Hello everyone. I’m blown away by the unbelievable response this blog has created. I never imagined there would be over 1000 of you reading my stories and supporting my journey. My elective has come to an end and I’m back safely in South Africa but I still have so many adventures to share that I’ve decided to continue writing. Before starting this post, I’d like to tell tell you about one incredible coincidence that has made this entire blog worth writing.

One morning, I received a Facebook friend request from Alex Matembera, a Congolese man whom I did not recognise meeting here. I accept and immediately receive an inquisitive message. Mr Matembera randomly stumbled on my blog while browsing Medium all the way from Canada. He was a nursing student in Katana in 1987 and wanted to know whether I was the son of Dr Nini Bulckens. It turns out he was one of my mom’s students from the class of ’87 and I put them into contact. My mom had unfortunately long lost contact with most of her students when they left DRC just before the Rwandan Genocide. A few days later my mother calls me beaming with pride after being reunited with her top student, Mr Matembera, and numerous other classmates from the 1987 nursing class.

She was so happy to find many of her students had went on to specialise overseas, complete substantial studies and even occupy prominent jobs all over Congo and the rest of the world. Their profound gratitude 30 years later is a testament to what people can achieve with just a small push in the right direction early on in life. My parents had created a short film documenting a Congolese student’s day in Katana to raise awareness and projected it to friends, families and institutions in Belgium back in the eighties. They managed to raise enough funds to sustain entire classes of students with lodging, food and tuition fees. Thirty years onwards, it is immensely gratifying to see the results of this gesture.

I was really struck by the kindness and gratitude of Congolese people during my stay in Bukavu. Upon my departure, I was met with many heartfelt goodbyes and messages from colleagues. It was very touching to leave Panzi realising I was able to make a small difference to both patients’ and students’ lives.

Lastly, I also want to extend my gratitude to Dr Charle Viljoen who supported me throughout my elective with numerous resources and consults necessary to organise an entire ECG lecture series in French. Your Facebook post was very moving and I want to say thank you to all the friends, classmates, doctors and specialists who’ve contacted and commended me on the initiative.

During my fourth week in Congo, I managed to visit a primate rehabilitation centre and old colonial research institute in Lwiro. Here’s how the experience went.

Lwiro primate rehabilitation centre

Lwiro Primate Rehabilitation Centre (Centre de Rehabilitation des Primates de Lwiro - CRPL) was created in 2002 by two Congolese Institutions: Institut Congolais pour la Conservation de la Nature (ICCN) and Centre de Recherche en Sciences Naturelles (CRSN). Poaching increased drastically during the Second Congolese War (1998-2004). This centre was created to serve as a safe place for orphaned primates to recover both physically and psychologically from the ordeals of poaching and primate trafficking.

The centre currently houses close to 100 chimpanzees and 105 monkeys of 12 different species, all of them victims of the pet trade/poaching. Without centres like these in Congo, no confiscation of captive animals would be possible. Every chimpanzee resident at CRPL was brutally taken from their forest home by poachers. The adult chimpanzees of such groups are usually shot and killed and then the meat is either eaten by the hunters or sold as meat in villages or large city markets. The infant chimpanzees are too small to eat and can often bring in more money when sold as pets. Sometimes the Congolese Government Wildlife Authority (ICCN) is able to intercept these infant chimpanzees while still being transported and as such prosecute the poachers. The infant chimpanzees are then transported to CRPL for long term care. Have a look at the video below to learn more about the centre and their mission:

I left Bukavu at 6am on a Saturday morning with Alain, a friendly driver I’ve met here with a rusty old Toyota Carina that he firmly believes can pass through any road in Congo. It takes us two hours to cover the 40 kilometers of muddy roads. After some drifting and car pushing we finally make it to the entrance of the Lwiro primate rehabilitation centre. Here we pick up one of the local chimp keepers who will be giving us a tour today.

The tour starts in the education center, where they often try and gather local villagers and individuals from the region to educate them on the perils of chimpanzee poaching and pet trafficking. I’m shown some of the cages these baby chimps were smuggled in when they arrived here at Lwiro. The sad reality is that I’ve seen similar cages being sold in Bukavu and heard of clandestine markets where one can simply purchase a baby chimpanzee without much hassle. For every baby chimp that gets rescued here, tens of them are not as fortunate and end up in the trafficking market.

It’s early morning and I get to witness various Cercopithecus species being fed in their closed enclosures. They’re beyond cute and it’s refreshing to see a well organised and funded center amongst all the chaos of the region.

We continue through the forest and come to the massive chimpanzee enclosures. There are currently five large open-air enclosures ranging from one to five hectares in size. The chimpanzees roam freely in their “miniature” forests and we can hear them playing in the trees somewhere within. Our first stop is the “bachelor” enclosure and the keeper starts calling them by their names.

