December 2, 2007

Dear Friends,

Mike and Nancy teaching a workshop on motherhood.

Why do so many women and children die in the developing world?

We know a lot about the causes of maternal, newborn and childhood deaths. We know that most of these deaths are preventable with the use of very simple interventions. Why do the deaths continue? What can we do to stop them?  These are not just questions; this represents the unbelievable suffering of marginalized, impoverished people who happen to be born into a world of little. It is not just.

It is difficult to know how to begin a letter about maternal and child mortality in the Congo. Numbers are easy to comprehend: One out of 13 women in Congo dies due to a pregnancy related problem. One in 100 pregnancies ends with the death of the mother.  One in five children in Congo dies before reaching their fifth birthday, with the most dangerous day of their life being the day of their birth. Each of those numbers is someone’s life, someone’s mother, someone’s wife, someone’s child.

As missionaries, our life’s work, education, and training have been aimed at addressing these critical problems. We have been blessed where we live, in Tshikaji, to have seen so much success in working with our dear Congolese partners toward finding solutions that respond to serious health and development problems. Since arriving in Tshikaji in 2001, we have wanted to be able to travel to the remote Presbyterian hospitals to work with our partners there as well. At last, this dream came true! We finally were able to achieve this dream with the means you have provided us in the form transportation (purchase of a vehicle) and project funds.

Nancy with Chief Kasongo, Bibanga Village.

Last month, we traveled to Presbyterian hospitals in Mbuji-Mayi and Bibanga. We were accompanied by an amazing team of talented Congolese health and development experts that included Pastor Augustin Mukendi (director of a faith-based program for those living with HIV/AIDS and a facilitator for the Training for Transformation community development program); Mamu Victorine Manga (family and women’s development expert and director of a micro-enterprise project for AIDS widows); Jonathan Kajidi (nurse specialist at the Nutritional Rehabilitation Center in Tshikaji); and Jean Luc Tshipamba (agronomist and Moringa Tree Coordinator.

Our team shared several ambitious objectives: (1) conducting an initial evaluation (including facility, services, personnel, materials and equipment) of the hospitals and their participation in community health work; (2) performing a village community health and development survey; (3) launching moringa tree malnutrition programs; (4) instructing health personnel in the World Health Organization’s program “Active Management of Third Stage of Labor (AMTSL),” a protocol that includes simple, but life-saving interventions aimed at dramatically reducing maternal and newborn mortality during childbirth.

At both hospitals we were met with great Congolese hospitality and our time was quite full. We worked individually and in teams with our teaching, evaluations, and presentations. Mike spent time with the hospital physicians and administrators examining the facilities, discussing their activities and needs, and consulting on high-risk patients and obstetric fistula cases. Nancy, Jean Luc, and Jonathan met with local health and community leaders to discuss the serious local problem of malnutrition, and initiated two moringa tree projects, including the training of 16 community moringa volunteers.

Pasteur Mukendi and Mamu Victorine Manga walked door-to-door in the local communities and met with several large groups, addressing issues ranging from beliefs related to HIV/AIDS, gender equality, Christian family behaviors, and barriers that block personal and community development. Nancy and Mike gave presentations to the physicians, nurses, and nursing students on how to incorporate three life-saving activities that actively assist what is called the third stage of labor (the time of expulsion of the placenta) where excessive bleeding is the single greatest worldwide cause of maternal death.

Our second evening in Bibanga, we were so thrilled that in spite of the falling rain, the entire village (2,000 people) came to hear presentations by our team! The Bibanga Presbyterian Church was filled to capacity, and the evening was a great exchange of ideas and efforts at critical problem-solving. There was much discussion and excitement over the concept of the community working together to recognize and take responsibility for the most serious problems affecting the local population.

At breakfast earlier that morning, there was a radio playing the background. Suddenly, our attention was drawn when we heard the names “Dr. Mike and Mamu Nancy” being broadcast! They were broadcasting information related to the moringa tree project that we had launched earlier in the week in Mbuji Mayi. Our trip was planned so that we would conclude with an additional day in Mbuji Mayi on our way back to Tshikaji. When we returned to Mbuji-Mayi we learned that as a result of local reporters picking up the moringa story, the demand for moringa was enormous. People were very interested and were arriving at the hospital in great numbers seeking moringa education, moringa leaves, leaf powder, and seeds. This created a small difficulty, as this unplanned publicity preceded the “product.” However, the Moringa tree isn’t a product; it is a community health and development project that has specific planned objectives and activities divided into logical progressive stages. In Mbuji-Mayi, the project was just initiated and now needs to grow and mature literally and figuratively. The moringa program in Tshikaji is much further along (started in 2004) now, with over 7,000 trees distributed and with measurable positive effects on the health of the community.

Great problems do not necessarily require massive and expensive approaches to solutions. They often only require a little education, self realization, and encouragement toward community involvement. We finished each of our extension visits to Mbuji-Mayi and Bibanga with a team evaluation session, inviting the participation of our hosts and partners in the two communities. We believe that our team and community approach is a right direction that will bear fruit in the form of saving lives, reducing suffering, and uniting communities.

Thank you so much for your support in these important efforts,

Nancy and Mike

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