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Democratic Republic of the Congo: a lone doctor runs a hospital in the midst of conflict

08-05-2009 Feature

Tharcysse Synga is the only doctor in the Minova hospital in South Kivu. He remembers those days in late 2008 when the place was hosting scores of war wounded and displaced persons. He had to perform up to 16 surgical operations a day.

   

  ©ICRC/VII/Ron Haviv    
 
  Dr Tharcysse Synga tends to patients.    
     

It is a bright January morning. The glorious view on Lake Kivu and the surrounding blue hills would make a proud advertisement for any upscale clinic in Europe. But the hospital's cramped wards and the long queue of outpatients waiting for the only doctor around tell a different story, as do the overpopulated camps for displaced persons in the background. This s tory unfolds at the Minova hospital – located in what was a war zone until a few weeks ago. Dr Tharcysse Synga, 35, has not had a single day off in months.

It was a relatively quiet day. The only surgery the doctor had to perform was a Caesarean for a first pregnancy. A healthy little girl was born. This is nothing compared with the up to 16 operations a day of the past months. " One day, we even did 17, " Dr Tharcysse remembers. " But that was too much for the material available at the hospital. The laundry had to work really fast to recycle everything so we could operate on new patients. "

Making choices about life and death was a terribly painful experience. " Many war wounded were brought in at the same time, and the seriousness of their wounds varied. We had to prioritize those for whom there was hope – serious cases, but with hope – and treat lighter cases afterwards. For very serious cases, though, we could do almost nothing. Just be with them till the end. "

 No time for rest  

In October and November 2008, the influx of displaced people and war wounded to Minova coincided with a strike by the hospital staff. Dr Tharcysse was left with only four trainees to handle everything: the consultations, the surgeries, the ultrasounds, etc. Rest " was not the order of the day, " and nights were spent at the hospital " because it would have been risky to move after dark in case of a medical emergency, " Dr Tharcysse explains. " This is not exactly what I had in mind when I accepted this job, one year earlier, " he acknowledges with a smile.

To this young doctor trained in Kisangani and Kinshasa, working in a small hospital, somewhere in a remote province, seemed a logical choice: " When I b egan studying medicine, I wanted to contribute to relieving the suffering of my brothers and sisters. I thought that this suffering would be more tangible in small towns, particularly those located in war areas. " The Kivus, on the eastern border of the Democratic Republic of the Congo, with their long history of bloody conflicts, looked like the right destination. As for the hospital in Minova, serving a population of nearly 160,000, it was badly in need of qualified, motivated health professionals.

Dr Tharcysse remembers that the last months of 2008 were " quite dramatic. " Like the day when the fighting came too close for comfort. " As you can see from its location, the hospital stands out. The patients started panicking, for fear of being targeted. So, with the orderlies, we had to carry them on our backs to their places, where they felt safer. " All the foreign humanitarian agencies had left Minova by then. Nonetheless, " the surgical kits donated by the ICRC to the hospital made a huge difference, " the doctor reckons.

 Sexual violence: a 'barometer of conflict'  

 

 
  ©ICRC/VII/Ron Haviv    
 
  Dr Synga performing one of his up to 16 daily surgeries.    
     

Another welcome contribution by the ICRC was the post-rape kits, which, if administered less than 72 hours after the rape, minimize the risk of contracting a sexually transmitted disease.

From his 18-month experience at the Minova hospital, Dr Tharcysse has learned to what extent sexual violence can cause horrific and deliberate trauma. " I remember a lady of 69 who had been raped by eight armed men. You can imagine the damage to her body. "

" Moreover, rape is a barometer of conflict, " he explains. " I have seen the numbers of women victims of sexual violence coming to my hospital go up and down with the fighting. " By this token, the doctor is doubtful about the latest cessation of hostilities declared by the main belligerents in the Kivus.

He says he has treated 30 women victims of rape in December, and more than 30 others in January, which had not come to an end yet. " Yesterday alone, we had seven new cases, " says Dr Tharcysse deploringly.