Feature

Learning Curve

Many lessons—but one stands out

By

Violence is breaking out more lately. There are soldiers everywhere now. People are getting scared that the battles are in the north and just west . . . Slowly and maybe surely getting closer. There are battles in a town called Sake . . . it’s about 15 kilometers west . . . we are getting a lot of soldiers from that battle. Yesterday, we heard machine gun fire . . .”

Opportunity to Serve

I sent that e-mail to my dad last September as I worked long days in an African town at the center of the latest conflict between government troops and Tutsi rebels. I am a nursing student at Crown College (St. Bonifacius, Minn.), a C&MA school where overseas missions is stressed in every major. The nursing program is new, so the class I am in will be the second one to graduate.

During the past two summers, Crown has organized a short-term missions trip to the city of Goma in the Democratic Republic of the Congo (DRC). After a couple of successful trips, officials at Crown College thought it was time for a semester-long internship at Goma’s HEAL Africa hospital. Kate Mankse and I were chosen to go.

Goma rests on the edge of Lake Kivu, which straddles the border between DRC and Rwanda. Goma lies in the middle of a highly active volcanic area, so unlike Rwanda, Burundi, Uganda or the other areas of DRC, the dirt isn’t red or dark yellow but very dark gray. In fact, it is estimated that an eruption occurs nearly every 30 years. The last time Goma had a river of lava flow through it was in 2003.

Since then, there have been eruptions of a different kind. Fighting between Hutu, Tutsi and Congolese soldiers is one of the reasons Goma is home to MONUC, the largest UN peacekeeping force in the world.

Meeting the People

Kate and I were assigned to language study in addition to working a certain amount of time in the hospital per week and completing online classes at Crown. During our first two weeks in Goma, we distributed bed nets to homes, which became our project for a community health class at Crown.

Delivering the nets was a great experience. Through a translator, Kate and I interviewed families from all neighborhoods of Goma as we taught them how to use the nets. We spent time in Congolese homes and really got an idea about how some of the people in Goma lived.

According to the World Health Organization, DRC has the second highest rate of malaria in the world. The nets are treated with insecticide and help to prevent malaria, which is transmitted through mosquito bites. I tried to get more funding for bed nets from other organizations by showing them reports of what I have seen and how I know that the nets are being used properly.

A Surprising Development

After two weeks of distributing bed nets, Kate and I were ready to start work at HEAL Africa. Events at the hospital seemed to have been secretly planned to coordinate with the beginning of our internship. The vast majority of nurses went on strike that very day because they were not getting paid by the government as promised.

Our arrival at the hospital was a jumble of excitement, confusion and shock. Under pressure, many of the nurses who had stayed eventually went on strike as well, so Kate and I were on duty for many long shifts.

We cleaned a lot of infected wounds that first day. We had put in a lot of hours studying the language in order to communicate somewhat effectively with our patients, and it was fun to see their faces light up as we spoke to them in Swahili.

The Cleaning Room

Our last patient on our first day was Gradi, a small boy around 13 or 14 years old. His face, some of the top of his head and both arms, shoulders and hands were badly burned. He also had pulmonary edema, a condition in which fluid enters the lungs, causing shortness of breath. A plastic surgeon was working at the Goma hospital for a few days, but Gradi kept getting bumped from surgery because of the soldiers coming in for treatment.

Kate and I helped walk him to the “cleaning room,” where one of the few orthopedic nurses that remained was waiting. The area was a small bathroom with a stool sitting in the middle of a stand-up shower. A broken toilet bowl next to the shower served as the biohazard disposal. Buckets of pus and blood went into this toilet, which sat right next to the hand-washing station and the burn patient cleaning station.

When people suffer third-degree burns, the scab, or eschar, that is formed when the skin is sealed by the heat has to be removed. I was interested to learn what needed to be done. We sat Gradi on the stool and removed his robe, since it was most likely the only clean one he had. The nurse gave me a scalpel and started cutting away the eschar on the boy’s face, while I started removing the damaged skin on his right arm.

