Ophthalmic Mission in the Town of Kole, March 2015
Kole is located on the Southern hemisphere's 23°30' parallel, deep inside the tropical jungle along the Lukenie River. It is rather isolated as the Sankuru District's main route runs 110 km from it. This distance, which has to be travelled in the forest, took us an entire day. Our trip was very tiring both ways, spiced with adventures and predicaments. I was planning to work in Kole not only in the field of ophthalmology but also on my „research area”, pentastomiasis. This would require electricity in the evenings for dissecting snakes, taking photos, writing, etc. – Let us take two cars; the marvellous solar power system in our ambulance easily fulfills this requirement ... or so I thought.
We prepared the small ambulance as best we could: we adjusted the brakes as well as the oil level, I checked the ignition and even adjusted the carburettor. A test run was very encouraging ... Well, four hours into our journey, some 110 km past Mbuji Mayi, the car began playing up. The motor misfired, it was losing power, and we couldn't drive uphill at all. Instead of the planned 400 km, we only managed 200 the first day.
Meanwhile, we disassembled the parts several times, until we realized that the problem was with the ignition cables; power was lost somewhere, there was no spark, and the car was running only on two cylinders instead of four ... The first 100-kilometer portion of the road had been pretty muddy in places, and it is possible that that is where the cables became waterlogged
Since we couldn't reach our target, we stopped in a monastery for the night. I was dog-tired, brooding all night over what to do. We couldn't continue at such a pace, moreover each additional kilometer would only take us further away from Mbuji Mayi whereto we shall have to get the car back. I decided therefore to leave the ambulance behind and try to move as much stuff as possible into the Land Cruiser continuing on our way in only one car. In the morning our small team was relieved to hear of my decision, and we immediately got on with the loading. By some small miracle we managed to pack almost everything inside and onto the roof rack, plus seat seven people! Like sardines!
Never mind, at last we sped along and by about 3.00 pm we reached the Sankuru River with Bena Dibele, our goal for the day, across the river. I won't go into the details of our river crossing, suffice it to say that we went ahead in canoes, hired some ferrymen and waited for the car to be brought over. It was terribly hot, so we ended up with Andrew, who was accompanying us, in a small beer garden. After all, complete dehydration had to be prevented by a life-saving liquid cure.
We started to come back to ourselves, it turned out that the owner had died three months ago, and some young lad was entrusted with the whole bazaar (beer garden, restaurant and a five-room hotel). Never mind, we were going to eat here – it turned out that the restaurant had re-opened that very day. There will be seven of us and we would eat in about two hours' time. Doctor Thomas, my current assistant for this trip, took control of matters. He returned after ten minutes, saying that we should go to the market to do some shopping, because there was almost nothing in the kitchen, and what there was, was suspicious looking ... Okay, I gave him money and Andrew and I continued to chew the fat. The car finally arrived at 7pm, just by sunset. The team was together again, but the kitchen was delayed. Thomas informed me that he needed some more money for charcoal. Ten minutes later it was salt and oil that were missing … in the end we had to buy everything ourselves. It turned out that Thomas was an excellent cook, and he prepared the goat meat fantastically. We bought four forks and four spoons as there was a shortage even in those … But truly hungry people are not fussy
The following day we set out on a very bad road across the jungle. After a while I blessed the Lord that we didn't have the ambulance with us, because we had frequently to maneouvre under fallen trees across narrow corridors. Sometimes we had to stop and dig so that the things on the roof shouldn't stop us from passing under a fallen tree trunk ... etc. Eventually we reached a rivulet called Lunga, but the bridge that was still standing two years ago has since collapsed, and we had to cross over some makeshift logs.
Behold the horror story of the bridge:
“There once was a bridge ...” or “The Bridge over the Lunga River.”
If I am not mistaken, it was built sometime in the fifties during the Belgian era. The Lunga River flows about halfway in the jungle between Bena Dibele and Kole. It is not too wide, approximately 25 meters, but after major rains its level rises considerably. That is why the Belgian bridge builders erected it pretty high. In 2013, when we went to Kole by car to care for ophthalmic patients, these 50 meters were the best section of the road. So much so that we didn't even realize that we had passed over it!
