Monthly Archives: December 2012

Seham El-Diwany, MD, Gets the Call: Where in the World is Wamaza?

Editor’s note: Seham El-Diwany, MD, FAAP, is a pediatrician at Kaiser Permanente San Jose Medical Center. She recently completed a mission in the Democratic Republic of the Congo for Doctors Without Borders.

I remember getting a phone call from Médecins Sans Frontières, also known as Doctors Without Borders,  to serve in my first mission to Africa with this organization. I was leaving San Diego’s airport with a group of friends returning to San Jose after finishing the Rock N Roll Marathon. It was exciting to finish the marathon however it was a special treat to get this call from MSF. Although it was a short notice until I could be leaving to Africa, I managed to switch my hospital calls, reschedule my clinic patients and have my Leave Of Absence approved, all in a two-week timeframe.

I had to stop by MSF’s office in New York City  on my way to Africa for briefing. I was told I will be serving as an inpatient physician in an Emergency Pediatric project for children severely affected by Malaria in a small village east of Kinshasa (the capital of the Democratic Republic of the Congo.

After another briefing in Kinshasa, I was flown by a small cargo plane to Wamaza to stay there for the following 4 weeks. The village had neither running water nor electricity and the children were dying at a rate of 1,000 children per month from the Malaria epidemic prior to MSF’s intervention.

In the hospital we had a generator to provide electricity, large “Rubber Bladders” to store clean water, a blood bank with enough safe blood supply, a pharmacy , a small lab,  a kitchen, an outpatient center and two pediatric wards.  More importantly we had enough supply of effective parental and oral antimalarial medications.

I worked six days a week from 8 a.m. to 4:30 p.m.  during the mission providing medical care to children affected by the epidemic, many presented with the anemic form and required blood transfusion, others presented with the visceral form and required intravenous fluids or with the encephalitic form and needed anticonvulsants, in addition all forms required parental antimalarial medications followed by oral medications. Low blood sugar at the time of admission was generally a marker for poor outcome from the disease; however, many children who presented with hypoglycemia were able to make a comeback after intravenous glucose intervention. In addition to malaria, some children had severe malnutrition, tropical hepatosplenomegaly or sepsis. Some presented with meningitis and required lumbar puncture prior to initiating their treatment.

Working closely with the National physicians and nurses in Wamaza was a very enriching experience. I was reminded one day by a nurse after the team successfully resuscitated an eight year old patient “you know doctor this girl got a new life today.”

We lived a simple life on the base, we had well water in addition to special water for drinking, we used latrines, a bucket of cold water to take a shower and sun to dry our washed clothes. The daily food menu was home cooked meals consistently the same for lunch and dinner and for every day. It consisted of Fufu de Manioc (dough like), feuilles de Manioc for vegetable, dry beans and rice. Oh! The only item on the menu that changed from time to time was the animal protein source; it consisted of chicken, ducks, fish, beef or pork.

We celebrated Independence day of DRC on June 30 with a party and African dances in the base where we lived , everybody who was part of the medical mission was invited and had to dance.

On Sundays we routinely ran 10 kilometers; it was a nice way to decompress and reenergize for the coming week

When time was up, I returned home via Rwanda. It was a nice treat of three hour ride from Goma in DRC to Kigali the capital of Rwanda. The route was scenic and breath taking as we traveled by Lake Kivu and across the rain forests.

I was glad to be back to the warmth of my home. I enjoyed taking my first long hot shower with running water and the magic of getting light on by switching a button.

I have fond memories of my first mission with MSF and look forward to serve again in the near future.