Congo Kinshasa: Exploding hot water flask puts Judith in peril!

The morning started as usual; Judith arrived for breakfast and we sat together at the little, plastic, square table in the corner of the sitting-room. In Basankusu, where my malnutrition centres are, we don’t have mains electricity, so, we don’t have an electric kettle. Instead, we heat water on a wood fire outside and put it into a Thermos flask. Judith had been very pleased with her purchase of a new Thermos flask in Mbandaka when she’d come to meet me the previous week. It was bright orange and quite large. Judith’s dad had visited, two days before, and commented on how hot the water was. The plastic looked quite flimsy, but, despite its lightweight appearance, and low price, we were very pleased with how efficient it was.

Francis Hannaway and Judith Bondjembo 

We sat down to a simple breakfast. I’d brought some blackcurrant jam from Kinshasa, and a sachet of Nescafé instant coffee. Local bakeries had sprung up in Basankusu after the civil war, with the help of UN agencies, and bread was usually made to a good standard. 

I took the heavy Thermos and poured it into my cup, and passed it across the table to Judith.  Once in her hands, the weight of it swung it a little on its way and it touched the wall briefly. She poured the steaming water into her cup. It was just when she was about to return it to the table that it happened. There was an explosion. It was like a bomb had gone off! We both sprang to our feet. A large cloud of smoke-like vapour hovered above the table! We saw that it was the flask which had exploded, the bottom and all that was inside had come out with a tremendous force.  Still in shock we sat down.

The bottom of the Thermos was blown off!

It was several minutes later that Judith realised that the scalding water from the flask had landed on her chair and she was now sitting in it! The shock of the situation had meant that she hadn’t felt it immediately! We’d both thought that there was no damage – but then I realised that I needed to act quickly to cool the scald. I rushed her into the bathroom and splashed handfuls of cool water onto the area at the top of upper leg. I tried to get her to sit in a basin of water, but she thought it was all a lot of fuss for nothing. 

She started to tell me about “nkisi ya bankoko”, traditional medicine, or, literally, “medicine of the ancestors”. Now, I’m not completely opposed to certain calming plant-based medicines that might help with a fever or a headache, but certain things need a certain approach. If you have a burn, you need to cool it. Immersion in water is the best way. I’m a trained First Aider and I cooled the wound. Unfortunately, she’d delayed doing that for a little while and it became a burn. A little bit later and huge, fluid-filled blisters started to appear. She asked me to pop them. I explained that the blisters protect the burn area. On further Googling, the advice was that large, painful blisters could be emptied. I emptied the largest one, which was about 10 cm long, and left the others.

The huge blister on the back of Judith's upper leg

Judith went outside to talk with her aunt, Mama Claude, who was a clerk in a medical centre, and who knows a thing or two (or thinks she does). People here are obsessed with medicines, be it injections, or pills or ointments. My advice was to leave it uncovered and let the some air get to it. No, it should have something on it – some cream, or antiseptic – was her aunt’s advice. OK, we’d been using tincture of iodine on surgical wounds, I wouldn’t object to that. No, we’ve used it all up, but you can get “blue” at the corner pharmacy kiosk. I assumed it was potassium permanganate or something similar. I still stressed that it didn’t really need anything on it.

The other women sitting outside started to chip in their ideas. Different leaves, the bark of a tree, the flower from a palm tree – and so on. I made it very clear, “Don’t put anything on it!” I said, and went back inside.

The vast majority of people in Basankusu are poorly educated. Many can’t read. Of those who can read, they don’t read because there’s nothing here to read. Faith in the ancestors trumps all knowledge that foreigners from developed countries can bring. It’s their secret. They know things that we foreigners couldn’t possibly understand. It’s very similar to our European ancestors believing that witches float and bleeding people with leeches reduced hysteria. Our ancestors were ignorant and their outdated knowledge has been superseded with modern medicine and medical practice. The ancestors of Basankusu were ignorant, too. Honey will not cure a snakebite; wearing amulets will not protect you from ill health!

An hour later, Judith came back into the house. There was something going on. She had a little smug look. 

“You’ve done something. What have you done?” I asked, noticeably worried. She showed me that all the smaller blisters had also been punctured and the whole area was covered in a sort of sawdust paste. 

“What on earth have you done!” My voice rose.

“It’s my body, I can do what I like,” she replied calmly. “It’ll get better quickly now.”

“No, it would get better quickly by itself; you don’t understand.” My frustration was hard to conceal. “These old wives’ tales don’t do anything. You’ve only heard about them being successful, but you haven’t seen the infected mess they leave on others. You’ll be scarred for life!”

