May 15, 2001

Dear Friends,

I recently made a trip to Congo. It was my first trip in ten months and many things had changed. The assassination of president Kabila and the inauguration of his son as president have begun a whole new chapter for Congo. International relations have opened, warring nations are removing their troops and UN peacekeepers are coming in. Guarded optimism is
everywhere as people speculate about what will happen in Congo when there is no longer war. But another thing that struck me was that the devastating effects of the war were far from over. People were the poorest I have ever seen them. Malnutrition, even among adults, is common throughout the country. People I knew that used to send their children to school or visit a health center when they were sick could not afford to do either. I was thankful that the visible presence of the church through its medical work gave people hope.

Kinshasa Health Program

The Kinshasa health clinics are struggling to adapt to the increasing poverty. Before 1994 each clinic saw an average of 300 curative cases per month and two times that many visits for preventive activities. At that time people could pay more than $4.00 to be treated. Now, even though the price of being treated has gone down to $3.17, only 120 patients per month can afford to be treated. In order to continue serving the community, the clinics have slashed their average salaries from $80 per month to $28. I was surprised to learn that despite this sacrifice, 40 percent of the staff has served for more than ten years.

In the best of times the clinics were operationally self-financing, but they always needed outside aid for capital investments and repairs. This is even more true today. I found some of the clinics in a deplorable state of disrepair. In one clinic a thief came in through the attic. When the guard heard him, the thief ran through the attic, breaking half of the ceiling tiles in the clinic. The place looks so bad that rumors went through the community that the clinic was closed.

When the clinics are well-supported, they do a great job, however. The Swiss government has built a maternity at the Boo Nsuba clinic because it is in a region of town that suffered the most destruction during the 1998 war. The
maternity was an instant success and is doing 140 births per month. Because of its good reputation, a population of 37,000 people are
using the maternity for births even though there are only 20,000 people in its official area of action.

The SANRU Project

Most of my time in Kinshasa was spent helping the Programme de Santé Rurale (SANRU III) project get started. The project is a country-wide program to develop the decentralized health care system in rural areas. Phase I has $1 million funding from OFDA to do mostly emergency relief work in 28 health zones. We were able to get a quick start on the project with an extra
$150,000 grant from Presbyterian Disaster Assistance program for essential medicines. Phase II will be a much more comprehensive program that includes interventions for malaria, AIDS, emerging diseases, nutrition, water and sanitation, vaccinations, and health infrastructure support in 60 health zones. There is also a large training component. This phase has not started
yet, but a memorandum of understanding promising $25 million was signed between Congo’s minister of health and the U.S. ambassador on March 30, and a contract for the first year was signed May 14. Even though the project is funded by USAID and recognized by the Congo government as their health strategy, it is totally implemented through the church. There is a
daunting amount of work involved in getting this project off the ground. Fortunately we have a very good local team and very good oversight of the project by Interchurch Medical Assistance. Frank Baer (the program manager for SANRU I and II) and I are the major consultants to the project.

Even with this large of a project, and this much funding, we are only scratching the surface of the health needs of Congo. With the current conditions in Congo, 900 children die of preventable disease every day. Recent studies find that three out of four children die before
they are two in parts of the country. This project only provides 50 cents of assistance per beneficiary per year. The real benefit of this program is that it gives an integrated structure in which church and other health programs can be more effective. For more details about the project visit www.sanru.org. Your prayers and concern for Congo and its people are greatly needed at this time.

Sincerely,

Larry Sthreshley

The 2001 Mission Yearbook for Prayer & Study, p. 32