The 'mondele' proves her mettle

Jessica Nestrell is responsible for a vaccination campaign for over 100,000 children in the DRC. So far, she and the team have been doing exploration missions of the region, planning the campaign by visiting the villages and regions where they will soon come with the vaccination campaign. She has been providing regular diary entries describing the work undertaken. Click for larger view Thirteen times we were able to lift the motorbike, push it over the tree trunk and keep going. But, with two of them, it was not possible no matter what we did. We tore our hands bloody trying to clear a little road in the jungle to get around the huge trunks. Soon we will be moving on to the vaccination campaign, but not quite yet. These past two weeks, I have been the sole person from the vaccination teams heading out with the Basankusu mobile team for one of the supervisory visits into the Djombo region in the northeast. The area is one of the most difficult to access and closed off areas in this territory. It was an entire day's travel on pirogues just to get to the starting point for the land part of the trip. There are quite a few of us - eleven in total with six motorbikes and a lot of luggage and we will eventually split into two teams. We lashed two big pirogues together for the journey - and one of them is the infamous jinxed pirogue mentioned in earlier entries. But the jinx seemed to have missed us this time and we stayed afloat all the way to Djombo. We did not get there untill after dark and we still had to unload all the goods and then ride the motorbikes up the trail to the health post where we were to spend the night all crammed into the nurses house. In the morning, we split into two teams and headed off in different direct. My team would be on motorbikes from here on. The other would take the pirogues further up the river and to the other side and then start from there. We will meet up again in a few days. I have a team of six people. Nele is the expat doctor from Belgium, working together with the national staff nurse, Jean. Bakomeka is a nurse from Mbandaka, and has joined the team to do information awareness on sleeping sickness. He is also one of the drivers. My driver, Benjamin is also the mechanic and logistics person. The driver of the pirogue will also drive the motorbike. When going out like this, it is good if people are able to do several functions. Our first destination was a health post in Bobambo, situated 20 kilometres north-west of Djombo. Since the road there was OK, I was able to a little detour with Benjamin and visit one more health post before Bobambo. The detour was reassuring. After weeks spent gathering statistics and preparing the campaign, the nurses there confirmed our plans, so nothing much should change. We headed off from Bobambo the next day, continuing west on a small trail leading us the 34 kms towards Boso Ngubu. The locals told us the trail was going to be hard, but good. We should be able to go out and back in one day. This opinion was not shared by the local fishermen we met further along when we were trying to get ourselves, and the motorbike, across the river. "The 'Mondele' (the local word for a female foreigner) will never make it on this road," they said. "It is better if you turn back". The idea of being in the jungle with a 'mondele' has not been lost on Benjamin, my driver. He is quite a tough guy and I could tell he was not too happy about heading off with an expat girl on a difficult trail in the middle of nowhere. But we pressed on, constantly running into troubles. Some 15 massive trees had fallen down across the trail, blocking our way. Thirteen times we were able to lift the motorbike, push it over the tree trunk and keep going. But, with two of them, it was not possible no matter what we did. We tore our hands bloody trying to clear a little road in the jungle to get around the huge trunks. This proved to be very difficult and took over 20 minutes each time. We started, one at each end of the detour, and met in the middle. When Benjamin drove, I went ahead to lift up vines and little bushes that were still blocking the way. Once, I fell into one of the bushes, complete with very small, mean little thorns that sank into my skin... We would never leave the post without a machete again. We also had to cross ten difficult bridges. In the end, we were very fast getting past the trees and the little rivers blocking the way. I would just quickly jump off and run to the front and lift up the bike. Benjamin would lift the back of the bike and push it over while I pulled and also tried to steer. On the small log bridges, it was the same thing. I elevated the front on to the bike and then I walked backwards steering it while Benjamin pushed and balanced it. When we finally reached the health post of Boso Ngubu it proved to be really worthwhile. By the end of the day I think I proved myself. And we had had a lot of fun. Few people live alongside the trail, but a large number live in the forest around the health post. You have to talk to as many key people - local nurses and village elders - as possible to get, and verify, information. Sometimes it is good to have a lot of people since you are able to compare their answers. From there, we took the trail a bit further to check out the way to the river. Unfortunately the path was too difficult and we will not be able to use it, in its current state, when we come back with the vaccination campaign. Somehow we need to either clear it, or use the river to supply the area with vaccines. The river might just be an option. Locals say it only takes an one hour to reach the main river by paddling. It might be possible to use a motor and then it would be only 20 minutes downstream - about double that going upstream. We have to consider this option when developing the plan. We had the basic information in hand, so now we had to get back to the health post in Bobambo. Another 15 trees all waiting for our return. Roadside consultations On the way back we met a mother with a small baby. She had seen us go by and now had been waiting on the trail for us to come back. Her little baby boy had infected wounds all over his body. The wounds had been there for some months, and the rest of the family had it to lesser degrees. Judging from the mother's skin, the whole family had scabies and the baby boy had an infection in his wounds. I usually have a good look around in the health post when I do my visit, just to know how well equipped they are - so I already knew that they did not have any antibiotics. The baby was feverish and also coughing, so it would have been best to take him with us back to the Bobambo health post. I could have tied him to my back with my sarong and the rest of the family could have come afterwards, but Benjamin refused. The road was too hard and it would have been very difficult to go with a small baby for more than four hours through the bush. But before we headed off, we made the family, and the village chief, promise us that they would start walking to the health post immediately. They would have to sleep somewhere on the trail during the night, then head off again at first light and reach the health post in the morning before our team left. You never know if they are going to come or not, but my experience is, if you involve the village chief, they usually