Before I know it, five large male chimpanzees appear along the enclosure fence. They all gather around their keeper who starts handing out fresh shoots he picked up along the way. I’m astounded by their intelligence and humanoid behaviour. It’s almost as if they’re able to communicate directly with their keeper. They immediately recognise him and their facial expressions change drastically.

We continue walking through the enclosures and I meet a group of 20 juveniles playing in the grass. Baby chimpanzees are making cartwheels and fooling around while the older individuals supervise.

I’m happy to see they all appear comfortable and continue playing unphased by our presence. It’s a testament to the wonderful work all these carers have undertaken. The chimps who’ve just arrived at the centre appear traumatised and frightened by any and all human contact at first.

Just before leaving, a large male chimpanzee appears along one of the fences with a twig. The fences are partly electrified and he is careful not to shock himself. It appears like he wants to pass us the stick which has a few forks and struggles to pass it through the tight fencing. I casually try and demonstrate how to break off the side twigs and he immediately understands and proceeds to imitate my actions. I spent the next few minutes exchanging this twig across the fence with him. I’ll never forget this moment and I’ve brought this very twig back to South Africa.

 

IRSAC/ICCN

The IRSAC (Institut pour la Recherche Scientifique en Afrique Centrale), now run by the Congolese Institute for the Conservation of Nature (ICCN), is a large research institute that was inaugurated in 1956. It served as one of Congo’s leading research centres during colonial time and beyond. It is nestled right next to the Lwiro Primate Rehabilitation Centre, amongst the fields and patches of forest. My mother performed gorilla research here in the eighties and recommended I make a stop here.

I was very excited to visit ICCN. My parents had told me tales of a beautiful library in the middle of the forest and immense collections of fauna and flora. The largest confirmed elephant tusks in the world (3.5 and 3.3 metres long) were supposedly preserved here when they lived in DRC. I detest trophy hunting and was glad to find out this specimen was returned to the Congolese people instead of being shipped back to Belgium to lay in massive museums or private collections. However, upon arrival I found out that ivory poachers had attacked the centre in the early 1990’s and ransacked the trophy. All that is left today are the stumps they were unable to detach from the wall mount.

If you know me well, you’ve probably realised that I’m a massive bibliophile. I couldn’t conceal my astonishment when I stepped into this spectacular antique Victorian library. The smell of century old books instantly transported me back to an era long forgotten. The library appears frozen in time, with the newest additions dating to the turn the turn of the century. I could spend endless hours reading and studying here!

I walk through the archives housing close to 500,000 publications from all over the world. The majority of shelves are buried in dust and likely untouched in decades. The staircase takes us up three floors, opening up into a large room. Here is where they strip, bind and repair all their books.

Clinical cases

Exams were fast approaching at the faculty and I was asked to invigilate one if the third year physiopathology exams. These poor medical students don’t have it easy. The lack of resources means they have to write three hour long exams hunched over chairs in hot and crowded halls. Their determination is exemplary and I spend the following few nights marking 230 exam scripts.

One particular case that stood out to me during this week was a middle aged man I admitted in the emergency room with sudden debilitating chest pain. Recognising the symptoms, I perform an electrocardiogram (ECG) and confirm a large myocardial infarction (heart attack). This case, in our first-world South African setting, would be an ideal candidate for fibrinolytic therapy or percutaneous coronary intervention (PCI). I had recently heard that the neighbouring general hospital in Bukavu had just acquired alteplase (a drug used to dissolve blood clots lodged in the arteries supplying the heart causing heart attacks) and successfully lysed their first few myocardial infarctions. I hurry to find the cardiologist and propose we attempt fibrinolytic therapy. Unfortunately, due to a mixture of local policies, politics and other factors, the general hospital and Panzi hospital do not share such resources nor refer patients who require emergency care. This frustrates me immensely and we’re left treating our patient with suboptimal therapies that will never return his heart to its normal function.

A few days later, he is lying in ICU with a feeble ejection fraction (the amount of blood your heart is able to pump every beat), pulmonary oedema and a probable pneumonia. I request a portable chest X-ray, only to find the radiographer swamped with work and unable to bring the portable machine to ICU. He has no assistants and tells me that the patient either has to come to the radiography department or is not getting an X-ray. My patient is oxygen dependent and under a host of monitors. There is no way he is making it to the radiology department.

Once again frustrated, I decide to take matters into my own hands. I was vaguely familiar with radiological equipment and head to the radiologist office. I propose to do take the machine myself and perform the X-ray. He reluctantly accepts and spends a few minutes explaining how to do it. I take a protective lead jacket and head back to the ICU slugging a large X-ray machine. A few days later, his pneumonia is treated and he is discharged home. Unfortunately, a fraction of the person he was, barely able to walk more than a hundred metres.