Family Planning is Not the Ugly Stepchild—It is a Lifeline for DRC

We traveled Manika health zone today, about 30 minutes from our home base in Kolwezi.

Jimmy, the director of the health zone told us, yes, your project is making a difference. “Men have learned that women are not just an instrument of men.” He said men have started to help out around the household, cooking on the weekends, and “cultivating” with their wives.

I want to believe him, but our project has been in true operation for just under a year. I am sure there are seldom cases where a man decides to dedicate his weekend to cooking for his 7, 8, 14 children, but I just don’t buy it that that is the norm—just yet.

But Jimmy, like we do, wants to show the project is successful. He wants the funds to continue with the good work.

That is the problem with these short-lived projects like ours. We come, we make a difference, sometimes a phenomenal difference in a short amount of time, but usually for a very small population, or with an approach that the government won’t support on its own.

Governments have their priorities, and family planning is often the ugly step child.

If they can do it, they will, but they will do other things first: things that are more acceptable, maybe a bit easier—fighting malaria, vaccines, offering sustainable water sources, even making deliveries safe for women.

Sexual and reproductive health—of which family planning is a part—is not always so popular. But in reality family planning affects EVERYTHING else. Without contraception, families will continue to procreate and suffer, without enough resources to support the children they love. Often, their children will die young, and sometimes they will too: working in hazardous conditions to make enough money to have a meal each day, or giving birth at age 14, and then year after year after year. Many of the kids that do survive will not have the chance to be educated, and without that, they will live in a cycle of endless poverty. The country will suffer too. Without an educated population, how will DRC ever prosper, grow, and move toward democracy and human rights?

Today, a lady nurse told me one of her clients she saw the other day was just 3 years younger than myself, 33, and she had 9 children. 9 children! She never knew that contraceptives were even an option before her husband heard about them from one of our community-based distributors. He went home to his wife and demanded that she stop having kids (like it was her fault) and get something called an implant. She rushed off to the health center the next day, and voila—perhaps she will be a mother of 9 and not 14—perhaps.

Two of the older lady community-based distributors I chatted with today had 14 children. The other 5 had no less than 5 children, but most had closer to 10. Long before contraceptives became available in their communities, they didn’t have a choice.

I feel very strongly about the work we are doing here and I want it to continue long after I step back on that plane to Washington, DC. I want it to continue for the 14 children of Marie Jeanne and Kashala and for the DR Congo as a whole.

I want there to be more women in DR Congo like Dr. Jacquie Bapura, a beautiful elegant pediatrician who joined our project in Katanga as a provincial coordinator because NGOs pay more money than working at public-sector hospitals. She lives away from her two children, who reside in Kinshasa (a 2-hour plane ride), to make the money she needs to have a respectable life. She lives with her sister, who cooked us dinner every night—a necessary and silent partner on our trip here in DR Congo. But there is little chance that women with 5, 7, 8, 14 children will ever become DR Congo’s next set of Dr. Jacquie Bapuras.

Mining for Life

The first thing we saw when we walked into the Director of Health’s Office in Fungurume Zone, Katanga Province, DRC, was one photo on a barren cement wall: it was of a newborn baby, its face deformed, and lying in its own pool of blood. The photo was hung in a cheap tin frame. The whole team of us, even the doctors and the public health professionals who had worked in some of the most desperate conditions—IDP camps on the Congolese border with Rwanda and Uganda—were staring. One of our senior advisors finally got up the nerve to ask: What is photographed there?

The director told us “this is the result of copper and cobalt mining in Fungurume.”

I couldn’t focus on whatever else the Health Director said for the next few minutes, probably several formalities of the many since we have engaged in since arriving in DRC . All that I could focus on was the horror.

The only other photo on his wall was the mandatory one: of President Kabila. As far as I can surmise, that photo is seen hanging in every public office. Kabila’s face is so familiar to me now. It covers billboards on the roads leading to Kolwezi with the slogan “Mon Congo”  - My Congo. 

Along with the billboards, when you drive through Katanga Province, one of the biggest mining destinations on the planet—copper and cobalt, uranium and gold—you see the beautiful mountain-scape punctuated by depots where the mined resources are bought and sold. You see long roads up to the mountains, sometimes behind huge chain-linked fences, where dump trucks enter and exit on a continuous basis. You see barracks where some of the hired miners live. They look like prisons.