do. The way back was obviously just as obstacle filled as the way there, but we now had the experience under our belts and we had already cleared the little paths to bypass the biggest trees - so it only took us four hours to get back. The family, if they came, would be on foot and slower. The next day we woke up to rain smashing against our tents. It was truly miserable since we all knew the planned route could not be done in the rain. We all stayed inside for several hours, doing nothing. But, despite all the rain, the woman arrived with her baby boy. Nele and I took care of the infected scabies. Everything should be getting better soon. Sitting in the rain is boring. After a few hours, we decided to try and press on with the bikes. In the pouring rain, we packed everything - and had an audience of locals who watched our every move patiently. But we had not even packed the bikes before we realised we would not be able to do everything in one go. Instead, we decided to leave some of the luggage with some nuns who have a small mission station on the road. And the nuns kindly offered us lunch - spaghetti!! Our eyes almost popped out of our heads. Travelling in the bush, your diet tends to be bananas and manioc. This was ... food. It was not long before we all felt better, recharged and, with the bikes now lighter and more manageable with less luggage, we set off eastward to Boso. Click for larger view I think the final kick off for the rainy season happened just after we left for Djombo because now it rains hard almost every day. The villagers said it was possible to do the road by foot and then take a pirogue to the Boso Masua health post and come back the same day - so early the next morning we headed off, expecting three kms or so on the river and then another four kilometres on the river. It turned out to be a bit different though. A collection of falls This path is particularly bad after rains as it becomes a little river dug into a deep canal that you have to balance through. Some parts are also very closed and difficult to get through with a lot of luggage. By now we had brought only what we could carry. The most experienced drivers always take more than the others, and both Nele's bike and mine were packed so well that Nele could not sit down between the driver and the luggage. Her driver, Jean, is really huge so I went with him instead. There was absolutely no space at all for me and I sat, between the driver and the luggage, completely squashed. The team fell four times that day. When you sit like this, all packed in and combined, you fall together. Two falls were with my bike. I could really see it coming and I screamed in horror before we fell. I must have scared Jean because he also screamed out as we went down.BR> Luckily no one got hurt. I was, however, able to add quite a few new bruises to my already impressive collection from the day before. About half way, we had a flat tire but do not have the right equipment to change it, so repairs took ages. Once done it was dark, but we had to continue since there was no point in turning back. Jean and I fell down again. Nele and Benjamin ran to our rescue. We were just not able to lift up the bike off us, so the others had to help. The other bike, with Bakomeka and Jean, was going faster when they fell down, but they also had no injuries. When we finally arrived we were all exhausted and just wanted to sleep. We put our three tents very close together, outside the health post. Before we went to bed, Benjamin and I asked the locals about a route that Benjamin knew about. This path is not on the map, but he had used it before during the dry season. I think the final kick off for the rainy season happened just after we left for Djombo because now it rains hard almost every day. The villagers said it was possible to do the road by foot and then take a pirogue to the Boso Masua health post and come back the same day - so early the next morning we headed off, expecting three kms or so on the river and then another four kilometres on the river. It turned out to be a bit different though. A path of swamps The 'path' was a swamp with water and mud up to the knees. When we hit the river, we continued with a pirogue. We had two men from the village Boso GBA with us as guides and they explained to our team where we were and where we were going. It is very important to tell people about your routes in case something happens. The river is more like a stream and only possible to use during the rainy season as, otherwise, it is too small and shallow. And again we ran into big trees that had fallen across the river. Each time, we had to get out of the pirogue, jump over the massive trees and get into the pirogue on the other side. Everyone else was standing up in the pirogue, but, since I was not able to hold my balance so well with all the crashing into roots and things, I had to sit down. And every time we tipped a bit, the pirogue took in more and more water. After about an hour and a half we reached the point where we continued on foot. I changed into my sarong and continued barefoot since I had so many blisters already. Come tomorrow, I would regret this, as I picked up a collection of small cuts and stubbed toes from roots and rocks buried in the muddy trails. We finally reached Boso Masua around noon and met a very surprised MSF team. The other team been there all the time we had been in Bobambo and Boso GBA. We were both very tired and decided to stay for the night, making sure to get word back to the team. That afternoon we took the bike to Ebongo Mbolu - a short drive on a good trail - and met with the village chief and some members of the health committee. They told us about an additional five small villages a whole day's walk into the forest. They were also able to point out more villages along the Lokoloko River. More hidden villages for the campaign. In the evening I sat with the nurses and a flashlight drawing more and more information on the map. I have learned a lot from this explo and I was glad that I went along, even if it was difficult. The next day we headed back the same route as before. This time it was more difficult for me since I had so many wounds everywhere from when I went barefoot. Back at the health post, we packed up and headed off. This time no one fell and we returned to the nun's mission station safely and picked up the items we had left behind. It had been a rough few days for my driver and me, and I was quite happy that the schedule planned in Basankusu before heading off to Djombo did not permit me to go anywhere the following day. I made two other explos before we headed back to Basankusu, but I think I will tell you about that in my next letter since the solar battery is running out and I have no more battery on my computer soon. One of the pirogues just arrived a few hours ago and we have been loading all the stuff in our new stock house. Yesterday we started the refrigerators to freeze the ice packs for the cold chain - a key element in the success of the vaccination campaign. When I think of how hard this effort was when we just had ourselves to worrry about, the idea of maintaining a vaccination cold chain in this jungle gives me pause. In my next letter I will finish the Djombo story and tell you what my colleague, Karl, our logistician, has been up to now that we are soon kicking off the campaign.