Save a Mom's Life in the Congo

Eastern Democratic Republic of Congo (DRC) is marked by the presence of numerous armed groups, particularly in North and South Kivu, who fight for control of the country’s vast natural resources (including gold, diamonds and rare earth minerals), terrorizing civilians and causing millions to suffer from ongoing conflict and displacement. The fighting causes massive population movement from areas where there is active fighting to areas of relative calm. Besides the risk of losing their lives, internally displaced persons (IDPs) also lose their property, means of livelihood and social support networks as families disperse, rendering them more vulnerable.

International Medical Corps currently supports 68 clinics and hospitals in North and South Kivu, providing medical supplies, training for health workers, and referral and transfer for patients in need of advanced care. In areas with no clinics, International Medical Corps runs mobile medical units to give vulnerable populations access to vital health care services. We also deliver health care in three transit camps for refugees returning to their home villages. In addition to supporting existing health facilities and providing mobile medical services, International Medical Corps works in close collaboration with the Ministry of Health and non-governmental organizations to increase the number of well-trained health professionals in DRC, including midwives.

Midwives have been of great support to health centers and community in Walikale, and provide safe delivery and essential newborn care, helping to ensure women are healthy and giving their babies a better opportunity to grow into healthy children and adults. Not only do midwives support mothers from maternity to birth, but they also deliver comprehensive sexual reproductive health services including:  counselling; malaria treatment during pregnancy; and services to prevent mother-to-child HIV transmission.

The impact of their work is vital to building healthy communities -- the United Nations Population Fund (UNFPA) and the International Confederation of Midwives assert that midwives can prevent up to 90 percent of maternal deaths where they are authorized to practice their competencies, and play a full role during pregnancy, childbirth and after birth (UNFPA, 2010). Giving birth without professional assistance increases the risk of developing complications such as fistula and infections that could affect either the mother or the child and lead to maternal and infant death. Midwives trained by International Medical Corps possess the skills needed to be their own best “First Responders” – helping women avoid or treat complications and deliver healthy babies.

Anastaticia, whose life was saved by an International Medical Corps-trained midwife in Eastern DRC, explained her potentially life-threatening situation; “I started labor at home, called for help and a friend came to assist. She, however, could not complete the delivery. I had to be rushed to the health center not far from my village for emergency assistance. The midwife at the health center was able to stop the bleeding and save the life of my baby, and I woke up to see my baby next to me. During the process, I was diagnosed as having developed a fistula, and had surgery to repair it 6 months later.  The experience at the health center and the support from the midwives helped save my life and the life of my baby.’’

In the Democratic Republic of Congo, where rape and sexual violence are often used as a weapon of war, International Medical Corps is applying a holistic approach to support survivors. By providing medical treatment, psychosocial support, and livelihood opportunities, International Medical Corps is helping survivors of gender-based violence build a better future for themselves and their families. One such survivor is Kalonge -- a 27 year-old woman who participated in our programs in Kalonge, DRC. 

In her own words:

“In 2008, my family was attacked by members of the Forces Democratic for the Liberation of Rwanda who killed my husband after raping me, and then burned down our house. We took refuge in Rambo with a generous family, where I spent my three weeks of mourning. When calm returned, I had to return to my village with my family, but I had no home to return to. I returned with my four children and stayed with a neighbor who had already rebuilt her hut."

“After three months, life had become increasingly difficult because the space was insufficient for two families. In the fourth month, the neighbor said she was tired of the conditions in which the family lives, and she asked us to find another place to stay. That day, I was shocked and felt as if the world turned against me. I began to remember my husband and thought that if he were here, I would not be suffering. I did not want to continue living, but I had to live for the sake of my children. I even thought about selling part of the land my husband left me, so that I can use the money to build a house."

“Eventually, I decided to see a pastor of a Protestant church in the village to explain my problem, hoping that he could help me. He wanted to help me and my family, but did not have enough space in his house to accommodate us.  He welcomed us to stay at the church and promised to mobilize members of his church to contribute towards the construction of a new house for my family. The church members, however, declined to mobilize resources because I was not a member of the church."

