Congo Kinshasa: The Road to Bibwa

We were up, washed, dressed and breakfasted by 9 o’clock ready for our taxi at 9:30. I wanted to visit Fr. Marius, a Cameroonian and most recent addition to the Mill Hill Missionaries team in Congo. Judith had kindly offered to accompany me. Marius and Fr. Otto live quite a way out of Kinshasa – past the airport, on a notoriously congested road. I decided to call the taxi-driver to remind him. 

Judith Bondjembo and
Francis Hannaway 

After several attempts over the next hour and an extremely bad connection, he explained that he was fixing something on his car, but it wouldn’t take long. By 10:30 we lost all hope and sent someone to get us a taxi from the street. I always tell them to agree a price before bringing a taxi to the house – which, of course, they always neglect to do, and we’re always asked to pay a ridiculous price. The taxi arrived

A standard yellow Kinshasa taxi
(copyright: Rahul Tilak) 

- $50, he said. 

- I’m not paying $50! I said in a raised voice.

He agreed to $30. Judith still reckoned that was high. I agreed it could be high, but I knew that a taxi to the airport would be between $20 and $30 – and we were late. Off we went.

We soon hit heavy traffic. It’s been a problem on certain roads for many years and was being rectified by a series of flyovers being built all over Kinshasa. The result so far – as they’re being built – is absolute chaos, often grid-lock, on the roads. The midday sun beat down; sweat trickled down my back and into my waistband. Hoards of people pushed their way across the road, bangingtheir hands on the struggling cars, lorries and busses. Motorbikes – a lot of them taxis - wove their way like a swarm of wasps through any gap they could find, even mounting the crowded pavements to get past the traffic-jam.

Judith wasn’t happy. “They could have come to us!” she said.

“Who could?”

“Otto and Marius – they have a car. They could’ve come to Procure St. Anne to meet us. Why do we have to suffer this? It’s impossible!”

“Don’t worry,” I reassured her. “I knew the road would be like this, but look …” I showed her the journey on Google Maps. The slow moving traffic would end in a few miles.” That seemed to calm her a little and she chatted with the driver – who told her that the only way to travel nicely on this road was to go at 4 in the morning. We came to a halt again. A succession of hawkers passed the window, selling banana chips, clothes, soft-drinks and water. We bought a small bottle of cold water each and continued slowly on our way. It was 12 noon.

Congested road in Kinshasa

Eventually, the road cleared; there was a little diversion through the middle of a large market and, after that, a clear run to the airport and beyond.

It turned out that the driver didn’t know the exact place we were going – and, come to that, neither did Google. We decided to ask at the side of the road. The crowds along the roadside had gone down in size, but there were still plenty of people about. The driver tried asking one or two – but they ignored him. It was around 12:45 as we crept along to a petrol station, which was just ahead, and the driver asked again. 

Suddenly, the front passenger door of the taxi flew open! A burly, policeman with flack-jacket and automatic rifle threw himself into the seat and grabbed hold of the driver. We realised the car was surrounded by police – all with rifles of varying kinds – and other police were in the back of a pickup. Our door was opened and we were asked to get out. The driver also got out and they started shouting at him. We started to walk into the crowd – after all, it was nothing to do with us! 

We were called back and told to report to the front of the pickup. A young officer – perhaps a colonel – ordered us to approach. He started to explain that, unfortunately, we’d been imprudent in stopping within 10 metres of a petrol station. I felt we were being accused of terrorism or some such thing. “I’m very sorry,” I said. “But, we’re just passengers.” He paused for a second and said, “That’s fine. You can go.” 

Judith gave our fair to the police who’d taken the taxi. People in the crowd started shouting that the two policemen in the car would steal it. However, a bit later, Judith said she’d already seen them hand it over to the driver.

“I feel sorry for the driver,” she said. “They’ll beat him up because he wasn’t apologetic enough. Then they’ll let him go”

A few motorbike-taxis buzzed about at the side of the petrol station. I explained that we needed to go to CENCO, and that it’s a Catholic place. “I know exactly where it is,” replied on driver, and within seconds, we’d set off again. Judith sat behind the driver, with me hanging on behind. “Yes,” the driver told her as he skilfully skidded through muddy ruts on the sand road, “it’s just a little way from here.” 

