Three Promises

Reflections on Goma and HEAL Africa by Laura Sera.
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

More Images from HEAL Africa

Photo Credit: Laura Sera

Who Is...

Click on the links (organization names or webpages) below to find our more about these ministry partners.

First Presbyterian Church of Berkeley

Global Strategies for HIV Prevention

HEAL Africa

Morning in Mugunga Camp

Morning in Mugunga camp, originally uploaded by Julien Harneis on September 4, 2007.

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

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.

September 7, 8 and 9

Some Reflections from Randy Bergen:
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

Another perspective - and technical update :)

Eric Nguyen is in Goma independently trying to get some IT work done, following up on some of my projects and embarking on his own, including the deployment of some management software.

For more info and updates, check out his blogs here:
http://mindtangle.net/2007/08/30/live-from-goma/

Melissa

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 Kenya, Rwanda, and Uganda that gave me a little bit of perspective. What I also remember quite vividly is how many people said to me, “When you go, you will find that you are going to receive much more than you can actually give.” I acknowledged what they said but I didn’t truly understand or appreciate that until after I came back and found that to be very true.

What I received from the people of Goma was a deep sense of thankfulness that resonates within me to this day. It was a thankfulness to God who continues to answer their prayers in ways that God and these wonderful people can only know. This thankfulness to God was evident from the beginning of their day in chapel services where their worship through song, dance, and prayer was contagious and uplifting. I cannot emphasize enough how important it was for each of us to begin each day where the focus was on God’s goodness while reaffirming His words of truth, protection, and hope. Starting each day helped to refuel and refocus us spiritually in a way that would provide us with the necessary gifts to enter into an environment that was filled with pain, suffering, abject poverty, ignorance, and violence.

From the first day where we had an opportunity to tour HEAL Africa’s various hospital rooms and witness how many people were being treated by the staff. I have rarely seen a group of people utilize their talents and limited resources in such an efficient, compassionate, and competent manner. The needs were many and everyone did the best they could with whatever they had. From street kids who were practicing Yoga, to women working in the sewing room while awaiting another fistula surgery, to AIDS patients who received visits from counselors, people were being helped and healed by the work of these people and through God’s mercy not only physically, but also emotionally, and spiritually.

One of the strongest memories I have is of our experience at Pastor Samuel’s church on Sunday morning. We arrived at a church that was surrounded on every side by either public toilets or an airport runway. At one point, I actually had to pause my message to wait for a plane to take off only hundreds of feet away from our worship service. This three hour worship service was one of the most remarkable experiences that I have ever had. The church was filled with young and old, men and women who were worshipping with all of their hearts, all of their souls, and all of their minds in a way that revealed God’s true character.

Like virtually every person that we encountered, these people were dressed in a colorful, beautiful, and handsome manner that displayed the pride they had in themselves and their desire to give their best to their Savior. I’m at a loss to describe how much joy, thankfulness, love, and praise filled these people in every aspect of their worship. This was a three hour church service that I didn’t want to ever end!

My experience in Central Africa and my interaction with the people there has brought me back to America with a fresh and new perspective on life. I am exceedingly thankful for the abundance that God has provided in my life and with how He is working throughout the world. By beginning each day with acts of worship and prayer that refocuses our attention away from ourselves and the problems around us and back towards God, we can keep Him at the center of our daily lives. Though I am even more aware of circumstances that are upsetting, confusing, and heartbreaking, I find myself having an outlook that is more like the people that I met. Because of their example I am finding ways to proclaim God’s goodness, His steadfast love, and His amazing ability to enter into these situations and provide relief, comfort and most of all hope.

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.

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 Congo for the last few weeks with a team that included medical professionals from First Pres. (Laura Sera and Randy Bergen). Art has written a couple of reflections that we wanted to share with you on the Goma Team blog.

September 1, 2007
First – some news has been reaching the US that there is increasing rebel activity in the area surrounding Goma, Congo where we are located. Yesterday, the roads to Binza and Masisi were closed. These are two areas where we (Global Strategies for HIV Prevention) will be implementing prevention of mother to child transmission HIV transmission programs. We just completed our training workshop for 24 nurses and 3 doctors from 2 hospitals and 8 clinics in the region. The team from Masisi was still in Goma when the rebel activity increased, and they are safe in Goma waiting out the tension. The team from Binza was preparing to return home when the fighting erupted in the area between Goma and Binza where they live. Joseph Ciza, a nurse we work with who often goes into rebel held areas to treat patients affected by the war, arranged for the UN peace keeping mission, MONUC, to fly all of the people from Binza home! They arrived safely and we pray for safety and peace in their region.. Here in Goma, along with the team from Masisi, we are safe. The UN security forces have been here in Goma for many years and in fact, are headquartered just down the road from the Lusi's home. Regardless what happens around it, Goma remains stable in large part because of their presence. Dr. Jo Lusi, the surgeon who heads HEAL Africa has been hovering over us and is checking in constantly with the UN. The Global Strategies teams stay at his home, a wonderful retreat at the end of the day.

