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| A view of the main building of the hospital. The chapel is on the right. |
L’Hopital Evangelique le Pionnier (HELP) is a mission hospital in the Republic of Congo in Africa. The hospital’s mission is summed up in a mural on the chapel wall. It is a depiction of the story of the lame man being lowered through the roof to get to Jesus below. The goal of the hospital is that when the patients come here they get their physical healing as well as spiritual healing. As part of this mission, we pray for each building before we leave when we are rounding. The hospital has a capacity of 60 patients and covers most aspects of medical care for the people of Impfondo and surrounding areas. We provide obstetrics, gynecologic surgery, minor general surgery, pediatrics and neonatal intensive care, as well as general medicine. We provide the highest level of care in the country besides the capital city, Brazzaville, which is a 2 hour plane ride or a 3 day drive away.
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| A view of the hospital grounds. Bldgs on the right are the delivery room and post-partum wards. The colorful bldgs are men's, women's and pediatrics wards. |
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| Our xray tech, Alpha, showing Tyrel the ultrasound. in the foreground is the xray machine. |
The hospital is on the grounds of an old youth camp from when the Congo was under communist control so it is made up of a bunch small block buildings. Each small building has up to 9 beds in it for patients. The way healthcare works here is that the patients have to have a family member here to help with nursing needs and providing food. They pay for each week that they are here. The hospital provides one meal a day for patients. Each department has a nurse that is in charge of it who makes quite a few of the medical decisions. Dr. Harvey, the medical director of the hospital, is trained in family medicine and also performs some surgeries. There are consultant nurses which act as nurse practitioners that run the emergency department and observation unit. There is a lab for basic tests, and a radiology tech who could shoot x-rays and ultrasound. We also would use a portable ultrasound to help us with diagnostics and treatments.
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| This is our dorm. |
Our role here as medical students is about equivalent to about a 2nd year resident back home. We are considered the doctors when we are here and are tasked with the ultimate decision making for all of the patients. Dr. Harvey has significant health issues, due to which he is only able to work at the hospital Monday, Wednesday, and Friday until noon. We make our decisions and then run them past him to "ok" it like a resident would. But also in his absence, we are the doctors on call throughout the night, every night. For example, we got woken up one night by the NP to go to the emergency department to look at a 6 day old baby boy with suspected neonatal tetanus. We gave our recommendations and made sure the patient was stabilized then went back to bed. We live in a dormitory on the medical campus, so it is only a 3-4 minute walk to the ED across the soccer field (more on living in Africa later.).
Typically, we would round on 20-30 patients every day and split them up between the three of us. We would start with the most critical and then work our way through the wards. We would work with a translator to help us since no English is spoken in the Congo - they speak Lingala and French. This was difficult since Lingala is a very rudimentary language. We definitely had some issues with things being lost in translation, literally and culturally. One thing that would cross cultures is that in every building, after we had seen everyone, we would offer to pray with them. Patients definitely appreciated this, and it also good for me to re-center myself.
Writing this now that I am home, we saw a wide variety of pathology that I will probably never see here in the US. It was a humbling experience to be in that position and to be directly responsible for so many people's medical care. This was the first time that I have truly felt the full weight of my decisions and had to be able to live with the consequences of them, good or bad. I will also write more about specific cases and decisions that we had to make urgently later.
- Frank
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