Poor little bridge, your fate was sealed by human folly. It was under the influence of a local parliamentary eminence that a ferry was to be delivered to Kole. It was tied behind a boat and towed on the Kasai-Sankuru River as far as the town of Bena Dibele. The plan was to take it from there by truck.
What an idea! Anyone knowing the local conditions would be dumbfounded. The Lukenie River is navigable all the way to Kole, therefore the ferry could have been easily sent all the way to Kole by water had it been shipped from the Congo River via the Lukenie instead of the Kasai.
Moving in the jungle with a truck in the jungle, carrying a hull is not child's play! In 2013, when we were in that area, the small convoy was doing 30 km in 3 months! There was a truck, with a ferry on it that fitted nicely on top except that its sides were hanging off, while a groundworks machine was clearing the woods, paving the way for the convoy…
No wonder they were progressing at a snail's pace. Neither the forest, nor the hill worried them; forward, never backward! Well, what a surprise! At exatly midway between the two towns, there was a bridge! No sign, how much weight it could carry and what was permitted. Never mind, nobody would be policing it. But then the biggest problem was that both sides of the hull became caught in the grid structure of the bridge that was approximately 1.5 meters high on both sides like a railing.
What to do with this unexpected hindrance?
No problem, they would raise the level, and then the convoy could proceed. (There were experienced engineers present!)
They did, indeed, raise the level with soil so that the hull should rise above the railings, and the truck would be able to cross the bridge. However, when it reached the middle of it the bridge collapsed, and truck and ferry fell straight into the river!
It was after these events that they fabricated the little bridge out of logs, the one that collapsed under our car on our way back from the 2015 ophthalmic mission on Easter Monday. That's as far as what the Koleans told me. I listened in disbelief and sounded out a lot of people. Even senior officials confirmed the incident. I am just passing it on; let it be a lesson for the future...
The ferry is having a rest...
Do not try to go on at all costs. Before you go, you might want to think a little, to plan your route! ... Let me continue after this brief digression with the story of our mission:
Hundred and five kilometers in 7 hours is by no means a good average, but the main thing was that we finally arrived safe and sound in Kole. The sisters of the Spanish order "Fellows of Jesus" – Sister Teresa, the director of the hospital, Maria, who runs the pharmacy, Adéle, the financial director, and her sister Annette, who looks after the young people's pastoral care – had already been eagerly awaiting us.
It is a cheerful, relaxed and closely knit small community. They put us up excellently in a separate small house where there was everything: water, toilets, and a solar system that, however, worked only during the day, a kitchen, shower and a large secluded porch. We were going to spend almost four weeks here.
This house had served as a base for a US program for Monkey Pox research. We found a lot of books, newspapers, and all kinds of equipment and the remains of an Internet station, which unfortunately didn't work. There was no telephone network either, and for political reasons they could not put up an antenna!
The following day we settled in at the hospital. Everything was unbelievably messy and dirty. That was perhaps the most characteristic trait of Kole hospital. We had to beg for water if we wanted to wash our hands. We also had to beg to have the floor swept before starting work in the morning. We had enough patients and soon we managed to establish a good program. Fortunately, the phaco machine worked well this time, and I could operate quickly and effectively with very good results. During our stay we saw 710 patients and performed 139 operations. On operating days Dr. Tomas looked after the surgery, which was of great help to me.
We operated on children and quite a number of bilateral cataract patients who leapt for joy when they realized they had regained their sight. Patients came from great distances, 200 to 300 kilometers was not a rarity. Many people came only to get reading glasses; they too were very satisfied because we had brought plenty of them...
Meanwhile I was trying to deal with pentastomes, these unusual parasites that live in the airways of large snakes. I was collecting them from patients where they showed up as incidental findings, and also let it be known that I would buy any kinds of snakes for the purposes of research. During our stay I bought eleven snakes so as to encourage the people to collect them.
