Day 2 has come and gone, but not without its share of exciting events. Despite going to bed early to try to kick this cold, I was able to sleep through the night (well, I woke up every hour, but there was this epic storm....and I love storms) so I felt rather refreshed. Jason and I both got up around 6am. We chatted and read for a while and Reol made us omelets with sides of fresh avocado (it's avocado season here....enough said), bananas (also amazing) and bread with freshly made peanut butter (yep). Over the next couple of hours Jason and I chatted some more with Nastasia about all that's been going on in the Congo, more about her desires to do global medical service work, and exchanged ideas. It's been absolutely tremendous having her here with us.....not only is she great company, but she is extremely knowledgeable about everything in this area and has really been able to educate us quite a bit. And, she speaks French and some Lingala. She's Haitian, so she speaks the French rather well. Considering all of our hosts here don't speak much English, it's been a lifesaver. This morning we had our money exchanged as well.....which would have been an utter disaster if she wasn't there. In addition to the money Jason and I exchanged, and some money that was wired to us for one of the nurses here, we had over 4 million Francs.....so I can say I've seen 4 million money bills anyway :). They quoted us at a pretty good exchange rate and said they use the "bank of so and so," some guy on the street who can somehow get a better exchange rate. Honestly, if you're ever lost in the Congo, find this guy. He comes walking in to Hotel Bravo and starts pulling huge wads of cash out of his right pocket, then his left....a few minutes later, pulls another stack out of his sock. He was a bout a million short, so he's like "hold on, I'll be right back." He disappears and in 5-8 minutes comes back with more stacks of cash. It was pretty awesome. I wanted to follow him and see where he had his can buried! But at least I know, he's the guy with connections for sure. Counting all that money took quite a while, and it was great to have Nastasia there to help translate all their questions and confirming we got the right amount of money.
A couple hours later we went off with Honore and Nastasia to see the Cataracts, which is where three different rivers all form into the big river that separates the Republic of Congo from the Democratic Republic of Congo. I can't remember the names at the moment, but I have a video where Nastasia explains it, so I'll post that when I'm back with the river names. Pictures are going to be worth a thousand words here, so I'll do my best to explain the journey until I get back to the states and can show you them. We will have some WiFi once we hit Impfondo, but all my pictures are on my camera and I don't think it's fast enough to upload all of them anyway. So Honore drove us there, which was great because he knew exactly the best place to go, and we found a lady who said we could park on her lawn for 1000 Francs (560 per dollar, so little less than 2 bucks). There is a great beach area and a bunch of really rocky areas all around. During the rainy season, everything in the area is covered with water and blends the rivers even more. The rainy season starts right about now, so it was pretty perfect timing for us to be there in order to see it. We could kind of see the main river from a distance, and then Honore came up and said he found a guy who would take us across the river closest to us in a "boat" for 5000F. It was like a small canoe, with the 3 of us in the middle and 2 of them on either end (standing) and paddling. Pretty fun, and I have some videos and pictures to post later as well. Once we were across the river, we started our trek. The guy asked if we wanted him to be a guide for us, and at first we were like oh no, we'll be ok (thinking he would want more money). But as soon as we started walking the wrong way, he just signaled to follow and so we did. We followed a "path" through the sand....which just looked like regular old sand to me at first, but after a while you could start to realize it was kind of a path. Then we approached the giant rocks. More like big boulders that damned the rivers from each other during the dry season. They said something about wanting to remove them all.....but you would need some crazy heavy machinery, so I don't see that happening. There were white arrows at this point along the rocks that guide you through so you know which ones are stable. This guide dude was like a spider monkey, just gliding through the boulders in his flip flops like it was nothing. Jason and I both had hiking boots on, so it was pretty easy. Nastasia had flip flops on as well because they told her prior to leaving, flip flops would be totally fine......I don't think they realized she didn't have spider monkey in her blood. We helped her along and trekked on for a good probably 1/2 mile to mile through the rocks. And wow, what a view. Across the river you could see Kinshasha, DRC (which is where we had our really short layover), which is pretty built up and a nice area for the rich. Being upriver, they don't have any problems with flooding like they do in the Congo during the rainy season. It was a crazy awesome looking rapids, and I asked if anyone went rafting down it.....and the guy was like, um no? There was a giant ship wrecked right in the middle actually, so I guess if a ship couldn't make it, probably a raft was a bad idea, but had to ask. All in all it was a great, once in a lifetime experience for sure. On the way back we talked a bit about how it's really untapped potential, like most of the resources in countries like this. In the same way that they don't export really any of their amazing fruits/veggies, all along the boulder path you noticed garbage and lost items, and they really didn't utilize the power of the river or the potential for tourist attractions for such a great spot. I'll come back to this a bit later, because it did inspire some ideas.
