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Bonobo
Health Clinic, Kokolopori, Democratic Republic of Congo
 The
Bonobo Health Clinic operates in Kokolopori (DRC), on
the Maringa River close to the equator. Indigo Foundation
has supported the clinic since July 2007 with the main
emphasis of our support being on malaria prevention through
the distribution of 1200 insectide treated nets (ITNs)
and anti-malarial medication. Education strategies on
malaria prevention are delivered in parallel with ITN
distribution.
Initially
the ITNs were distributed randomly- a survey indicated
this led to some reduction in malaria in those who used
their ITNs on a daily basis. A new phase of the project
will involve a total coverage strategy so that everyone
in the 35 villages gets a net at the same time. This,
coupled with comprehensive community education (including
targeting the eradication of mosquito breeding grounds),
should ensure wider and more sustained impact. To that
end, we will be looking to secure the assistance of
a large international agency that has resources specifically
targeting widespread malaria reduction.
A
recent monitoring and evaluation trip (September 2009)
has found that the health project has undoubtedly made
significant progress since it was first initiated. With
funds from IF and the US based Kokolopori-Falls Church
Sister City Partnership (KFCSCP), the clinic is now
a government recognized entity with one doctor, 6 nurses
and aids, and 10 midwives being trained to practice
in the surrounding villages. Recently, a ‘Solarstik’
solar power generator (donated by KFCSCP) was installed
at the clinic to power electric lights for night time
medical emergencies.
Context
The
Democratic Republic of Congo (DRC) is one of the poorest
countries on earth, with the lowest per capita health
expenditure in the world. Malaria is the leading cause
of death of children under four years old in the DRC.
In 2004, approximately 196 out of every 1000 children
died before they reached five years old. An International
Rescue Committee survey indicated that 34.2% of children
who died between 0 and 4 years of age died from malaria.
Other diseases facing people in Kokolopori include gastrointestinal
parasitic infections; malnutrition (in children); tuberculosis
and obstetric and perinatal problems.
Kokolopori,
with a population of 8000 people, is a cluster of 28
villages over 70 kilometres on the Maringa River, a
tributary of the Congo River. It incorporates large
tracts of primary jungle, which is home to a unique
variety of wiildlife including the Bonobo, the most
endangered of the planet’s great apes.
In
January 2007, there were two medical centres in Kokolopori,
both operating without medicine, medical equipment or
trained medical staff. As a result, when villagers in
Kokolopori required medical assistance, they had to
travel to the nearest town of Djolu, some 70-100 kilometres
away, a journey of up to two days.
Partner
since: 2007
Project
Managers: Leanne Hankey and Phil Strickland
Management Committee Representative: Phil Strickland
Project
Partners:
Funding:
July 2007-September 2009 $US35,000
Activities
Martin
Bendeler, Director of BCI Australia, undertook a monitoring
and evaluation visit on befalf of Indigo Foundation
and the Kokolopori-Falls Church Sister City Partnership
(KFCSCP) in September/ October 2009. His visit has highlighted
the impact that professional medical care is having
on the people of Kokolopori. These stories are not just
about impact at an individual level. The individuals
who receive medical attention are heads of households,
teachers, elders, bread winners, and students - people
whose demise would have devastating consequences on
those who rely on them.
Martin
writes: ‘Babeesh, a primary school teacher [who
had appendicitis] was lying on the table, a blanket
of sorts covering her abdomen except for the area of
operation. Around her were Dr Saidi and three nurses
- Eduard Limboto Losase, Nestor Baelonganoi and Albert
Alukana (who oversees a dispensary and who was administering
a local anaesthetic)… With nine stitches and around
45 minutes, Bebeesh’s life was saved. Such a simple
thing as appendicitis, as common here as it is in the
West, kills horribly and almost certainly if not surgically
treated’.
With
funds from IF and the US based Kokolopori-Falls Church
Sister City Partnership (KFCSCP), the Kokolopori clinic
is now a government recognized entity with one doctor,
6 nurses and aids, and 10 midwives being trained to
practice in the surrounding villages. Recently, a ‘Solarstik’
solar power generator (donated by KFCSCP) was installed
at the clinic to power electric lights for night time
medical emergencies.
As
Martin reports: “Three years (after my first trip),
from nothing, I find there is now a doctor, four nurses,
10 midwives and a pharmacy, saving lives, winning hearts
and making a tangible connection between the welfare
of the community and the welfare of the bonobos and
their forests”.
Successes
- A
reduction in the incidence of malaria. A survey conducted
during the second year of the project indicates that
there has been a 22% reduction in malaria between
July 2007 and June 2008, including a decrease in the
number of children under five and pregnant women who
have malaria.
