in the hospital, but for evenings when we are at home, I picked up a wireless modem that uses RwandaTel (a mobile phone company) to provide internet connectivity. (For you technophiles, it uses EVDO over CDMA.) I'm using ad hoc wireless routers from meraki.net to share my Internet connection so everyone else can just connect via WiFi. I'm using the same routers to set up networking for the hospital, and already have a link spanning the ~300 meter (I haven't actually measured it) distance between the Internet/Library room and the hospital. We have about 6 routers with us on this trip, so I could just try it out to make sure it works. To cover the entire hospital, we'll need quite a bit more... (btw if anyone is interested in getting wireless routers for their homes, the meraki routers are quite good and fairly inexpensive - $50 each for the indoor routers).
I spent some time earlier today speaking with Dr. Vindu in the pediatric HIV clinic about electronic medical records and how she wants to use computers in the hospital. Almost immediately she suggested OpenMRS, an open source project in collaboration with Partners in Health and already in use in major projects in Kenya (hi rachel!), as well as the Millenium Village Project in Rwanda. At the close of our conversation I asked her what she thought was her most pressing need for the clinic. I expected her to say something like more doctors, more medicines, or even to ask for more computers and better data management. Instead, she said
the most pressing need was for the families that were caring for the HIV-infected orphans. About 240 of the 360-some children in the clinic are orphans, being cared for by relatives or other community members, who are often quite poor themselves, and cannot afford the school fees (including books, uniforms, and supplies) for the orphans. Indeed they often cannot afford the fees for all of their own children. Not only am I amazed by the selflessness of this request, but also heartbroken that such a basic need is not being filled. Of course there's a whole list of other needs to be filled at this hospital as well... we just have to decide where to start. In the meantime, Naomi's working very hard on a mural to cheer up the children in the clinic.Okay early church tomorrow and I need to get to bed. Thanks for reading and please keep praying! Pray especially for the teaching at the three churches tomorrow, and for Rebecca, the 7 day old premie in the incubator at HEAL Africa.
Melissa
Life In Goma
Saturday, August 18, 2007
Tim (for the entire Goma Team)
Worship in the Congo
Thursday, August 16
Hi Everybody (from Sarah)!
It's about halfway through my trip here in Goma, and it's been pretty challenging to fully grasp all of the complexities of life here, in a country that continues to be terrorized by guerrilla warfare. Certainly the war is "over", but in the eyes of the innocent Congolese people, this war is far from over, and the psychological effects will remain for generations to come.
In Goma, our team mainly spends time at two places, and they couldn't be more different. We stay at this beautiful house along Lake Kivu, a lake at least twice the size of Lake Tahoe, with a beautiful English Garden, and comfortable but simple rooms with private bathrooms. For meals we eat out on this amazing verandah that overlooks the Lake, where we enjoy the company of not only our team from Berkeley, but people from around the world, learning and listening to their respective research projects they are working on while they stay in Goma. Sometimes we have 20 people at dinner! The house is impressive, complete with it's very own obnoxious dog, and workout room in the attic so we can get our wiggles out and sleep better at night. Last night we had a lightening storm, and I sat with a friend in a hammock on the verandah as we watched the sky light up over the lake.
Outside the gates of the house, however, is a much different story. In 2003, a volcano (which you can see from the hospital if it's not super hazy and looks very majestic with smoke rising from its top), exploded and lava covered 40% of the city. Not only that, the presence of armed forces, Congolese police forces and army, are at every corner, controlling traffic, stopping people at will. The UN forces are also a presence and every time I see a truck of peacekeepers roll by I am reminded that although the civil war ended a few years ago, guerrilla groups continue to exist in force outside of the city and continue to terrorize the Congolese civilians. The city is covered in black lava, unlike the red dirt that exists in the majority Africa.
The other place (aside from the house) where we spend our time is around the hospital, HEAL Africa . Inside the walls of the hospital, (which is in desperate condition, yet is one of the best hospitals in the DR Congo), there is intense suffering. Despite all of this suffering and chaos, even in the midst of it, I see both the pain and hope of the Congolese people. Let me tell you a story. Every morning we go to chapel at 7am, a service for the entire hospital staff and it's patients. Three choirs perform each day, probably about 5 or 6 people per choir. As I was sitting there in church listening to them sing, I was comparing their songs for that day to the songs they sang on other days, acknowledging that today just wasn't "as good". I was disappointed. I laughed at myself, realizing my selfishness, and shook my head. What happened next will always stay with me, and if this is what heaven sounds like, then count me in, seriously. Luckily we have this recorded, I don't think I'm about to do it justice. The women in the church, the broken, the ones suffering from Fistulas, and some pregnant by their rapists, began signing this song about taking their bags to Canaan, because they were free. As they sang this song, people started clapping to their own rhythms, and placing whatever they had, purses, babies, Bibles, whatever up on their heads and forming a conga line around the room. As I clapped and danced along with the people, I watched the line go around the room. There was this woman singing carrying this baby with his skull twice the size of what a normal head should look like. I choked back tears and watched her love the Lord through song and dance, and all of the sudden I was amazed at the resiliency of all of these women, men, doctors and nurses. I get to come and go as I please, for my little two week stint in the Congo, and then I go home to the comfort of my home, my big bed, my mattress, my fiancé, my diet coke, my big meals, my comfortable life in Oakland. The people here are faced with this reality day after day, they face it head on, with determination, resiliency, hope, and faith in their God, who is a God of justice, a God of Healing, and a God of Life.
Whew. I know most of you are wondering what I'm actually doing on a day to day basis, and lets just suffice to say, that I'm learning TONS, and my mind is constantly being expanded to what the CONTINENT of Africa really has to offer the world. I'm investigating how HIV/AIDS education works here, what individuals are doing to keep the epidemic from taking control of this generation like it has so desperately in South Africa.
In case you were wondering, I'm also learning that colonialism really sucked and continues to plague African society to this day.
I'm also learning that despite my sickness on Wednesday, my missing cell phone, and slow internet, the frustrating language barrier, it really just doesn't matter.
I love you all, keep those prayers coming!
Sarah
Tuesday, August 14, 2007
A Resilient People
You may not want to read what I’m about to write. I want you to read this. I think you should read this. I’m going to tell you a little bit of what we saw today at HEAL
Tim, Bridget, Timo, Dan, Sarah, Naomi, Melissa, Paul and Ryan