“For four years I suffered with my children in a church where I could not light a fire or cook. This development began to gnaw at my heart, and I hung around the church because I did not have anywhere to go."

“One day, when I was returning from the field, I met an old acquaintance. It was a woman with whom I had grown up during our childhood. We had time to talk about life, but I did not know she had become a community volunteer. After I told her about my suffering, she invited me to her house where I got some food and other items for my family."

“The next day she came to see me at church where I was still staying with my children. That's when she told me about a program that supports people who are facing similar challenges. I thought to myself that I'm not really interested because the advice they will give me there cannot build a house for my family, but I gave myself the courage to go to the community center for advice about the rape that I had suffered, because the experience kept coming back to me and it was very painful to my heart."

“A woman greeted me, accompanied by my old acquaintance who originally told me about International Medical Corps. We talked for a long time, and she gave me advice and some food and clothes. That day, I realized that I would take control of my recovery so that I could raise my family. After two meetings with her, I was given a paper to take to another office where we had a conversation with a woman who worked there. She told me that I could train with other women in similar circumstances on how to identify our skills that can be used for activities that would help us earn money. At the meeting, I chose to sell peppers because I knew how to do it because I used to help my mother when I was young. I worked with the woman to plan how to support my family selling peppers, and she helped me collect all the materials I needed to start my new business."

“The first day I went to the market, I was determined to earn the money needed to build a house for my children. I received 15 measures of peppers that I sold in less than four days. Pepper is a rare and seasonal product and I was among the few people who knew where to find them. In two months, I had earned a profit of $160 because I was saving all the money I was earning. The following month, I made roughly $120, part of which I saved and part of which I used for the care of my family." 

“As the months went on, I gradually started buying nails, sticks and other building materials that I used to construct a two-room house where I now live with my children. I can now also pay for my children’s school fees. I joined other women, and together, we formed a village savings and loan association (VSLA), and I continue to think of new ways to improve my income through other activities.  I have already purchased a few iron sheets with earnings from the village savings and loan association, and I hope to have an iron sheet roof soon."

“I am very grateful for the help I received from International Medical Corps, and it feels like my life is improving.”

International Medical Corps has worked in the Democratic Republic of Congo (DRC) since 1999, providing health care, nutrition, food security, gender-based violence prevention and treatment, and water and sanitation services. The prolonged conflict in the DRC is characterized by extreme violence, mass population displacements, widespread rape and collapse of social services. Rape and sexual violence is pervasive in eastern Congo and exists in many forms. Often used as a weapon of war, armed militia and military rape and brutally terrorize women as a way to humiliate families and communities.

Unfortunately, there is still a great deal of social stigma that is attached to the survivors of sexual and gender-based violence in the DRC. The stigmatization of survivors can lead to them being shunned by their families and the community as a whole, often leading to survivors being chased from their own homes. Being rejected from the community often puts young mothers in a very dire situation that can become life threatening when they find themselves homeless and without any means of supporting themselves and their children.

International Medical Corps is applying a holistic approach to combat this problem by providing medical and psychosocial support the survivors of sexual and gender-based violence, while also working to modify the way communities view survivors of rape, which helps deter future attacks and accelerate the recovery of survivors. Below is a story of a courageous young woman who was able to rebuild her life after a very traumatic event with the help of International Medical Corps’ livelihood programming in DRC:

The International Medical Corps trained Kalonge psychosocial team first met Aisha in 2012 Aisha (*Aisha is not her real name and it was changed for her anonymity). She had walked 50 miles from her home in Ninja to escape the fighting and seek help after her ordeal in the hands of a group of armed men.

“I was inside my house with my husband and children. It was the night of March 21, around 9:30 pm. It was common during those days for armed groups to come into the village to steal and rape women and girls. We lived in constant fear of our lives.”

