Knee Replacement in Congo – Part I

The Democratic Republic of Congo

The Democratic Republic of Congo (DRC), formerly known as Zaire, is not a tourist destination.    Because of ongoing violence, much of the country is inaccessible.   There are warnings for travelers posted on the US Embassy website. There is an ongoing yellow fever epidemic.   The DRC is one of the largest countries in Africa and also one of the poorest.  The country has been devastated by multiple wars, corruption, and a dictatorship. So why would I travel there?

Knee Replacements at Biamba Marie Mutombo Hospital

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. Dikembe Mutombo, an NBA Hall of Fame basketball player, who is from Congo, asked our group to go to his hospital. Biamba Marie Mutombo Hospital is a 150 bed hospital with modern equipment including the only CT scanner in the country, an intensive care unit, and 3 operating rooms. Our group would be performing the first knee replacements done in that hospital, and possibly the first done in the country.  This was an incredibly challenging trip.  This is our story of what it was like to do knee replacements in Congo.

Travel and Logistics

It was a long plane ride.  Over 16 hours of travel.   We were met at the airport by police officers with machine guns who would be traveling with us everywhere we went.   The team was all assembled at the hotel. We are a large group with over 40 volunteers  including surgeons, scrub techs, nurses, anesthesiologists, internists, physical therapists, and a translator. Last month, a smaller team had traveled to Congo for the weekend to select patients for surgery.   We arrived Thursday evening, with the plan to start operating on Friday.   We planned to do  52 knee replacements in 4 days of surgery.  In March, 9000 lbs of orthopedic equipment and supplies had been sent by ship to the DRC.  We had been told the cargo was there and an advance team had arrived  a day early to unload and unpack the shipping container.

Challenges

There was only one problem.  The cargo was not at the hospital.   It was in the country, but we needed a signature, or maybe more than one, in order for it to be released from customs.   Mr. Mutombo spent Thursday and Friday trying to get those signatures.   Our team was waiting at the hospital to unload the cargo.  By 6pm on Friday, we were worried.  Supposedly the signatures had been obtained but a customs agent could not be found to escort the cargo.  An ultimatum was given.  If the cargo did not arrive by 7 am the next day we would not be able to do our surgeries.   We were about to leave the hospital when word came that the cargo was on its was on its way.  Mr. Mutombo had called the president of the country, and a customs agent had been found.

Teamwork

The shipping container arrived around 9.30 pm, along with Mr. Mutombo.  We were tired, hungry, jet-lagged, and excited.  Everyone pitched in to unload hundreds of boxes and more them to the operating rooms and the hospital floor.  Boxes were loaded onto stretchers and laundry carts.   It was truly a team effort.   Pizza arrived an hour later and was the best pizza we had ever tasted. But boxes still needed to be unpacked and the equipment organized. By midnight we were all on the bus for the ride to the hotel.   The  next day buses would leave at 6.30 am and we would finally be able to start doing knee replacements.