Ebola Update from Nyankunde Hospital

September 20, 2019

"I will be brave Mom."

We have had two Ebola cases at Nyankunde Hospital this past week. They arrived in the middle of the night, and it seems that they intentionally deceived the staff.  They lied about the town they came from.  They had a family member who had Ebola.  Rather than comply with the recommended observation period, they fled and came here.  One of them died in the hospital, and the other has been transferred to an Ebola Treatment Center nearby.  Both of them have tested positive.  

A safe burial of the dead patient has been conducted.  Decontamination procedures have been performed.  We are hoping that vaccinations willl take place in the near future.  Several of our medical staff were exposed to the patients, including a training doctor who had not been vaccinated.  Neither Lindsey or myself had any direct contact with the patients.  

This has been an unsettling experience.  It is difficult to identify high risk patients when they intentionally lie and deceive. We do not know what will happen next.  I have done a few operations, but we are trying to keep a low profile and minimize our exposure in the hospital. 

We are also facing the uncertainly which will result as other missionaries consider their own evacuation procedures.  We

Many children and family members of health workers were vaccinated

are not currently evacuating.  We believe that our current risk level is low (no evidence that it is replicating in the community) and we want to serve as long as we are able to. If we begin to see more cases popping up, or if we can not practice effectively, we will re-evaluate.  Our family has been immunized for Ebola which is imperative to our being able to live here now.  Emmanuel received his vaccine yesterday and has handled it very well.

It was inevitable that we would get another case sooner or later.  This disease is simply not going away anytime soon.  It has a disruptive effect on the hospital on many different levels.  We will do our very best to be cautious.  Lindsey and I both feel that God has called us to serve in this difficult place at this difficult time. We know that he can take care of us.  

Please do pray for us as we live and serve at Nyankunde.



Blessings,
Warren, Lindsey, and Emmanuel Cooper

Giving consent to receive the Ebola vaccine

Measles Outbreak

September 13, 2019

Pediatric Wards at Nyankunde Hospital

Many of you are aware that DRC is experiencing an Ebola epidemic, but you may not have realized that the Congo (and the world) is also experiencing a measles epidemic on a larger scale.  This past month the number of deaths from measles has surpassed the number of deaths from Ebola this year alone.  There have been over 3200 deaths and most of them are children!  The measles outbreak is the world’s largest and fastest moving outbreak-with 165,203 cases so far this year.  Since June the government has declared the measles outbreak with emergency vaccination already reaching >3,4million children.

I don't usually talk much about public health, but I really feel it is important.  Measles is not just a problem in Congo.  There were more measles cases reported worldwide in the first 6months of 2019 than any other year since 2016.  There have been 364,808 cases worldwide by July 31^st.  It is one of the most infectious diseases

One measles case is considered a public health emergency by world standards.  In April, New York City declared a public health emergency due to the presence of measles.  It is highly infectious and the consequences can be catastrophic if the brain is affected. Children who are immunocompromised or malnourished have a high risk of contracting the disease.  Herd immunity occurs if 95% of the population is vaccinated. This article points out that in DRC immunization coverage was only 57% in 2018.  https://www.telegraph.co.uk/global-health/science-and-disease/measles-has-now-killed-people-drc-ebola-almost-children/

This is all fine and good. Measles is a problem.  But now this disease affects my medical practice and could even affect my family.  As I looked through hospital records today, I found 12 cases in our hospital since July 2019 (and a few in the months preceding this). This is just in our hospital and it probably ties the incidence of the number of cases of treated meningitis.  The World Health Organization is following the situation closely and has prioritized our health zone as a priority for vaccination this month, and upcoming months.  

The initial focus here has been vaccinating displaced peoples, protecting an estimated 27,000 children living in crowded camps in and around Bunia (an hour from us).  There are an estimated 35 refugee camps like this across our province.  It is hard to imagine the living conditions and scale of the problem from reading the news. It is under conditions like this that measles spreads, as do other diseases.  

https://www.msf.org/deadly-measles-outbreak-spreading-wildfire-democratic-republic-congo

I am hoping to bridge two very different parts of the world.  Measles is a worldwide problem.  It occurs in parts of the world where the vaccine is readily available, but it really shouldn’t be there.  It is more understandable in parts of the Congo which are largely unreachable by road and where cold chain is hard to maintain.  Our health zone is working hard to eradicate it here and protect our vulnerable children.  May God help us and bless the work of our health zone.

