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Page last updated at 05:48 GMT, Tuesday, 8 August 2006 06:48 UK

Breathing life into DR Congo's sick hospital

By Joseph Winter
BBC News, Lubumbashi

When Professor Stanis Wembonyama became director of the main hospital in Democratic Republic of Congo's second city, Lubumbashi, last year, he could not believe what he saw.

Professor Stanis Wembonyama
Prof Wembonyama says the flowers he planted helps the patients recover more quickly
"The hospital did not even have a single thermometer, armed robbers had set up their base in some of the buildings and there was human excrement everywhere," he told the BBC News website.

Most of the beds had been either stolen or stripped down and sold as scrap metal.

After years of gross mismanagement and financial problems at Gecamines, the state-owned mining monopoly which used to be in charge - theoretically - of the Jason Sendwe Hospital, the institution had been left to rot.

Doctors and nurses had not been paid their salaries for five years and so they earned their living by demanding cash before treating their patients.

"Patients were being held to ransom - they had to pay to get the slightest thing done."

Prof Wembonyama was sent by the University of Lubumbashi to turn the hospital round.

"I had to remind people that their job was to save lives," he said.

Ingenuity

The two most important things he did were to clean up the hospital and instil some management discipline.

He has even planted some flowers outside his office and takes great pride in them, watering them every day.

Rachel Kanabwingi
It is much cleaner now but it is also much more expensive
Rachel Kanabwingi

"They help the patients psychologically, which helps their recovery times," he said.

In terms of management, he reopened the hospital's pharmacy, which sells drugs to the patients and insists that they pay 200 Congolese francs (45 US cents) a night for their stay.

Even such limited resources make a difference when well managed, and the hospital is now breaking even without any outside funding.

The hospital staff have also had to use their ingenuity - for example by employing their own team of mechanics to fix the beds and remove spare parts from broken pieces of equipment to fix those which are salvageable.

With some 30% of the patients unable to pay for their treatment, one doctor admitted that they sometimes over-prescribe drugs to patients who can afford it and use what is left over for those who cannot.

Medical personnel are still not being paid - that is the responsibility of the government in far-off Kinshasa - but they do get regular "allowances".

Broken equipment

While the grounds and wards are relatively clean, many window panes are still broken.

Patient on bed without sheets
Even sheets used to be a luxury
Dust and rubbish are blown through the gaping holes into the hospital.

Three of the four sterilising units in the operating theatre do not work and some of the spotlights above the operating tables cannot be used because the bulbs have blown and they are difficult and expensive to replace.

Nevertheless, operations are still carried out - surgeons were removing an appendix while I was there - and head surgeon Alphonsine Biuma insists that patients are not in danger despite the limited resources.

In the maternity unit, the main sterilising unit is broken. Only a small one works and its rusty door is held shut with a brick.

The ward has holes in the ceiling, no mattresses for the metal cots and the blankets are filthy, but this is still an improvement on how things once were.

It is still presumptuous to call this place a hospital
Prof Wembonyama
"It used to be chaos here," said Rachel Kanabwingi, 36, who is well-placed to make comparisons, having just given birth to her ninth child.

"It is much cleaner now but it is also much more expensive. I know people who can no longer afford to come here."

National example?

Hospital administrators insist that prices have not risen that much - it is just that now there is a single charge, instead of having to pay a series of small fees.

I was told that even cleaners used to give injections - for a price.

But not everyone is happy with the changes.

Nurse Mimi Kinyanta
Nurse Mimi Kinyanta says she was better off selling drugs to patients
The nurse in charge of one of the maternity wards, Mimi Kinyanta, says she used to be far better off working as a "volunteer" under the old system.

She says she used to earn 5,000 francs ($11) a day by selling medicines she bought in pharmacies in town to the patients.

Patients were not allowed to undercut them by bringing in their own drugs.

Now Ms Kinyanta gets an allowance of 15,000 francs ($33) a month but hopes to get a proper salary one day.

Prof Wembonyama is extremely proud of what he and his team have achieved in just 11 months but knows his task is far from over.

"It is still presumptuous to call this place a hospital," he said.

But he is confident that the situation will continue to improve.

The country as a whole is at a similar stage - just about out of intensive care after years of mismanagement and looting.

Elections were held last month, giving the Congolese people the chance to choose their leader for the first time.

So what advice does Prof Wembonyama have for the man who - once votes are counted - will be taking on an even bigger rebuilding job than the one he started last year?

  • The first thing is to match people's skills with their jobs, and not employ people because they are friends or relatives, he says.

  • Secondly, put productive resources in areas where they can generate more revenue. Even a small amount can go a long way, if well used.

  • Third, discipline; work to deadlines, with leaders showing the way by working day and night. If the leaders delegate everything, nothing will get done.
  • Finally, teamwork and know your limitations. When you get stuck, ask someone who knows better than you, instead of waiting for help or trying to fix it yourself, Prof Wembonyama says.

DR Congo's hard-pressed population will be hoping their next leader takes such simple homilies to heart.

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