June 18, 2007

Dear Friends,

We want first to thank everyone for your continued support of God’s work in the Congo. This month, we want to focus on two different aspects of our service. The first is an update on the moringa tree malnutrition project. This community-based project was started in our village of Tshikaji in 2004, with the promotion of nutritious moringa leaves (fresh or dried and transformed into powder) as part of a comprehensive village health promotion program. This initiative has been a great success, with over 2,000 mature moringa trees thriving in Tshikaji, and many more growing throughout our province.

A child in Tshikaji eating a donut made with the nutritious leaves of the moringa tree.

The results of incorporating moringa into the daily family diet (especially children under age 5 and pregnant and breastfeeding moms) have been dramatic. Last month, Nancy directed an evaluation team of 35 health workers, who went door to door in Tshikaji, weighing and measuring 1,880 village children. In 2004, before launching the Moringa Project, 30.5 percent of our village children were suffering from moderate to severe malnutrition. Last month, when we analyzed our data, we discovered that less than 10 percent are in that category. God is so good, and we are so grateful for this amazing gift of the moringa tree. Currently we are holding “cooking with moringa” demonstrations throughout our village, teaching mothers how to easily add moringa to common foods like cooked greens, sauces, hot cereal, and doughnuts.

We are also extremely honored to have the moringa project featured this month on the Presbyterian Women’s Web site!

Mike would like now to report on his work both in treating and preventing obstetric fistulas. We want to introduce Ntumba Kayembe to you. Ntumba is 20 years old. Three weeks ago she went into labor with her first pregnancy. Her labor lasted a long time, several days as far as we can tell. She was laboring at home. Finally, her family took her to a health center where they tried to get her baby delivered by cutting a large episiotomy. The health center nurse was unsuccessful at delivering the baby, so the family took Ntumba to the government hospital in Kananga (the city located just seven miles north of us). At this hospital, a doctor performed a caesarian section, delivering a dead baby and not suturing the episiotomy. Ntumba was kept a week in that hospital and was transferred to Good Shepherd Hospital when she developed both an infected abdominal wound and an infected episiotomy site. Finally, when the family had no more money for her treatment, Mike was called to evaluate her. He noted that her bladder was quite full. She could not control her urine, having what we call an “atonic bladder,” which means that she could not voluntarily urinate and when the bladder became overfull it emptied itself. She was also incontinent of feces.

Mike inserted a urinary catheter into her bladder and began a treatment of soothing therapeutic sits baths. Due to nerve damage and partial paralysis of her left leg from the traumatic labor, she could not stand up or walk. Originally, the incontinence of feces was due to the absence of tone in her anal sphincter muscle, but after several days, when Mike re-examined her, he sadly discovered a hole between her rectum and vagina, a recto-vaginal fistula. The medical staff wanted to do a colostomy to divert the feces that was infecting her unclosed episiotomy in hopes that it would heal well enough to close this wound, but Ntumba had a fever and was also very anemic, which made her a poor candidate for surgery.

Ntumba Kayembe is in Tshikaji waiting for repair of a vesico-vaginal fistula.

It took a week, but we finally found some people who agreed to donate blood for Ntumba. She received the blood transfusion, and we were hoping to allow healing, possibly close the rectal fistula and do a protective colostomy at the same time. At this point, she began to leak urine. Her damaged bladder had finally developed a hole, and she now has a vesico-vaginal fistula as well. She also has a re-current fever, so we cannot yet go ahead with the colostomy surgery.

Ntumba’s story is repeated many times every day in Congo. At Good Shepherd Hospital, we have a complete ward only for women suffering with obstetric fistulas. Many more women are awaiting treatment. The complexity of their cases often requires several surgeries, and they often travel from far away, arriving in Tshikaji all alone and with no resources. We have found a means to provide food for these wonderful ladies; we promise them that we will do all in our power to help them. This promise is all that keeps them going. Without this hope, many will commit suicide.

In this letter, we have included Ntumba’s picture. We want you to see and get to know this lovely young woman. She, too, is a child of God; she could even be your child or wife or sister. What has happened to her is simply unacceptable. Our Lord certainly calls for justice for her and the many others like her. We thank you profoundly for allowing us to help answer that call. We pray that you will continue to help us bring hope to these women.
 
Contributions from individuals can be designated for fistula care at Good Shepherd Hospital can be sent to to Presbyterian Church (U.S.A.) Individual Remittance Processing, PO Box 643700, Pittsburgh, PA 15264-3700. Contributions from churches should be sent to the normal receiving site or: Presbyterian Church (U.S.A.) Church Remittance Processing, PO Box 643678, Pittsburgh, PA 15264-3678. Write the title—“Haninger-Fistula”—and the ECO number (E320202) on the subject line of the check Give to fistula surgery at Good Shepherd Hospital:

Instructions for contributing to the moringa project are the same except the title is “Haninger-Moringa” and the ECO number is E320402. Give to the moringa project:

Our gratitude from Congo,

The 2007 Mission Yearbook for Prayer & Study, p. 313