Bibwa is one of Kinshasa’s new suburbs. In the past, we would have considered the airport to be outside Kinshasa – Bibwa is further, and the inhabitants think of it as a part of Kinshasa. We passed lots of partly built houses, and little businesses with freshly painted signs. The roads were pure sand – but we noticed that mains electricity was connected to each house. In just under 15 minutes, we arrived at a new church, in a big enclosure. It was very neat and tidy and there was a man sweeping up leaves a little way into the grounds of the church. Our motorbike left us outside and then went back the way he’d come. I approached the man. It was 10 past 1.

“We’re looking for Fr. Marius,” I said. 

“No, I’m sorry, I don’t know him,” came the reply. At that moment I got a call on Messenger; it was Marius. 

“We’ve arrived!” I declared. “Where are you?” I expected to see him striding from one of the newly built buildings to greet us. 

“But where are you?” Marius answered. “We’ve got no power here and my phone is about to shut down.” I described the church. “Oh, no – we’re not there! That’s a long way from us. Just take a motorbike-taxi and you’ll be able to find us near the main road.”

We’d been quite close when we’d arrived at the petrol station. Compared to the crowds of people along much of the main roads, this newly built (and only partially built at that) suburb was so quiet, I wouldn’t have been surprised to see tumble-weed roll by.

A group of 3 youths sat in the shade of a tree, opposite the church. We asked directions and they quickly volunteered one of the group. “I’ll take you if you buy me a beer,” he said as we set off. He was a very pleasant young man and said he was only joking about the beer. We chatted along the way. Not so, Judith, who was about to explode! 

“What are we doing here, Francis? You know this is a dangerous area! Why couldn’t they send someone to get us? Where’s Fr. Otto and his car? This is ridiculous!”

“Look. It’s a pleasant place to be. We’re not in a hurry, you know. Fr. Otto’s probably out at a meeting, or something.” I tried to calm her down a bit. She lagged behind. Now and then we stopped to wait for her, struggling on the loose sand in her wedged sandals. The sun beat down harder and I could feel my skin starting to burn. I fished about in my bag and put on a wide brimmed hat. We turned around to wait for Judith again and saw that she’d bought a pair of pink flip-flops along the way.

Our guide knew all the little short-cuts, taking us through broken-down walls to cross empty plots of sandy land until eventually, after about 25 minutes, we could see traffic passing on the main arterial road, near the place we’d had the run-in with the police. It was 20 to 2.

And there was Marius, standing tall, in the shade. And with a big smile he greeted us in his warm baritone voice, “Francis, Judith, welcome!”

Fr Marius Tapang mhm

Congo Kinshasa: Little Justine's malnutrition battles

The letter was written on a page torn from an exercise book. The paper was folded in two and fastened with a single staple.

“Boboto Medical Centre, Basankusu Diocese.

Dear Monsieur Francis,

We have a child here in our care. She was sent from a medical centre in a nearby village, with severe malnutrition. We’ve treated her as best we can, but she really need to have good food if she’s to continue to improve. Please send the following: Special milk powder F-75 (5 tins), rice, corn, sugar, vegetable oil, peanuts, beans, and dried fish.”

It’s not that we wanted to refuse them these essential foods, but our experience had taught us to be cautious. If we’d sent the things they’d requested, it would be the start of a slippery slope. A few of the staff at the medical centre would take a few cups of each thing, to use at home. We can sympathise with these little “borrowings” – perhaps their own children could do with a bit more nutritious food. What we suspect is that next time – and there would be a next time – they would ask for more foodstuffs, and take even more of it home. A slippery slope – and it would leave our children short. I wrote a reply.

“I was very pleased with your letter describing your patient and the care you are providing for her. Unfortunately, it’s against our policy to sent food to other institutions. We would, however, be very happy for you to transfer the child to our care.”

The little girl was Justine, a pale, frail looking 6-year-old. She’d arrived from a village, somewhere on the road to Bokakata, 20 km away. She was painfully thin. A lot of her initial swelling had gone down because of her treatment at Boboto Medical Centre, but she was very pale – and her skin was peeling as if she’d been burnt.

 Justine just after arriving at my house

Judith smiled. “She just needs the right food – in a couple of weeks we see a big change in her,” she said.

A couple of weeks went by. Justine was usually lying down next to her mother on a raffia mat, which was on top of her bamboo bed. Judith called me across to where they were so that I could give my opinion. We couldn’t see any change. She just lay there, listless. She started to develop pressure sores where her bony knees, and her hips, lay against her bed.8

“You need to change her position frequently,” I told her mother. “Change the position she lies in every half an hour. Raise her knees and where ever else she has a pressure sore from the bed, by making a cushion from clothes on either side of the wound. Dress the wounds with palm oil – we’ll give you some chloramphenicol to mix with it to avoid any infection.”

