Saving Lives in the Democratic Republic of the Congo
by Darla Rowley
Disheveled children of every age and size crowded around our vehicle as it ground to a stop in front of the United Methodist Mpasa Reference Health Center in the Democratic Republic of the Congo. It was in this sprawling suburb of Kinshasa, DR Congo, that I was to assess health facilities for the Central Congo Conference. Dr. Rebecca Yohadi, the conference's Chief Medical Officer, told me that the Mpasa suburb sprang up in 1998 near a military installation as a camp for displaced persons and refugees. Civil conflict had driven people there from surrounding villages, and others had fled there to escape wars in neighboring countries. So the Mpasa Health Center had been established in 2000 to address the myriad health needs of people living in abject poverty.
As we toured the health facility grounds, Dr. Yohadi pointed out the lack of employment opportunities and the paucity of garden plots within a 10-mile radius of the center—an area with a population of 22,720. This, she said, had led people to desperate survival measures, including prostitution and sex trafficking, and had bred a high incidence of gender violence. Just that morning, a 5-year-old victim of sexual assault named Elizabeth had been received at the health center. There are 67 reported rapes of female victims daily, and the widespread use of gender violence as a weapon of conflict increases the risk of exposure to HIV/AIDS among children as well as adults.
The DR Congo (formerly Zaire), in the equatorial region of Africa, is struggling to recover from nearly 10 years of political instability and civil conflict. The conflict, lasting from 1996 to 2003, has resulted in some 4 million deaths and more than 3 million displaced persons and refugees. It has left the third-largest country in Africa in a precarious situation.
The country's overall population is 61.5 million, with 80 percent living below the poverty line. This widespread poverty, lack of infrastructure, and loss of livelihoods have been primary factors contributing to the spread of HIV/AIDS.
Prevalence of HIV/AIDS in DR Congo
One of the first African countries to recognize HIV/AIDS was the DR Congo, which began registering cases in 1983. Heterosexual activity accounts for 87 percent of DR Congo's cases. There are an estimated 1.5 million Congolese living with HIV/AIDS, including about 52,000 children, from birth to age 14. Adult HIV prevalence is 3.2 percent; however, sex workers in Kinshasa, the most at-risk population, have a 22.2 percent HIV prevalence. Only 129,000 (8.6 percent) of the 1.5 million HIV-infected adults and children in the DR Congo are receiving life-enhancing antiretroviral (ARV) drug therapy.
Children, such as Elizabeth, are particularly vulnerable to gender violence, the loss of one or both parents to HIV/AIDS, and the possible mother-to-child transmission during pregnancy and childbirth. While the prevalence of infection among pregnant women aged 15 to 24 rests at 3.6 percent, those most affected by HIV/AIDS are youth and adults aged 15 to 49; their infection prevalence rate is roughly 1.5 percent, according to the Joint United Nations Programme on HIV/AIDS. Thus poverty-stricken grandparents and other elderly relatives are left to provide care for the estimated 270,000 to 380,000 children orphaned by the scourge of HIV/AIDS.
HIV/AIDS control is a priority for the National Poverty Reduction Strategy Plan of the DR Congo. This strategic framework favors prevention, care, and advocacy activities that highlight community participation, human rights, ethics, and the needs of people living with HIV/AIDS. To implement this strategy nationwide, the government has solicited participation from all its developmental partners, including the private sector and nongovernmental and faith-based organizations.
United Methodist Health Network
As a faith-based organization, the United Methodist Committee on Relief (UMCOR) is working collaboratively within the strategic national AIDS framework of the DR Congo Ministry of Health. UMCOR and United Methodist churches in the Central Congo, South Congo, and North Katanga annual conferences are engaged in a unified effort to break the silence and overcome the stigma associated with HIV/AIDS. This effort may save the lives of countless Congolese.
The three conferences of The United Methodist Church in DR Congo have a combined membership of well over 1 million, along with 215 health facilities and numerous churches strategically located both in urban areas and in remote, isolated parts of the country. Large numbers of dedicated clergy, laity, community health workers, and health professionals are the church's major assets in combating the country's HIV/AIDS epidemic.
In 2008, the church in DR Congo, in conjunction with UMCOR, formed the DR Congo UMC Joint Health Board. It serves as the springboard for developing and initiating an integrated approach to overall health-care needs countrywide. The first of this three-pronged approach is about building the operational, technical/medical, and leadership capacity of the overall UMC health system in DR Congo. This includes financial management workshops for hospital administrators, work on developing governance policies for the health boards, and strategic planning. Continuing education and training for health workers and other medical staff are part of the plan.