Although we departed San Francisco over 1 week ago, we have been in Goma only 5 days. It takes 3 days of travel to get here. We just missed the First Presbyterian Church of Berkeley (FPCB) team. They were the first of 3 groups from FPCB to come. They still talk of the group here, the impact that they had in pastoral care and are already looking forward to their return.

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 Congo. Each night we would “download” during and after dinner. One of my favorite evenings was when Bridget Nolan gave a detailed history of the Congo to Congressman McDermott. The Congo receives virtually no US aid compared to its neighboring country, Rwanda.

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 Congo and his first time to Africa. He was greeted with a full surgical schedule and lecture topics. Randy Bergen, a pediatric infectious disease specialist arrives in several days. He will be helping Dr. Vindu who is now caring for over 500 HIV infected children. Many are now on treatment for HIV and nutritional supplementation as malnutrition is quite severe in Goma. Randy will also be giving lectures to staff, students and doctors.

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 HEAL Africa, and doing a lot of one on one connecting while also gaining knowledge about the many ramifications of HIV on the community.

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. Communication is difficult once we leave so we pray the meetings will be productive and clear.

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

________________

September 4, 2007
When Jesus saw the crippled man lying by the Bethesda pool he asked, “Do you want to recover?” The man had been lying there 38 years “Sir,” he replied, “I have no one to put me in the pool.” Jesus answered, “Rise to your feet, take up your bed and walk.” John 5

We were reminded of the man who waited by the pool of Bethesda for someone to put him into the water to be healed. John Schmaelzle, a urologist, had arrived on his first trip to Africa and HEAL Africa in Goma, Congo. In the States he wondered what he would be doing, what resources were available for surgery and who he would be working with. On his first day of surgery, one of his patients was a man who had been operated on 4 years ago following a crush injury. The surgery to repair his urethra failed. He waited 4 years for someone to come to HEAL Africa with the expertise to make him well. It was a wonderful match – the patient in need and John Schmaelzle who had the expertise to help. Indeed it was like the story of the man waiting by the pool of Bethesda to be healed.

It was also Randy Bergen’s first time in the Congo. Randy is an infectious disease pediatrician who came to HEAL Africa to help Dr. Vindu, a Congolese physician, care for 175 HIV infected children who were being treated with antiretroviral drugs (the first in Eastern Congo). With funds from First Presbyterian Church of Berkeley, we are providing desperately needed nutritional supplementation. Randy’s first day involved seeing children not yet on treatment, reviewing his teaching schedule at the hospital. I stopped counting at 7 lectures scheduled in 10 days.

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 Congo. On Monday morning I had a poignant visit with a little girl and her mother in circumstances that reflect the harsh reality of HIV/AIDS in Congo. It was the most difficult mixture of happiness and sadness I have ever seen. This mother, in the process of planning an adoption for her daughter, has already placed her young son. The reality of being an HIV infected widow in the Congo brings with it a heavy burden. Having had episodes of being very ill with the disease, she has become anxious to place her daughter; it is her greatest worry. The sorrow felt so raw as we talked of her plans for her daughter but the mother seemed joyous. Her daughter would be safe and loved and would have a future where she was going.

I have also been talking with a young boy at HEAL Africa. He spends his day in a wheelchair, his right leg partially amputated. Today he asked me to take him home with me. This serious young boy was at home in a rural village when rebel troops attacked. He ran away from the soldiers but fell into a ditch and a soldier came and cut him on his right leg. His father brought him to HEAL Africa where he has had several surgeries on his leg. It was the seriousness of this boy, his intense, quiet plea, his eyes that held a world of pain within them that continues to move me each time I see him. I wonder what is ahead for him. Children are very vulnerable in a war zone. HEAL Africa, our partner, brings children like this one real help for their present needs and hope for their future. I thank God for the work that is being done by the caring staff of this organization and for bringing me here. It has been a gift.

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 Congo is a strange mix of peace and war. We pray that peace will triumph.

Sincerely -

Arthur J. Ammann, MD, President

Children of Congo

HEAL Africa is a multi-faceted, holistic, visionary ministry with many partners. They are first a hospital that has a special mission to care for women who have been brutally assaulted by rebel forces in eastern Congo. Their mission statement reads: Our mission is to provide holistic care for the people of the Democratic Republic of Congo: training health professionals, strengthening social activists and providing physical, spiritual and social healing. Femmes Plus Nord Kivu is one of HEAL Africa's ministries, providing assistance for widows and orphans. This short video is of some of the children we met on our visit to this community. Click HERE to learn more.

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

Timo Acosta with kids in front of the HEAL Africa chapel.

































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.