Judith let me know that it was the pollen-filled middle of a palm-tree flower. I explained that she was putting dirt and bacteria into an open wound and that it would become infected. Did she want to lose a leg? I told her that the wetness in the wound was blood plasma, but none of it seemed to bother her. She insisted, despite hardly being able to walk, that she’d climbed the tree and plucked the flower herself – I knew it couldn’t be true. I took her again to the bathroom and insisted that I wash it off. It was a struggle but she eventually agreed. It wouldn’t come off; it was stuck like glue!

I went outside to where Mama Julie, Mama Claude, and several other women were sitting.

I was looking for the yard-long, flat, wooden paddle that’s used for mixing fufu. I couldn’t find it so I picked up a length of wood to worry them with.

“Who has done this terrible thing to Judith!” I announced. “Who decided that they knew better than me and decided to give her an infected wound?” They could see I was angry – they sat with their heads down and said nothing.

I went to Dr David’s house, he lives just next door but one. A big smile spread across his face as I told him what had happened and he started to laugh. 

“Leave it to me,” he said. “I’ll take her to my clinic by motorbike. You can follow later to see how it’s going.”

Half an hour later I joined them in his surgery. On the way, I bought some more tincture of iodine and dressings. Dr David removed all the scalded skin from the blistered area. It left a clean but very red, very much the-skin-underneath wound. The red-raw wound was about the same size as the palm of my hand.

The scald wound after Dr David removed the palm flower mixture, and cleaned away damaged skin. 

“It’s a second degree burn,” he said. “It seems to have become so bad because Judith didn’t feel it, at first. But, don’t worry, it’ll heal just fine.” He told us he’d dress the wound himself every 2 or 3 days. 

The wound healed very well. There’s a slightly different colour to it, but it’s definitely not scarred, despite her picking bits of dead skin from it, like sunburn, over the weeks of healing.

Judith says she agrees with me about the flower being dirty and an infection risk. However, I’m not completely convinced. If she’s with her friends she likes to ridicule my rejection of nkisi ya bankoko – I never know whether she still believes in them, or, more probably, she just likes to wind me up!

Judith Bondjembo at the malnutrition centre

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Congo Kinshasa: Momba and medical dilemmas

I hadn’t seen Momba since before I went to Kinshasa at the end of August, last year. At that time the swelling in her face, caused by TB, had gone down considerably, and she’d gained weight. We left her with the instructions that sometime in September she should return to her village of Bokakata. While she stayed at our second centre, she’d followed a course of drugs to cure her. She’d got her appetite back – and amazingly, become a new person. Any further medication the hospital might give her she could carry with her to her village. Our work was done – we’d already saved her life.

Mama Momba with children the day before her hospital visit

She came to see me, only a few days after my arrival in March. I noticed that, although most of it had gone, the swelling in her face was still there. She had always talked about “when the bone started to stick out!" and we always assumed she was describing the TB ganglions that made her face swell. This time she showed me inside her mouth. Her back teeth at the back seemed double. Along the length of her teeth on one side there was a ridge of toothlike growth, but just the thickness of a comb. “When I lie on this side, it hurts. At first, it was the other side – but now it’s this side,” she said.

Dr Eric was busy with a patient when we arrived at the Catholic hospital next door. She was able to be examined by one of the Medical Assistants (nurse practitioners), Jean-Paul. I’d done my own research and could have come to several conclusions – one of them, bone cancer. Jean Paul confirmed my suspicions. “It could well be bone cancer,” he said. “But it seems to be made from tooth enamel. That had already been in my research – bony spurs growing from the jaw and associated with TB. “She’d need specialist treatment in Kinshasa. It would be expensive and there’s no guarantee of success,” he added. “But you’ll need to see Dr Eric for confirmation."

Dr Eric was now free. He was certain it wasn’t cancer. The tooth enamel growth could just be removed – but it would need to be in the operating room. “Leave it with me and I’ll research it a little more at home. But meanwhile, I’ll book her in for the operation tomorrow morning. It’ll be under general anaesthetic.”

I went back to my house and told Judith what had been decided. Judith wasn’t happy.

“We’ve already treated her TB and paid her keep for 6 months, Francis,” she explained. “Her costs have been more than any one of the malnourished children we’ve treated. What if the operation goes wrong and she dies? Then we’ll have more problems!” 

Judith was getting annoyed. Momba had reminded her of a recent patient whom we’d offered to help. The patient had suffered a crush injury, in Baringa, after the wall of a house had fallen on him. He’d been bed-ridden for almost 2 years and the family had finally agreed to amputate his leg. I’ve known his family for 30 years, and so was keen to help. Although the family had paid most of it already, Judith and I agreed to pay the remainder of his hospital bill for the amputation. In addition we would pay for any further medication and dressings. 