“As we sat with my family, the door suddenly burst open. Three armed men entered the house. They ordered us all to lie down and started tying up my husband’s hands and legs with ropes because he had tried to resist them. While they were tying him up, I screamed hoping neighbors would come and rescue us. They beat me up and said that if I screamed again, they would kill me and then kill my husband. This was enough to silence me. I was afraid that we were going to die. The three armed men proceeded to rape me in turns. They then asked my husband to show them where the money was. They gathered everything including our goats. When they had finished, they came back into the house and asked me to lie still on the ground. They called my children who had escaped to the next room and asked them to surround me and one of the men attempted to rape me in front of my children. My husband started screaming and one of the soldiers killed him.”

“The next morning at my husband’s funeral, I narrated the story to my mother in law who happened to have suffered the same ordeal in a different village. Three days after the incident, my mother in law and I decided to relocate to Kalonge. I was worried because we did not know anyone in Kalonge but I was determined to leave my home to forget all that had happened.”

International Medical Corps has trained many of the staff members at the Kalonge hospital and also built several health centers that offer services to survivors of sexual and gender-based violence. Adding to the provision of healthcare services, International Medical Corps also supports livelihood programs that help sexual and gender-based violence survivors become self-reliant by teaching them a trade, such as making a product that they can sell at local markets. International Medical Corps’ holistic approach to the problem of sexual and gender-based violence in DRC, and especially Kalonge, has created a network that can help a rape survivor at all stages in their recovery.

“Upon arrival in Kalonge, my Mother-in-Law and I reached a health center and I decided to get help because I was not feeling well. At the health center, I told the midwife what had happened and she directed me to where a woman who could help us was located. This woman took us to a community center where we received clothes, soap and food for one week. I met another woman who talked to me and gave me advice and helped me to gradually learn that I had hope even after all that had happened to me. The women also helped us to get someone to give us a place to stay. I continued to come to the community center because I could find help there. There are many times when I did not have the courage to look at someone in the face. My heart could start pounding and I could start crying when I remembered what happened back in my village. As I continued to go to the community center and receive more help from the women there, I gradually became stronger. I found the courage to join other women in the activities in the center.”

“During these sessions, I made friends and found out that some of them had gone through the same thing, but they had gained renewed hope. The woman who met me the first time continued to invite me to her office to talk more about the progress that I was making. She even came to visit me in my home. Of course I was still going through difficult times. My husband had been the sole breadwinner and now I have no one to support me and my children. I had no land to cultivate or a business through which I could make money to buy food. I struggled to feed my children and my mother in law with the little assistance from the community center.

“In September, my mother in law died and I was left alone with my children. Life became so difficult that I could hardly feed my children. To add to this, the house that community members had given us to stay in was destroyed by heavy rain. I was forced to seek refuge in a church. I went back to the community center, but this time, I was trained on how to start a business and given materials to start the small business of selling cassava flour. It has been 5 months since I started a stall at the local market. I am able to feed my children and myself. I have also been able to repair the house that was destroyed by the rain. I have the courage to laugh and even burst into laughter. I have hope to continue living and I am even thinking of returning to Ninja, back to my village.”

“I am thankful for the support that I was given by the people at the community center and all the support I received from International Medical Corps. I have the courage and the will to live despite the difficulties. I encourage the women to continue supporting other women who went through the same thing like me. Don’t give up. Thank you.”

International Medical Corps prioritizes reproductive health services and family planning in the Democratic Republic of Congo. Gynecological and obstetric care is especially important in this area where 98% of all obstetric complications result from either sub-par medical care or rape. By increasing the quality and availability of reproductive and maternal health care, as well as the uptake of these services, International Medical Corps has significantly improved long-term health outcomes for women and children in DRC. Our goal is to save the lives of mothers by providing the care they need before a medical emergency arises.

Safe Motherhood through CycleBeads: 

Faida, also known as Mama Sammy, is 25 years old and has been married to her husband Sammy since 2010. She lives in the village of Kabusa, located in the Walikale territory in Eastern DRC.  Over the course of two years, she suffered a devastating loss after experiencing two miscarriages. The suspected cause was poor spacing between her pregnancies. This is her story:

“I gave birth to a baby and got pregnant after three months. As I was trying to keep the pregnancy and take care of the child, the first one passed away. I also miscarried the second one ... I was astonished and stressed because I could not understand the situation.