Pain management is a priority in the United States, but in Africa, it’s a sign of weakness not to take the pain. Perhaps it helps the people cope with the actual lack of medication. For two hours the poor boy sat in that small, dirty room in the stench of his infection, naked, bleeding and screaming that he wanted to die. It was terrifying for me—I was torturing this kid. It frightened me to think of how many patients before him had gone through this same kind of treatment.

After the eschar removal, we treated Gradi with a topical antibacterial ointment and then bandaged the wounds with coarse gauze, since nonadherent dressings were not available. We walked the boy back to his bed, where he lay without moving a single muscle. He never moved a muscle.

I wrote home and asked many people to pray for this boy. The following three or four days Gradi lay on his bed with a lifeless face. Then the oddest thing happened. I received two e-mails assuring me that many people were praying for him. That very morning, I went into the orthopedic ward, and for the first time I heard Gradi call my name. He was sitting up in bed and no longer had evidence of pulmonary edema when he spoke.

He asked me if I was going to clean him that day. “Do you want to be cleaned?” I asked. He told me that he wanted Kate and me to treat him. Just the evening before, he lay in his bed lifeless, and now he was actually asking us to help him. God had answered prayer; I had peace that Gradi was going to be alright.

The One I Didn’t Tell

“I am horribly tired and am wondering when you will get this message since I type it and then send it whenever I can. . . . I wouldn’t worry too much about the fighting. The people here said that they will let us know if we need to evacuate in good time to be safe. The house we are in is extremely close to the president’s house . . . That could be a good thing—haha—and a bad thing, I guess. God isn’t blind to the situation.”

I learned many lessons during my time in the hospital, but one stands out. I was treating a patient in the orthopedic ward when a doctor suddenly rushed toward me and told me to follow him. He looked nervous and anxious. We gathered supplies, and he led me to a private room in a different building, where a man was lying on the bed with several people huddled around him. He was suffering from a massive diabetic necrotizing fasciitis in his right foot.

When the doctor asked me what I needed, I realized that I would be the one treating the wound and he would be assisting me. I did what I could. Later that night, I learned that the patient was the chief of the whole North Kivu Province. He was telling everyone that a young white man—me—had given him the best treatment he had ever received. I have to admit it felt great. They appointed me “in charge” of the chief ’s foot, even though the next evening he would have it amputated.

Two days after the surgery, the chief died of major postoperative pneumonia. The day he died, I saw him lying on his bed. Although it looked like he was gone, his body was still fighting to stay alive. I felt sad—he was a nice man, at least for the short time I conversed with him.

Most people in Goma are Christians, and many patients in the hospital expressed faith in Jesus Christ. I found out the chief was Muslim. The one man I didn’t talk to about spiritual matters happened to be the one I needed to the most.

I felt as if Jesus were screaming at me through this man’s struggle. I know Jesus wanted the chief ’s salvation. I too would have liked very much to have him in heaven with me. An overwhelming sense of hopelessness covered me. The gospel must be shared, and no matter what we do, no matter our occupation, nothing is more important on this planet than the salvation of those around us.

Advancing Forces

“The fighting is getting worse. Where I am staying, I have connections with people who know inside matters. Evidently, things can become quite violent. The battles in Sake are getting worse. By the end of the year the UN and ‘others’ think the fighting may be in Goma. Or all around it . . . . Death threats are everywhere.”

I wrote this to my father in late October of last year. Our internship ended prematurely when Laurent Nkunda’s Tutsi rebel forces reached the outskirts of the city. Nkunda’s forces were headed straight toward Goma, the tension was rising and battles were drawing nearer. Officials at Crown College decided that it was best for Kate and me to leave as soon as possible. Many of the other white people evacuated with us. It was incredibly embarrassing to leave the way we did; it felt like cowardice was being force fed to me.

Despite the strike and tribal tensions, I made great friends and had some wonderful experiences; I hope that I will be able to work in a similar environment in the future. There is a lot of hurt on this planet; it would be an honor to give holistic care (physical and spiritual) to patients around the world for the glory of Christ the King, who will wipe away every tear and overcome this whole mess.

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