What actually happened was this: six weeks after his operation, he died. The remaining bill for the operation was never paid, even though we’d given the family the money for it. As well as that, they’d done another operation on his hand where the skin had torn apart, without our consent. We ended up with a bill for $400 and the young man was dead. He died from poor bedsore management – his whole body had just deteriorated. Incidentally, the amputation was a great success and the wound was very clean and healing very well – but not so the rest of his body. It was for this reason that Judith had sworn we’d never get involved in someone else’s operation again.

I told her that we’d come so far with Mama Momba that it would be a shame to leave it all now. I insisted that she have the operation, and that it would just be like a visit to the dentist. Reluctantly, she agreed.

The next morning, Momba arrived with some family members. We made the short journey to the hospital and I found them somewhere to sit and wait. A porter came across and said that Dr Eric wanted to see me. I went across to his little office and entered. There, sitting on a chair behind the door, was Judith! She’d been for a chat and explained her worries! Judith left me to talk to the doctor.

“I did some more research,” Eric said. “I’m coming down more on the side of possible cancer, but we can’t be certain yet. Judith is right to be concerned – you could be starting a long line of procedures. Let’s see how it goes for a while.”

The truth is that diagnostic capacity is very low in Basankusu hospitals. Eventually, our resources have to be taken into consideration. We can’t save the whole world – and if we tried it would bankrupt us very quickly. 

Dr Eric called Momba to his room and told her that he’d decided not to go ahead. She was happy, and told us how she’d had a dream in which she died and went to heaven, during the operation. 

“So, it sounds like you’re very relieved,” laughed Dr Eric. “Do you remember telling me last time about falling and the ‘bone’ broke off?” 

“Yes,” she replied, “that’s when it started on the other side.” 

“Let’s wait and see if the same happens this time,” he said.

We got Momba back to the house. I kept in mind that her condition could possibly bring her back at a future date. We gave her some money and food to keep her going and told her the time of the next boat to Bokakata. And she thanked us and promised that she would go.

But she’s still in Basankusu – she never went!

Congo Kinshasa: Planes and boats and corona tests

The weeks started to drag. Each time we submitted a document, there seemed to be another one I had to procure. “Go to the town hall, go to your doctor …” and so on. But eventually the day came when everything was accepted and submitted. Our charity for malnutrition would become national, and I would get a new 5-year visa. Now to travel back from Kinshasa to Basankusu. 

Francis & Judith after
their return to Basankusu. 

The day I set off for my Coronavirus test, followed a night of heavy rain and, therefore, in Kinshasa, some severe flooding. Taxis and minibuses were not only hard to come by, but the streets were almost gridlocked because of the standing water. I took a motor-bike taxi, being the second passenger after a young woman. When I finally arrived, he charged double the normal fare. Perhaps he knew that he wouldn’t make much today – he was quite bare-faced about it. I didn’t care – I was going back to Basankusu.

Mama Geraldine had kindly offered to buy my air-ticket to Mbandaka with Congo Airways and with that in mind, I entered the IRBN compound and was directed to a large building to the left for my Cornavirus test. After that – nothing. Two crowded halls, one of them with payment windows, had nobody at all to give directions. What do I do? Who can I ask? Everyone sat staring at their mobile phones. One the wall was a piece of paper: WiFi logon and a website address. I eventually worked out that the idea was to connect to the website and register my details. I sat down, and worrying about the passing time, tapped in my details and uploaded a photo of my passport. It crashed. I started again – and eventually, success. In the melee of perhaps 100 people, I plucked up the courage to sit at one of the windows, whereupon someone sat opposite me and half threw a piece of paper through the window. He was followed by his friend who remained standing. I asked the friend. What do I do next? Someone else jostled through the crowed and handed his phone through the payment window. The friend smiled, took my phone, clicked the last button on the screen and a q-code appeared. He told me to hand it through the window where it was duly scanned and I was allowed to pay my $30, before being passed on to the next window. Just as one of the operatives started putting a sticker on my form, Mama Geraldine phoned. 

“Don’t do the test! The plane’s not until Thursday!” she blurted.