By the time we made it back, we were realizing the full extent of just how hot it was, and we were quite thirsty. Glad I wore long sleeves though and my Tilley hat, because I didn't get burned. We stopped at a Pharmacy after that so I could by a Z-pack. At this point my chest has been burning so bad, I've been coughing like crazy, my throat is raw, and my chest has been so tight it's hard to breathe.....so Nastasia was like, we should get a Z-pack now. The pharmacy sells antibiotics over the counter actually, and even though it was 3 times the amount of money it would have been in Impfondo, it was worth it. Hopefully it knocks this out and by the time I get to Impfondo I'm ready to hit the ground running. We grabbed some water from a next door shop and headed off to the University Hospital in Brazzaville. Dr. Harvey set up this great experience for us and connected us with a resident named Aucolz. He's a 2nd year general surgery resident. Really quick I'll explain their education system, since it's a bit different than ours. In the states you do 4 years of college, 4 years of medical school (in my case throw a masters for 1.5 years between), and then a residency. General surgery is 5 years, and emergency medicine is 3 years. In a lot of foreign countries, it's a bit different. So here, out of high school they go into an 8 year medical school program. During the 7th year they are considered interns (which is our first year of residency), and then their 8th year they do a research project and present kind of like a dissertation almost. Then they jump into residency from there. In Aucolz's case, he had just graduated last November and started his 2nd year of residency (because they do the intern year in medical school year 7). Hope that made sense. Anyway, he met us out front and he speaks pretty good English, though we still had Nastasia to translate quite a bit for us, when needed, so that was awesome. Aucolz brought us into the conference room where the surgery attendings, residents, and interns were having an educational discussion. He introduced us and introduced each of them, and they seemd quite happy to meet us. As they went through their educational session, Nastasia translated the gist of the teaching point, which was largely centered around hernia repairs, open vs. laprascopic, mesh vs. no mesh, strangulated vs. not. The interns were lost on what a strangulated hernia was and it seemed like the head surgeon was chewing them out a bit....so glad nothing changes in different countries haha. After the session finished, Aucolz took us on a tour of the hospital, which was pretty amazing overall. It's very open, with all the connecting hallways being exposed to the outside (couldn't really do that in Chicago, there would be snow everywhere sadly). It had a great feel to it. In the ICU, outside on all the doors they had fresh flowers hanging. Since we weren't in scrubs we couldn't go into any of the operating rooms to see them, but we got a pretty good idea of what things were like. Things work a bit different at the hospital, namely in that usually if you cannot pay you cannot receive treatment. There are a few exceptions. The absolute exception to the rule is a C-section. They realized too many pregnant mothers were dying and so they made an adjustment, and now if you come in emergently and need a C-section, you absolutely get it no matter what. Other emergency type situations, say like appendicitis, or head trauma, that requires surgery, they will do the surgery but you are required to come up with the money before you leave the hospital. This is similar to the way that Dr. Harvey does it in Impfondo. There, if you don't have the money, they will still do things if it's urgent, but they can actually hold you in the hospital until you pay them. Overall, things are relatively cheap. An MRI only costs $300 USD, and a daily stay in the surgical suite costs $12 USD per. If you've ever gotten an MRI or stayed in a hospital you know what I mean. But for a lot of people it's astronomical still. If it's not an emergency situation, and you can't pay, then they for sure won't do anything.
As we were getting ready to leave the hospital, we passed by one of the peds/neonatal areas, and this guy had just lost his baby/young child. He was walking up and down the hall screaming in despair. It was a rather sad moment. To perhaps make it worse, we watched as he had to carry his dead child out of the hospital and got into a taxi. It was the same when I was in Haiti -- if a family member dies in the hospital, you take the body with you and make arrangements. Pretty different from the US. I can imagine losing a child is heart breaking, but I can't imagine it helps to carry the dead body out with you into a taxi. With that, we said our goodbyes to Aucolz, who informed us that he would stop by Hotel Bravo tomorrow to visit with us. He's a cool dude, so I'm looking forward to it.
We got back to Hotel Bravo and Jason and I grabbed our stuff and were going to head out to look for some dinner. Reol said that they made some extra and we could just eat there, so we figured why not. A couple minutes later a huge storm hit and rain just poured down.....so we were happy. We would have been drenched with not much guarantee of finding food at that point. After dinner I had to go turn in and rest. Really trying to kick this illness now, and on top of that had a bit of a migraine today. Started the Z-pack and hoping that it helps to knock it out. At least I remembered cough drops this time....provides at least a bit of relief for the raw throat.
Before I close out for the day, I wanted to touch on something briefly that we discussed with Nastasia, which is in regards to farming, or really the lack thereof. I guess in the Congo, it is really considered an unlofty thing to be a farmer. Everybody wants to get an office job of some sort, because they think that's what westerners would consider important. What's sad, is that their land is prime for growing all sorts of fruits (papaya, pineapple, bananas) and avocados, etc. If they could see the potential for growing/farming and starting to export, they could really turn the wealth of the country around. Now, I'm not sure how much politics plays into this either, but even locally, they will line up on the river and buy stuff from the people of the DRC rather than grow it themselves. It's really a shame. What we were discussing this morning was ways to implement sustainable health care, and one of those being to find a way to increase the economics of the area and help fund a clinic. I suggested giving a couple money to help them start a farm, tell them we would take a percentage of it which would go to fund a clinic, and as it started to grow and they saw the financial potential, maybe it would even inspire others around. Nastasia said it might work, if you gave the money to a woman in the area. The men are very against farming and it is a lowly position in their mind, but a woman might be willing to give it a try. Just thinking of ideas for the future, but if in a region like this you could find a few that would be willing to at least try it, it could just work. Again, I suppose it would depend on the politics, but I think part of any type of long term medical care in a country is getting in with the political officers and making it beneficial for them as well. It's all a work in progress, and feel free to add some comments at the bottom if you have any suggestions. I really want to implement sustainable health care, and influencing the public health is key (clean water, building the economy, etc).....and I'm more than open to input. So please utilize that comment box!
Thanks again for reading!
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