On the other side of the road from the natural treasure chests are squatter camps where artisanal miners have set up camp to trek into and out of the mines. They are like freelance miners. They do not work for a company, but for themselves. They scrape what they can together to sell to the big companies that control the exports—most of them Chinese. I’ve heard the big companies pay them scraps compared to what these minerals, and the products that come from them, go for on an international market. I believe them. They are living in squalor.  

You will see large plastic bags loaded to the top with the minerals, stacked in minivans, on motorcycles, and on people’s backs, until they can reach the nearest depot and sell them for a small fraction of what they are worth.

The men under the mountains picking away at their living and carting around the heavy sacks need to do it. They are often supporting 6, 7, 8, 10, and 12 children.

That’s why the work we are doing here is EXCITING. It is IMPORTANT.

We went to the central market today to witness an outreach event organized by our project. At these events, bands of trained health volunteers, called community-based distributors, tell the community about all the family planning methods that are now available to them and refer them to a makeshift “clinic” at the back of the market where women can receive counseling from a trained health provider, and if they wish, the contraceptive of their choice.

And many do wish. When the community-based distributors took out their megaphones and started announcing their presence to the market, flocks of women—and men—arrived at their tables. They wanted to know about this thing called family planning, in the hopes they could make things for their families just a little bit easier.

So, we are addressing one tiny slice of what these populations need for one small slice of time.

Welcome to the Heart of Africa

I’d missed Africa. After I landed in Kinshasa yesterday and left the air conditioned airport, I stepped out into the thick, humid air.  It was almost as if I carried a cloud down from the sky with me. Following a recently departed winter back home, that humid air felt like a gift.

After my colleague who is traveling with me left one of his bags mistakenly inside and ran like a bolt of lightning back into the airport, I waited there on the sidewalk with the throngs of Congolese. They wore Western dress and African dress and many held signs with Western names on them—Congolese there to safely transport foreigners within what are notoriously known as unsafe borders.

To my left was a raucous gathering of people my age or slightly younger. When they saw their friends and family members arrive from inside, they let out cries of pure joy—a kind of joy that seeps into you and rests there for a while: another gift. They embraced their loved ones with such force that couples of them almost of fell to the ground. It was unbridled emotion, not something you see often in the US. Or, even if you see something akin, you certainly aren’t gifted the same feeling very often: that feeling of not really being all alone this world, of communion, of solace with other human beings. It is something we search for all of the time, but rarely find.

So, my first thank you to DRC came at that very moment. 

The warm, fuzzy feeling, of course, comes along with quite the opposite. After all, it is Africa’s heart, my love, my continent of paradox.

I’m reading a book while I’m here, Dancing in the Glory of Monsters, which is bound to pepper my blog posts from here forward. As the title suggests, the book chronicles la catastrophe that is Congo’s history and politics. “The Congo has always defied the idealists,” writes the author.

My idealism, my captured joy, took a strong hit the next morning when we returned to the airport to take an in-country flight to Lumumbashi, one of the largest cities in DRC outside of Kinshasa, far to the East and known for the province in which it is located—Katanga—one of the most mineral-rich places on the planet. I returned with my colleague, a Nigerian doctor, to the airport and it didn’t take long for DRC‘s politics to start to seep in. Because he is Nigerian, the immigration officials said he could not travel outside of the capital due to a sour political relationship between West African countries and DRC. 

I was quickly ushered into the immigration office (because my colleague does not speak French), where I had to argue, in my very mediocre French, for 45 minutes about how he is a respectable doctor, how we have visas for the travel, how our work is important to people in the rural provinces of Katanga, how we are supported by their friend, the US Government. It was only after I softened my tone with the two men (one who was asleep for the first half of my arguments) that they softened as well. I stopped trying to strong-arm them and instead smiled politely, maybe even slightly flirtatiously, to win the favor. The only thing left to do after winning my argument was to have a lady security guard make some photocopies of our documents for us. I followed her through the airport to the photocopy machine, where she paused, stood with her arms folded, stared at me for a good 15 seconds with a disapproving face, and rubbed her two fingers together.

“L’argent!” Bien sur, l’argent.

I handed her 5 $1 bills out of the stack of 200 singles I was told to bring for just such situations. She held out for more, but when I stood my ground, transforming from soft to hard again, she slowly moved toward the window where the photocopies were made.

In my two weeks here, I have no doubt that I will capture at least a few more palpable joys, and, at the same time, I will lose just a little more faith in humanity.