We found pentastomes in two cases, both in vipers (Bitis nasicornis). It is typical that Armillifer Grandis 'lives' in big vipers. We found about 12 pieces of mature specimens in it. They cling with their four hooks inside the lung of the snake and keep sucking blood with the middle of its body, which is its mouth. Interestingly, its shape resembles a spiral spring. Talking to the locals it turned out that they very often see some of them, it is practically a daily experience. Folk science has it that these springs help the serpents to move. What they do not know, is that the millions of ovum-like eggs generated by the adult female infect humans if they consume barely cooked or fried snake meat. The ingested eggs hatch tiny larvae and live in the abdominal cavity and other organs, waiting for the host to be eaten by a large snake, thus make their way to their final destination, the respiratory organs of a snake, where they can finally become adults. Since snakes rarely eat people, man is the dead end...
Meanwhile, we examined other small mammals as well, especially mice and rats and, without exception, all of them were packed with cyst nematodes. Andrew, a professional photographer, was taking lots of photos so I didn't bother as his were of fantastic quality and he thoroughly enjoyed himself. On weekends we enlivened the mission by taking small trips; we spent a day at the Lukenie River and an afternoon in the woods.
Lent was drawing to a close, the number of our patients was naturally decreasing and since I did not want to travel during Holy Week, we spent the holidays In Kole. On Easter Monday we set out on our return journey, and I was rather worried: what will become of our ambulance? Can it be fixed? In what condition will we find it after four weeks? The road in the woods was very bad; we reached the bridge about 60 km out of Kole. To our surprise we saw that on the other side the Road Maintenance Company's people (engineers, skilled workers, etc.) were just then taking apart the beams with a truck crane. It turned out that they were about to lay down new ones because they had to get the mobile crane across, which was too heavy for the earlier bridge. "No worries," they said, "we'll quickly put them back and you'll be able to go across, and you won't have to wait two days." They slightly reinforced the only remaining one and began to direct our car. Reaching the middle, the profiled body on which the wheels rolled became more and more bent, then a huge ominous creaking, the beams broke in half and the car plummeted onto the metre-long stakes driven into the river.
I saw that the end of the world has arrived. Fortunately, our driver got out unscathed. I was so desperate that I couldn't even take part in the vehement argument that erupted. I have seen and experienced many things on these roads, but nothing like this has ever happened to us. I decided to go for a walk to clear my thoughts. As I moved further away from the noise at the bridge Slowly, as the bridge moved away from the noise, my despair was replaced by a little hope; after all, they were the specialists, they have seen all kinds of situations and would surely think of something. I went back after about half an hour, and saw that they begun to thread the car with steel ropes and hanging on the crane. The span was very big, and the crane could raise only 7-800 kg that far. At the first attempt, however, one could already see that the combined lifting and dragging inch by inch would achieve results, and the car was eventually pulled ashore and lifted up. In the end, we also helped with our own winch and our battered car landed successfully next to the truck.
It was high time too, as it was already 3.00pm, and we had managed only 60 km in 6 hours. Well, that's how things are when travelling by all-terrain 4WDs; anything can happen. By evening we reached the town of Bena Dibele and stayed at the same place. Next day's crossing was again problematic. Experts from Mbuji Mayi were repairing the ferry, as the original hydraulic steering had broken down. They were converting it to manual, so that just like a sailboat, it could be steered by a pole. It was 3.00pm by the time we finished the crossing, and we started the rockets to reach Mashala, the little 4WD's home station. Early in the morning after a good night's sleep, the driver and I with the driver installed. We definitely established that the HT (high tension) cables were to blame, and that was why there was no spark. By chance I had something suitable in the toolbox; it just needed a small adjustment. After saying farewell to the sisters. we left at around 9.00amWe started to speed like a bullet train. The road was very bad, we got stuck a few times, but eventually we arrived safe and sound in Mbuji Mayi at eight-thirty in the evening! What a pleasure it was to be back after such a long absence in the Mbuji Mayi mission, where they were already eagerly expecting us. Four weeks now in Mbuji Mayi and then comes the next mission trip. A missionary's life is certainly not boring!