 Lindsey

Adjusting Back to Life in Congo

September 2019

Adjusting Back to Life in Congo

We made it back to Congo about 3 weeks ago and are adjusting to life.  It is an interesting process, the coming and going, packing and unpacking, goodbyes and reunions, letters and intentional time with people, layovers and missed flights….all of this is part of being a missionary.  We become accustomed to change, but it isn’t always easy. It is an interesting process of seeing things with new eyes.

We traveled through Rwanda and into Goma where we knew we had a better chance of getting vaccinated. We were vaccinated against Ebola our second day in DRC.  We spent about 4 days in Goma, a city built on lava, a very interesting place.  Then we took a commercial flight to Bunia and then to Nyankunde.  We were “traveling” for a total of 6days before we got to our final destination. It is all par for the course.  

We through a birthday party for Emmanuel’s 5^thbirthday with other missionary families. It

was a blessing for him to have his friends over and feel special.  He had been looking forward to his birthday party in Congo for weeks!

Then our first week here was challenging on all fronts.  We were dealing with health problems of our own, a child with emotional outbursts struggling to speak French, hospital disappointments, frozen bank accounts/phone numbers, etc…In fact if a tree had fallen on our house (as usually happens when we are away for an extended time), this would not have surprised me.  Although it had its challenges, it was also a rich time of re-connecting with our friends and colleagues.  It is nice to feel like people are glad you are back, that somehow you can give hope in simply sharing life together. 

It feels like we have two homes-one in the US and one in Congo.  It is an interesting thing to “belong” to two VERY different places.  I have thought a lot about this watching Emmanuel work through it.  I think he now has the idea that he is American, like his grandparents.  He knows he has a home in North Carolina, but he also knows that Congo is a very important place.  He knows he is different somehow.  He is becoming more aware of differences such as children bathing in the river without swimsuits on.  He thinks it’s silly and I say, Emmanuel they don’t have a “swimsuit” like you do.  He wants so much to connect with Congolese kids his age-to sing songs and feel like he belongs.  He climbs trees all day long and runs around barefoot!  

Little things about life: 

-It gets dark at 6pm every night here.  I forget the rush to get everything done outdoors before the sun sets and maybe get a run in if I am lucky.  Evenings are pleasant, always cooler and quiet.  There is time and space to hear yourself think.  I have a need to be outside when the sun is setting…I am not sure exactly why.

-There is no need for air conditioning.  You just open the windows and enjoy the breeze.  I don’t need to know what temperature it is indoors-it doesn’t even occur to me.  If it’s cold I get a sweater and if its’ warm I open the windows.

-We eat organic food without trying very hard!  I love this, not having much packaging, and simple but healthy meals.  Squash is a treat, as are green beans and peas!  Coffee takes some planning…you need a good stock of charcoal and a forge (!) to roast local beans.

-We have time to spend with each other.  Life doesn’t feel harried.  People are very important, more important than completing a checklist. 

- We live less private lives here.  We want to know and be known by others.  I enjoy having people in my home and working together with local people.  Our parrot is constantly talking to people walking and birds flying by the house…he is starting to imitate everything.  It even sounds like he is doing the local tribal greeting: “Nebo” in the morning.    It is funny.  Less private, yes, especially with a parrot.

-It is nice to work in the dirt, feed the chickens, and take goats out to pasture.  

-It feels good to speak French again daily.  I can hear Swahili better after a time away.  I have retained a fair amount of Swahili which is neat.  It is a blessing to worship the Lord in another language. Things take on new meaning.  I love this.

-I have more stuff than I need.  There is a lot of stuff to re-organize and give away.  It is easy to give things away here.  

We are getting back into the swing of things.  I have been attending meetings with the hospital about nutritional programming, looking at statistics and thinking through the best way to do operations.  We have been working through proposals for hospital capital improvements and trying to think strategically about what the needs are. Warren has been doing surgery every day and working with residents.  

Thank you for your interest in our lives.  We would love to hear from you!

Blessings,

Lindsey for the Coopers

Prayer Requests

-Pray for Emmanuel’s schooling, that we would know what his needs are, that he would be

First day of school

learning and growing in 2+languages.

-Pray for our hospital that we would represent Christ well, that our staff would feel valued and have their needs met.  

-Pray that we would be directed in how to spend our time in the hospital, ministry projects.

-Pray for protection of our area from Ebola and the end of this epidemic.

-Pray for our continued adjustment to DRC and security of our whole area.