Fortuntely, the staff behind the glass screen were able to reassure me that I would still be OK. Today was Monday, but the result would arrive at night, so it would still cover me for Thursday. Where to next? They pointed me in the direction of the second hall. The crowd had subsided now and there were only a few people there. Still nobody to give directions. I asked a man sitting with his phone on a bench. “Go into room 2” was his advice. The door of a small room in the corner had a number 2 printed on a piece of A4 on the door. I tried it. It appeared to be locked. “Push harder,” the advice came again. It opened and inside I saw a nurse just withdrawing the long probe from a man’s nose! 

“Oh, I’m terribly sorry!” I stammered. 

But the nurse gave me a smile and said that she’d be free in a minute. The test was what I expected: very professionally done and very quick. The nurse apologised for the lack of organisation and reassured me that my test would be valid well into Thursday evening. She said they’d email me the results and that I could collect them the next morning. Her instructions were less clear about where I would collect them, but I knew I could ask for directions when I arrived.
The next morning, I saw the email on my phone with the result – negative, thankfully. I realised that I didn’t need to go back to pick up the results – I just went to an internet café and printed them out.

I asked Gracia, our next-door neighbour, and Judith’s cousin, if she could drive me to the airport on the Thursday of my flight. Unfortunately, she was already committed to drive her children to their various schools, but she had a reliable taxi-driver who she could phone. Later on, Christiantus, our Nigerian friend, who is a diocesan priest in Basankusu Diocese, said he would drive me their – even at the early hour of 5 o’clock, as soon as the curfew finished.

 
In my life, it seems that if something can complicate the situation, it will.

Torrential rain pelted down all night.

That could mean more flooding. Congo gets 12 times the amount of rain Britain experiences each year. That means that a whole year’s worth of British rain falls in a single month – so you can imagine how heavily it must fall! Around 4 o’clock it started to lessen. The curfew would end at 6 am and really we needed to be on the road as soon as possible after that.

 
I attempted a few desperate phone calls to Christiantus and eventually got a reply. We set off at 6:20. The road was dark and wet; the headlights were remarkably dim. Here and there we encountered partially removed roadblocks, left like that after the night’s curfew.

 
Christiantus explained that he had to say mass later and wouldn’t be able to hang around to help me in the chaos of check-in. We came to a barrier and the soldiers who guard the gate to the airport. Chris wound down the window a little, cold splashes of rain helped to wake me up a bit more. 

“Catholic priest,” he told the soldiers. No reply. 

“I’m a Catholic priest,” he said again. Still no reply. 

“Francis, give them 4,000 congolese francs (£1.70)” 

The barrier rose.

 

Father Christiantus

I stepped out into a pool of water. A young man held an umbrella over my head as I took my suitcase from the back seat. Christiantus drove off. The umberella guy started to walk with me towards the airport buildings. 

“No, I didn’t call you,” I said firmly. 

He continued to walk with me. 

“No, I refuse! I don’t want you! Go away!” 

These people are opportunists. They say they’ll help you through check-in, but will often disappear with your case, your money, your passport – whatever!

Eventually, I was met by another man wearing a yellow day-glo vest and a name badge. These registered porters can also trick you, but are more likely to guard their reputation.

The plane was late. My fixer held my travel documents, paid my airport tax and so on, while I had an extra 2 hour wait. Oh, well, at least I wasn’t late. When we were finally called to move through check-in, he asked me for $10 so that I wouldn’t have to open my case. It’s a dreadful practice – the Congolese (at least the very small percentage who use airports) haven’t arrived yet at the seriousness of airport security. I accepted it because I was already weary from the whole process, that, and the fact that I had a 1 litre carton of South African red wine in my case, which, anywhere else in the world wouldn’t matter, but here they might decide to remove it.

 
I’m 100% sure the fixer didn’t hand over all of the $10, but suddenly I found myself at the boarding gate. I watched 12 noon approach and pass. Other passengers boarded their planes and departed. Eventually, two young women in the uniforms of another airline, CAA, walked by asking their passengers to group together in one area of seating. I told them that I was with Congo Airways. 

“No, no, you’re with us! Look at the tag on your bag!” 

I looked, and sure enough, it said CAA.

I’d asked Mama Geraldine to buy for Congo Airways – no wonder I had to change from Wednesday to Thursday!

The plane arrived, fairly small, two seats on the left and two on the right. A small plane takes longer, but, after following the River Congo for 2 hours and a half, I finally arrived in Mbandaka.

Judith had hired a dugout canoe outboard and driver; she’d come along with a young girl to help with cooking and our watchman to help with buying provisions for the malnutrition centre. 

Mbandaka is officially a town, but people still live as if they were in a village. Cooking is still done from raw ingredients, freshly caught fish, cooked on firewood or charcoal. I got to go out for a drink a couple of times with old Basankusu friends. We enjoyed the view from where we stayed because it was literally on the shore of the Congo River.