I discussed with my husband who was also concerned about the loss of our two babies and was worried about the opinion of the community. We decided to try to avoid frequent pregnancies, but my husband never wanted medications or any chemicals. So, we tried the natural way on our own but with many worries because we had no tools for counting.

I convinced my husband to consult the medical Director of Kabusa Health Clinic and follow prenatal consultation as advised by my mother because she trusted the midwife trained at Kabusa. 

We luckily meet Mr. Ngoko Lipanda Andree, the medical director of the clinic. He explained to us several methods of family planning that we could use to avoid the risks of death of the child and the mother. One of these options was CycleBeads® which my husband really liked. It was a natural option we both appreciated.

Since we started using the method we have never experienced unwanted pregnancies.

We now enjoy life with our 1 year and 3 month old baby without any more worries.”

Note on CycleBeads® and The Standard Days Method®:  

"The Standard Days Method® is a fertility awareness-based family planning method that identifies a fixed fertile window for women with cycles that are between 26 and 32 days long. For women with cycles in this range, the method identifies days 8 through 19 as potentially fertile days. A user simply tracks the start date of her period and the days of her cycle to know if she is on a day when pregnancy is possible or not.

Researchers at the Institute for Reproductive Health at Georgetown University developed this family planning method and tested it in large-scale clinical trials. It is proven to be more than 95% effective at preventing pregnancy and with the right tools, is very easy to use.

If a woman wants to prevent pregnancy using this family planning method, then she should avoid intercourse or use a back-up birth control method such as condoms during her fertile days (days 8-19). The patented CycleBeads® tools help a woman use this method by tracking her cycle, identifying her fertile and non-fertile days based on when her period started, and confirming that her cycles are in range for effective use of this family planning method. (Source: www.cyclebeads.com)"

Blandine Butundi, 18 years old and expecting, was suffering from a life-threatening pregnancy complication. 

“My first three months of pregnancy were the heaviest weight I carried since I was born …. the midwife of our Mundindi Health Clinic advised me to consult a doctor in Walikale [the regional capital]. I felt very heavy, yet I was only three months along.

One day I felt dizzy and collapsed at the house door. I was rushed to Walikale General Hospital on a motorbike, not knowing which world I was in. My heart was beating so fast and I felt very thirsty. I was sweating heavily. In the consultation room the midwife just said: ‘You are a lucky lady, you met the specialist in women’s care.’ It was Dr. Kennedy [head of obstetric surgery].

I was given an injection, and the only thing I remembered was the doctor telling me: ‘Something is wrong Blandine, we have to remove whatever is inside your stomach before serious damages occur.’ The rest of the story I was told by my mother.”

Blandine had suffered a miscarriage, and she needed surgery or would face infection and possible death. Thanks to the intervention of Dr. Kennedy Musavuli, she will soon be able to return home in good health. Dr. Kennedy, who received training in emergency obstetrical care and fistula care from International Medical Corps, was able to diagnose the miscarriage and conduct the necessary surgical procedure that saved Blandine’s life.

“The training we received with the support of International Medical Corps shaped our knowledge and experience much more,” said Dr. Kennedy. “Personally, I am so thankful to International Medical Corps for health support in many ways.”

Blandine is also thankful for the support of the skilled surgeons, and expects to return home from the hospital in the upcoming days.

“I have nothing to give to this doctor,” she notes. ”He is such a blessing to the Walikale people, a person who does things with his heart.  If he was not there… I was already dead, my mother said. Now I am feeling like a normal person and I hope soon I will get back to my house.”

As part of its safe motherhood initiative, International Medical Corps trained surgical staff from the general hospitals at Walikale and Chambucha,located in Eastern Democratic Republic of Congo, in emergency obstetric surgery to address health issues such as Blandine’s. 

In Blandine’s home territory of Walikale, International Medical Corps also recently organized trainings for frontline healthcare workers, such as the midwife in Mundindi who referred Blandine to a doctor, to recognize danger signs during pregnancy, ultimately benefiting over 33,000 women in the area.