by Kathleen A. Hogan, MD
“Going up that river was like traveling back to the earliest beginnings of the world, when vegetation rioted on the earth and the big trees were kings.”
Joseph Conrad – Heart of Darkness
Traveling to the Democratic Republic of Congo (DRC)
It takes approximately 19 hours, flying over 7000 miles to reach the Democratic Republic of Congo (DRC) from Boston. It is not a trip that many people take for just a weekend. Indeed, the DRC is not a place frequented by American tourists. But recently I found myself flying to the Congo for a quick 36 hour trip. Why? Together with a nurse, an internist, another orthopedic surgeon and a physician assistant, I was there to pre-screen patients for total knee replacements at the Biamba Marie Mutombo Hospital in Kinshasa.
Why the DRC?
I am part of a group of female orthopedic surgeons (WOGO) who travel to third world countries to improve the lives of people by improving mobility through joint replacement. We also believe it is important to teach doctors in those communities and to be role models for young women. On this trip, we are partnering with the Dikembe Mutombo Foundation (DMF). Dikembe Mutombo, a former all-star professional basketball player, is from Kinshasa and has developed this foundation to improve the health, education, and quality of life of the people of the Congo. The hospital opened in 2007 and is named after his mother. Over 100,000 people have been treated since it opened.
About the DRC
The DRC is located in central Africa, on the equator. It is the third largest country in Africa, two thirds the size of Western Europe. It has vast natural resources and its forests are home to endangered species of Mountain Gorillas and elephants. However, the recent history of the DRC has been one of war and unrest. A former colony of Belgium, the country gained independence in 1960. After a political coup, the Congo became known as Zaire under its dictator Joseph Mobutu from 1965-1997. From 1998-2003 the country was at war and over 3 million people were killed. Free elections were held in 2006 and the country became known as the DRC.
Income, Life Expectancy and Disease
Joint replacements are seldom performed in DRC. Those who can afford it travel to other countries such as South Africa or India for surgery. The average income in this country is approximately $600 per year, which ranks it as one of the poorest countries in the world. Life expectancy is only 45 years as 20% of children die before age 5. Malaria and other tropical diseases are extremely common as is tuberuclosis, polio, and HIV/AIDS. Most of the people we met were in their 60’s but a few were in their 80’s. Most were surprisingly very healthy, with high blood pressure and diabetes being the most common medical problems.
The Patients We Evaluated
In a day and a half, the five of us met with the team of doctors and nurses we will be working with during our trip. Everyone worked incredibly hard. In this short time, we evaluated almost 90 patients. Many people that we saw had very severe arthritis. Many patients had much more severe deformities then we typically see in the US. Everyone was extremely grateful. Some patients waited over 10 hours to see us that day in 90 degree heat. When I apologized to my last patient of the day for her long wait, she said simply “when you are in pain you will wait.”
The people of the Congo have endured much hardship and poverty due to wars and political corruption. Access to good medical care is extremely limited. We hope that we can make a positive difference in the lives of the people we care for during our return trip to the DRC in July to perform knee replacement surgeries. More information on our upcoming trip can be found at wogo.org.