We set off to Basankusu at 6 am, 28 February, repleat in waterproofs and orange lifejackets. The river was calm.

 We gave places to Antoine Mbula, a former Mill Hill student whom I taught in the 1990s, and Moise Lofinda, who is the boss of the bonobos re-introduction project in Basankusu. The wife of one of the protestant pastors also joined the trip – she sat in the bow of the boat and cooked for us. The driver, who was owner of the boat and motor, asked if we could take a young couple and their 2 children. We reluctantly agreed because we were already full.

Cooking on board was done in a charcoal burner. They put the burners in the bow and in a plastic bowl and put a couple of inches of water into the bowl, so that the heat wouldn’t damage the boat. We brought some beer along and Judith and I shared a bottle during the first hour of the journey. The cool of the morning started to lift and I took off my raincoat.

It wasn’t long before we started seeing various river craft. A baleinier, literally, a whaling boat, is a barge or series of barges, or whatever might pass for a barge, being pushed by a small tug-like boat. They are often over laden with goods and people, who camp out on the deck and others on top of goods, or even felled trees. A masua is another type of boat, still over laden, still with people sleeping on deck – but also with the possibility of a cabin. River journeys can take weeks – Kinshasa to Basankusu can take between 3 and 5 weeks, for example.

We travelled north from Mbandaka, hard against the current. sitting in flimsy plastic chairs. Our canoe was about a metre across; Judith had paid for a cover to be erected with some bits of wood and some old roofing sheets, so that we wouldn’t be exposed to the blazing sun.

Then we came to the tributary of the Lulonga River, the river for Basankusu. We stopped after a couple more hours. The driver wanted to visit someone in a tiny fishing village. We took advantage and used it as a comfort stop. More beer was brought out and we each drank another bottle.

And so the journey continued. Now and then people would call out that they had fish to sell. They would come alongside and haggle over the price – but it was always cheaper than the price in town!
As evening came, so did the threat of rain. The river was very low and a few times we ran aground on sandbanks. The propeller on the outboard would sometimes get tangled in weeds or grass, and we would drift aimlessly while it was being sorted out.

The wind picked up and the sky turned grey. The calm river suddenly became like a choppy sea. Waves with sharp peaks appeared and it looked like we might have trouble. Fortunately, it all passed within 30 minutes and the water became calm again.

Night came. I tried to sleep in my chair. I regretted accepting the young family on board, because it gave us less room to spread out. I must’ve dozed now and then, and eventually the sun appeared again. I looked for Judith in the seat behind me – she wasn’t there! Then I saw her under the chair just waking up on the floor.

The pastor’s wife got the charcoal burner going and we were soon drinking coffee and eating bread and sardines!
We started to speculate on what time we would arrive in Basankusu. Originally, we thought that 24 hours would be enough. Failing that, surely we’d get there by 12 noon or perhaps 1 pm. During one of our stops, Antoine confided in me. 

“They’re not using the motor at full-throttle,” he said. “They want to go home with some fuel themselves. You paid a high price for this trip, but they’re trying to take advantage again!” 

I agreed and relayed the message to Judith. Judith didn’t want a fuss, but said she’d tell the driver. 

“Perhaps they want to conserve fuel to be sure of arriving,” she suggested. 

And so we continued.

As we got closer, we saw a huge masua, a really massive riverboat, with people looking out of windows down its side. It had run aground on a sand bank and seemed incapable of shifting itself. Perhaps they would sit there several days until the river slowly released it again. Perhaps they were already digging away at the sandbank. We gave it a wide berth.

The first view of Basankusu was the red light at the top of the telephone mast. Judith and I turned on our phones, racing to get a connection. Because we were travelling with Moise, we were able to land at the ABC (Amis du Bonobos au Congo) beach. It was 7 pm – we’d been on the river for 36 hours! Lots of Judith’s nephews and nieces came down to help us carry our things. Then we saw our watchman struggling with the boat’s driver. What on earth were they doing! They were locked in a tight bear-hug of a struggle. The watchman had been following events and had come to the same conclusion as Antoine – the driver had conserved fuel and was now going to go home with it! We estimated its value at about $25 US. It all got a bit out of hand. The last thing Judith wanted was for me, a foreigner, to be associated in a fracas. It could jeopardise my status. She called off the watch man and we unloaded our goods.  

We then learned that the driver had also charged the young couple and charged them to carry their foam mattress! 

We were happy, though, to let Judith’s family spirit away our goods and cases, and went together on foot to our house.

More beer? Yes there was!