Chronological Report

November 4, 2023
Departure from Zaventem to Kinshasa, overnight stay at Procure St. Anne, Gombe.

November 5, 2023
Departure to Kisantu, arrival, installation, and welcome.

November 6, 2023
Start of the medical mission:

• 8:00 AM: Meeting with hospital management.
• 9:00 AM–6:00 PM: Start of mission with outpatient clinic, patient discussions all day.

November 7–10, 2023

• 7:00 AM: Breakfast.
• 8:00 AM–6:00 PM: Outpatient clinic, patient discussions, bedside teaching, and surgeries (one operating room session until 8:00 PM).

November 11, 2023

• 9:00 AM: Lecture on clinical examination of orthopedic patients, various topics.
• 11:30 AM: Visit to the football field.
• 3:00 PM: Administration and preparation for the upcoming week after a siesta.

November 12, 2023

• 8:00 AM: Breakfast.
• 10:00 AM: Walking visit to “Jardin Botanique” with lunch on-site.
• 4:00 PM: Rest during a heavy rainstorm.

November 13–16, 2023

• 7:00 AM: Breakfast.
• 8:00 AM: Outpatient clinic, patient discussions, ward rounds, bedside teaching, alternating surgeries by Dick and Jan (one operating room session until 8:00 PM).
• November 16, 2023: End-of-day structured handover of patients, including a follow-up treatment plan, followed by a well-attended farewell reception at Solfa.

November 17, 2023

• 8:00 AM: Plaster control for patients.
• 10:00 AM: Departure to Kinshasa.
• 3:00 PM: Arrival at Procure St. Anne.
• 6:00 PM: Dinner at “Chez Flore.”

November 18, 2023

• 8:00 AM: Breakfast.
• 10:00 AM: Luggage check-in at the city office.
• 12:00 PM: Visit to the “Siafe” project in N’Sele by Father Johan and Marcellin.
• 3:00 PM: Lunch by the Congo River.
• 6:00 PM: Arrival at N’Dili Airport and departure for home.

Mission Report

Composition:

• Two orthopedic surgeons and one anesthesiologist.
• An operating room nurse was unable to attend due to a family bereavement.
• Logistic support by CLIC Africa, represented by Lieve Vanreuselt and Jan Leemans.

Travel:
The flight proceeded smoothly.
Traffic in and around Kinshasa remains a challenge: busy and chaotic.
The return journey from Kisantu to Kinshasa on Friday, in preparation for the Saturday evening flight, may have been overly cautious. A Saturday morning departure could be considered in the future, depending on weather and road conditions.

Team Accommodations:

• Kinshasa: Accommodation at Procure St. Anne is satisfactory.
• Kisantu: Accommodation with the sisters is acceptable. Improvements could include replacing towels (large and small) after a week. During this mission, there were two days without running water and one evening without electricity due to external circumstances (storm).

Medical Infrastructure:

Hospitalization:
Several wards have been refreshed both inside and out, making them acceptable by Congolese standards. Overcrowding remains a significant issue, and hygiene and cleanliness could improve, but limited resources and space make this difficult. Some orthopedic tools, such as bed sliders, splints, and crutches, are lacking.

Operating Rooms:
The facilities are good, and consumables are sufficient. However, surgical instruments are outdated and heavily worn. Donations and new equipment have provided some improvements, but renewing basic surgical materials remains a priority.

Outpatient Office:
The space has been refreshed. However, there remains a lot of material and items that do not belong there. Specific attention has been given to addressing this issue.

Orthopedic Workshop:
The workshop has been thoroughly cleaned and rehabilitated. Shipped materials have been inventoried and unpacked. A retired former employee is temporarily in charge, but activities have not officially restarted. Training a motivated young person is planned, but significant steps remain to be taken.

Collaboration:

Hospital Management:
The hospital management provided full support and good communication. Agreements were implemented or clarified (see meeting report).

Medical Personnel:
Doctors:
A highly enthusiastic team of four doctors:

• Dr. Makiadi Damien (head of the orthopedic department).
• Dr. Nzeza Jocelain (working at the hospital for two years, now assigned to orthopedics).
• Dr. Mavitidi Jean-Michel (a young, recently ordained priest and doctor, assigned to orthopedics).
• Dr. Bertine (a fellow in the orthopedic department).

The entire team was consistently present, genuinely interested, eager to learn, and actively participated in all activities without any issues.

Operating Room Staff:
Highly motivated and engaged in the mission. They demonstrated excellent cooperation and genuine interest.

Paramedical Staff:
Active and involved, with requests for more support and training for their specific tasks, such as wound care and plaster casting.

Physical Therapy:
The physiotherapy department operates autonomously, based on doctor referrals. However, its management lacks clear direction. The department, which previously handled conservative clubfoot treatment with serial casting, is not well-integrated with the inpatient ward. As a result, hospitalized patients do not receive the appropriate follow-up and maintenance physiotherapy they require. Integrating physiotherapy into the orthopedic department is recommended.

Orthopedic Prosthetist:
The retired employee can manage a few tasks but is insufficient to lead the department. The selected candidate for training in Kinshasa awaits funding to begin their education.

Collaboration with CLIC Africa:

The logistical support provided by the CLIC Africa team was particularly complementary and appreciated.

Education

Teaching and Training Opportunities:
All medical activities were conducted jointly with local colleagues, trainees, and paramedical staff. Every opportunity was utilized for bedside teaching.

All participants showed genuine interest, and knowledge transfer was interactive and smooth. In practice, colleagues also participated in all surgeries and occasionally carried out some activities independently.

During the weekend, a formal lecture was delivered on Saturday, focusing primarily on clinical orthopedic examination and diagnosis. Due to late working hours, evening lectures were not feasible during this mission. However, this could be planned in the future.

Educational Materials:
Extensive digital collections of orthopedic textbooks, slide series, lectures, and presentations were provided to all colleagues.