- The
anti malaria project has raised community awareness
of the causes of malaria and methods to prevent it,
along with a greater awareness of health and disease
prevention. Based on the data of the number of people
treated at the clinic for diseases, hundreds of people
in Kokolopori are using ITNs and/or are being treated
for malaria.
- The
health clinic presence has triggered a number of positive
outcomes. For example, the villagers now have access
to free vaccinations provided by the government’s
National Health Program. Importantly, the clinic is
now a government recognized entity with one doctor,
6 nurses and aids, and 10 midwives being trained to
practice in the surrounding villages. Indigo Foundation
provides salaries for two of the three most highly
qualified (A1) nurses at the clinic, as well as salaries
for an A3 nurse and the patient admissions officer.
We have also helped provide much needed medicines,
medical supplies and in-country logistical costs,
such as transportation, which is exorbitantly high
in isolated regions like Kokolopori.
Challenges
The
anti-malaria project, located in one of the most isolated
regions on earth, is not without major challenges:
- The
rate at which ITNs have been supplied to villagers
has been slow and sporadic, due to the limitations
of transport (mainly bicycles and small boats). The
public health literature recommends that it is better
for a whole community to be supplied with ITNs in
as short a period of time as possible because the
fewer people who have malaria, the lesser chance there
is for malarial mosquitoes to become infected with
the parasite and infect humans.
- The
lifespan of the ITNs is shorter than anticipated because
a particular type of moth eats the nets, mice nibble
holes in them, and they easily rip because the bamboo
beds, to which they are attached, tear the fabric.
- There
is the pressing issue of the diagnosis of malaria.
It is important to properly diagnose malaria because
all sorts of illnesses can present themselves as malaria,e.g.
fever, chills, headache and this increases the danger
of wrong diagnosis, wrong and wasteful treatment and
its associated negative side effects. Although the
clinic has a microscope, a high priority is to obtain
malaria diagnostic kits (including slides) and to
train the existing nurses or hire an already trained
nurse to take the place of the trained technician
who passed away last year.
- One
of the project’s major challenges over past
years has been a lack of communication with the field
given the remoteness of Kokolopori. To help mitigate
this problem, Leanne’s husband – Rob Hankey
– provided Albert Lokasola with a new computer
and associated equipment to facilitate communication
between Indigo Foundation, Vie Sauvage, the clinic,
KFCSCP and BCI. This has improved communication significantly
over recent months; though we’re still working
on establishing more direct communication with Kokolopori.
Lessons
Learned
Relationships
are critical to the success of this project. In July,
Leanne met with Albert Lokasola of Vie Sauvage who travelled
to the United States to visit BCI (US) and KFCSCP. Leanne
was able to spend time with Albert and this provided
helpful insight into the realities of the situation
in DRC – the context, opportunities & challenges
for people living and working there. Continuing communications
with Albert (via internet from Vie Sauvage’s base
in Kisangani) has been extremely beneficial and will
help inform the contents of Indigo’s next Commitment
Agreement.
Over
the past five months, the relationship with our two
partner organizations in the United States has developed
significantly, so much so that all three entities are
now actively engaged in communication, strategizing,
feedback, assistance and encouragement to one another
at both organizational and personal levels, the outcome
of which cannot help but benefit the work as a whole.
If
you would like more information please contact the Management
Committee representative Philip Strickland at
p.strickland@mauricebyers.com. Alternatively contact
the project manager Leanne Black at
indigo.foundation@bigpond.com.
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Project
Manager Profile
Leanne
Black (nee Hankey) became involved in Indigo Foundation
in 2002 after meeting Sally Stevenson in East Timor
whilst on a PhD field research trip. Over the years,
Leanne has written various articles for Indigo Foundation
publications and, since 2007 as been our newsletter
coordinator. Leanne has recently become Project Manager
for Congo since (having moved to Virginia, USA in 2003)
she lives in close proximity to the two other small
not-for-profit donor organisations involved in Kokolopori,
DRC. This appointment will help strengthen links between
our respective organisations, and will hopefully bring
greater and, more targeted, benefit to the people and
region of Kokolopori. During 2002-2007, Leanne’s
focus was full-time postgraduate research titled ‘Assessing
the Relationship between Capacity Building and Poverty
Reduction’ where she examined contemporary evaluation
methods and explored ways to more appropriately evaluate
complex development programs (like capacity building).
Previous to this, Leanne was a community development
worker among the nomadic Wodaabe/Fulani people in Niger’s
Sahel region, West Africa. Leanne has studied community
and international development for 10 years and is looking
forward to being involved in the very practical and
challenging aspects of our Congo project. |