Justine’s mother and grandmother did a really good job. They made little cushioning pads to raise the affected parts of her body away from the bed, they changed her position frequently and they painted her wounds with shop-bought palm oil mixed with chloramphenicol powder. (We crushed tablets to make the powder.)

Another week passed, and we still couldn’t see any improvement. Her skin got worse and she couldn’t resist scratching. She scratched her face and removed a lot of skin. She was a mess. Her shoulder blade stuck out like an axe.

Justine's condition deteriorated 

“What more can we do, Francis?” implored Judith. Justine had had all the usual tests and treatments. She’d taken tablets for worms; she’d been checked for malaria. Perhaps we’d assumed too much about her treatment at the Boboto Centre. “Let’s take him to our hospital, next-door,” I said. 

“But she’s already been to Boboto – what more can they do?” said Judith, obviously worried. 

“The doctor knows his job,” I said. “It’s very easily something we’ve missed.” It crossed my mind that Justine could have an underlying condition – leukaemia for example – and not all of such conditions could be diagnosed here. If they could be, perhaps they couldn’t be treated.

I went with Judith to take Justine and her mother the short distance to the hospital. It didn’t take Dr. Eric very long to decide that her blood iron was low, and that a transfusion would help. 

I’m always reluctant when severely malnourished children are sent for injections, and transfusions. We had a little boy who had several intramuscular injections, at Basankusu’s general hospital. He developed huge wounds at the site of each injection and died, that night, of shock. So it’s easy to understand my apprehension. 

“Don’t worry,” Dr. Eric reassured me. “That’s only a problem with injections into the muscle. We’re not doing that. The blood transfusion will give her some appetite! She’ll start to eat with gusto! You’ll soon see a change in her.”

My experience of blood transfusions in Basankusu, has also left me wary of the eventual outcome. In the past we’ve had both adults and children who’ve improved tremendously after a transfusion, but then gone downhill again after two weeks. 

Justine’s mother agreed to the transfusion. She wouldn’t have been able to afford any treatment at all. The nurse sent someone to call one of his trusted donors. Even when they trust the donors, there’s still a risk that the blood could be harbouring some disease or other – but here in the Congo, everything is a risk.

Justine stayed in hospital for 5 days after her transfusion. They wanted to keep an eye on her. Her mother, who was pregnant and had another small child in tow, went home to their village. When Justine came back to us, she told us how nice it was to sleep on a foam mattress. She decided that the mattress had helped heal her pressure sores, which could be true, but it could also be the result of the transfusion. It’s true that she won’t return to one in her home village, but we decided to buy foam mattresses for all our in-patients.

Justine with her mother at the hospital

Justine’s grandmother was becoming more impatient with her stay at my house. She wanted to return to their village. Around this time, we were arranging to travel to Kinshasa. There’d been a national lockdown on all domestic travel, because of Coronavirus, and so this would be my first chance to travel since my arrival, this year, in February. Justine’s grandmother decided, without foundation, that they wouldn’t be fed properly if Judith went to Kinshasa, and so she’d rather return to their village. 

I discussed the situation with Judith.

“Yes,” she agreed, “we could send them with food for a few weeks, but I doubt that they’d give it to Justine alone. They’d feed the whole extended family with it – and perhaps sell some of it. Justine wouldn’t make much more progress.” 

Justine after leaving hospital.
Her shoulder-blade still as sharp as an axe. 

I shared my worries about how the good effects of a blood transfusion might wear off after a couple of weeks, and that they should stay with us for another couple of weeks. “If not another month!” added Judith. 

A photo of Justine taken a few days
before she was taken home
to her village

After some discussion the grandmother reluctantly agreed to stay a few more weeks. We flew to Kinshasa and Justine was transferred to our main centre, on the other side of town. A week later, unable to settle at the main centre, they moved back to the accommodation at my house. We were happy that the spent a further 3 weeks to help Justine put on more weight. All her bedsores had healed, her colour had returned and she looked altogether better.

Send a donation to Francis by PayPal 

So here we are in Kinshasa – still working hard, buying up provisions and equipment for the centre in Basankusu.

One day, Judith’s phone rang. It was Justine. Even though her village is 20 km from Basankusu, they have a clear view of our phone mast, and can make phone calls. Judith was over the moon to hear how well she sounded.