A Story of Extreme Neglect

In DR Congo the problem of neglect has many tentacles. There is the neglect of the governing authorities to provide education, the neglect of justice for those who are wronged, abused or attacked, then there is the neglect of medical care and infrastructures.

Kasongo wa Ngoy lives in a small village of Mulumba. The nearest state hospital is 55 km from her village. There is a small village clinic 15 km from her home in the village of Muyumba where some basic treatments are given when medicines are available. When Kasongo fell pregnant with her first child she had just turned eighteen. While the pregnancy progressed normally, Kasongo was noticeably a young woman of small stature, partly due to years of poor nutrition. The awakening of labour pain took Kasongo to the local village midwife. Unfortunately, that’s where the normal turned to the nightmare of five days obstructed labour. Kasongo was just too small to realise a normal birth. After many hours of labour, Kasongo was loaded on a bicycle for the long journey of 56 km to a government hospital. After making a payment of $90, the doctor performed a caesarean section delivering a stillborn child. In the days following this surgery, Kasongo found that her normal body function failed her. She was constantly leaking urine with no possibility of control. Kasongo was suffering from a fistula. Socially she was quickly being avoided by the village people due to the smell that this condition produces.

It was ten months later that Kasongo heard on a local radio station that the Mission Hospital at Mulongo was hosting a medical campaign to treat women with fistula conditions. Visiting American surgeon’s Dr Soo and her husband Dr Geoffrey were to finance a training campaign, with Dr Serge and his team of Congolese doctors to provide surgery to repair this condition. There were two motives, intervention for the suffering women and secondly providing training to Congolese doctors in this complex procedure of fistula repair.

Again, Kasongo travelled, this time 100 km by pushbike, with the hope that someone could rescue her from her life of pain and shame. When she arrived at Mulongo, she was welcomed by our hospital staff and registered as a candidate for the examination. Kasongo was examined confirming the presence of fistula. Fistula has many levels of severity. In Kasongo’s case due to her bad birthing she had serious tissue damage and a one-centimetre hole in her bladder. The caesarean section had also been poorly done with the incision being too high which in turn had resulted in further complications.

To describe the surgery is perhaps not for this article. The repair is a complex gynaecological procedure that is seldom seen in the west. Here in the one province, we live in it is estimated that there are many thousands of cases of fistula. To be abandoned by friends and often your husband is sadly common. Certainly, life is extremely limited both socially and physically by the condition.

The delight and joy that is felt and expressed when this condition is able to be repaired is so rewarding for all those involved in the medical team. Fistula is a condition that requires explanation and education as part of the repair. Future births must be caesareans. The culture here demands children. As many of the women are very young it requires skilled counsel to guide these ladies in planning for a safe future.

The Bible’s counsel in James 2 v 14 says “faith by itself, if not accompanied by action is dead” The deeds of medical care in our hospitals could be considered just these opportunities for our Christian doctors, nurses and hospital chaplains allow them to share their faith message of hope that the gospel (Good News) gives. Each morning there is an open-air service for all the patients that come for treatment here at Mulongo. The gospel message, prayer and singing all form part of this time. Then the chaplains visit each patient and spend time sharing and praying with them. In short, medical work accompanied by the message of faith in Jesus Christ offers not just healing of the body but the healing of the soul!! It is easy to quote this passage in James perceive to be short on action. However, we do well to consider the perspective of God and eternity. The Bible states “deeds without faith are also found wanting.” I personally am glad to carry the gospel message with me in all the processing of our deeds in D R Congo. The soul is in as much need of healing as the patient with a fistula condition. Faith in God thankfully makes sense to many Congolese with many becoming Christians during their hospital stay. This faith message also makes sense to me. I find it sustains me, the worker whose deeds are needed in such extreme situations.


The fistula condition and its repair is a process that requires nutrition building before the operation, and then post-operative rest, treatment and care, on average this involves a three-week engagement with these women and our medical teams. With campaigns that involve  visiting surgeons from the

U.S or Europe this is a funded process. The reality is these special events are a once a year engagement and treat from 30 to 50 women. The good news is that some of our local Congolese doctors have increasingly gained the experience and skills to perform these procedures. Fistula repair costs a minimum of $500 per patient. This is a cost that most of these women simply cannot find. Clearly the physical and social consequences of such situations are worthy of our concern and consideration.

The $500 delivers-

  • preoperative hospitalisation when nutrition is stabilised and examinations are done. At this time any other medical conditions can be treated. For example, infections, malaria etc.
  • surgery to repair the fistula
  • post-operative care and recovery
All this good work requires the patient to stay in the hospital for a period of three weeks minimum.

While visiting surgeons are hugely important and appreciated, the reality is their visits are for but a brief period. The future of sustainable care for these marginalised women depends on the increasing skill of our Congolese doctors who are a permanent presence in our medical structures. Check out our Facebook page, Stevenson Missions for more info and ways to help.

DAY 23