The second approach targets health-facility revitalization by repairing and equipping existing United Methodist health facilities, especially those damaged during recent civil conflicts. This involves upgrading water, electrical, and plumbing systems; roofing; laboratories; and latrines.
The third approach seeks to prevent the three diseases of poverty: malaria, tuberculosis (TB), and HIV/AIDS in the communities served by UMC hospitals. All of these diseases weaken the immune system and leave the body susceptible to anemia, weight loss, and dehydration. Among adult TB patients in DR Congo, HIV infection is estimated at 17 percent, as tuberculosis can be an opportunistic infection caused by HIV/AIDS. Malaria can lead to anemia in children, requiring blood transfusions that increase their risk of exposure to HIV. Anemia also reduces the effectiveness of antiretroviral drug therapy. Good nutrition is vital for HIV/AIDS patients. One key component in reducing maternal and child morbidity (illness) and mortality is to teach people how to prevent HIV/AIDS and how to improve the quality of life and care for those living with the disease.
The Connectional Church's Role
UMCOR Health provides funding for health and health-related projects through several channels. Funded projects may target water purification and sanitation, nutrition and food security, maternal and child health programs (both pre- and postnatal care), immunizations, child-growth monitoring, family planning, and training for community health workers.
Strategies for breaking the silence and stigma of HIV/AIDS through United Methodist projects in DR Congo are innovative and broad in scope. In the South Congo Conference, Dr. Simeon Kashala, Chief Medical Officer, initiated the training of hospital staff in safe blood transfusion to prevent the spread of HIV-infection among malaria-stricken children and adults at UM Samuteb Memorial Reference Hospital in Kapanga. Additional training for 50 community volunteers in Musumba—a remote, rural area of 60,000 people living near the hospital—helped to address the increased risk of HIV/AIDS exposure for women in polygamous households. Community volunteers also provide education and resources to help these vulnerable women prevent the spread of this deadly disease.
In the North Katanga Conference, Dr. Guy Kasanka initiated the first faith-based workshops to train 150 peer educators in Kamina. They, in turn, will bring HIV/AIDS education and prevention strategies to clergy, laity, military personnel, secondary school students, police, cultural associations, and sex workers. The second phase of this project will establish a voluntary testing and counseling center and provide home-based care for persons living with HIV/AIDS.
Dr. Pierre Manya of the Central Congo Conference launched a project to teach staff at Wembo Nyama Reference Hospital how to provide safe blood transfusions to children and adults. They also will give safe birthing kits to pregnant women, showing them how to reduce the risk of exposure to the disease during labor and delivery. Since 28 percent of Congolese 15- to 24-year-olds have had sexual encounters before age 15, Dr. Manya also introduced a project to train 120 youth as HIV/AIDS peer educators for secondary school and university students. This training is based on the ABC methodology: Abstinence, Being faithful, and Condom use. In Minga and Tunda, two areas hard hit by civil conflict, projects focus on home-based care for those living with HIV/AIDS. This training includes patient care, education, and income generation through microenterprise development for orphans and vulnerable children. Youth are trained as peer educators to encourage voluntary testing and counseling.
To counter HIV/AIDS transmission through sex trafficking and gender violence in the Mpasa community, Dr. Yohadi developed a strategy to train 25 community health workers, laity, and clergy to educate the community about HIV/AIDS prevention. She indicated that the DR Congo United Methodist Church, with the assistance of UMCOR, was ready to mobilize itself to fight HIV/AIDS.
Besides the ministries of doctors Yohadi, Manya, Kasanka, and Kashala, there are HIV/AIDS projects in which countless other United Methodists in the DR Congo are engaged. Community health-care workers, medical staff, and United Methodist youth, men's, and women's groups have initiated projects in their own communities. Courageous United Methodists breaking the silence and stigma of HIV/AIDS exemplify a labor of love. The fruits of this labor are the improved health care and quality of life for those living with HIV/AIDS and the lives saved through HIV/AIDS education and prevention in the DR Congo.
Darla Rowley served two missionary assignments in Africa, along with her husband, the Rev. Glenn Rowley. She was part of the Senegal Initiative in Dakar, where the Rowleys worked with other missionaries to establish a United Methodist mission presence. Darla also served in Mozambique, where she helped to implement health-care education.
Date posted: Nov 01, 2009