Interview with Dr. Serge Makolo Kasadi, IMCK, Kananga, Democratic Republic of the Congo (DRC)
The following is a summary of an interview with Dr. Serge Makolo Kasadi in October of 2019. Dr. Serge is the administrator of Institut Médical Chrétien du Kasai (IMCK). IMCK is a large complex located just outside Kananga in south-central DRC. It includes a lab tech school, a university-level nursing program, a high school level nursing program, a 140-bed reference hospital, programs for nutrition, public health, research and medical internships, outpatient clinics and a dental program.
Editorial note – the DRC presents one of the most difficult environments for health care development in Sub-Saharan Africa, with the health status of its people ranking among the worst in the continent. Ongoing political instability and violent conflict, breakdown of infrastructure, and continual economic decline are making the continuing viability of health facilities almost impossible at times. With the constant brutal conflict over the last three years, more than 1.4 million people in DRC have been displaced by the violence from rebel gangs and government militia.
Dr. Serge opened the discussion explaining that at various times during the conflict, there has been an influx of patients, especially those without the ability to pay. He emphasized that the increased patient load strains the hospital’s resources. Limited finances result in the hospital’s inability to pay adequate salaries, maintain facilities, replace equipment, purchase drugs, and provide charity care. Our administration team frequently struggles with how to continue operations with limited available resources. Dependence upon donated or used equipment is not always reliable. With resources focused on necessities such as water and electricity, staff are often forced to choose a “quick fix” for difficult situations. Without enough cribs and working incubators in the maternity ward, babies are packed together to keep each other warm. However, our dedicated hospital staff remains to care for patients even while going without pay for months. Short of medicines, lab, and surgical supplies, the hospital still manages trauma injuries, TB, AIDS, delivery of babies, and the ongoing battle against malaria.
IMCK nursing schools were briefly shut down in 2016 for the safety of the faculty and students. Operations resumed, and enrollment is now near capacity. Instructors receive no government funds; they are paid only from student fees. With the limited available revenue prioritized to pay lagging faculty salaries, this leaves no funds for facility repairs or replacement of training supplies and equipment. Dorm facilities require repair, and while there is a meager library available with some French textbooks acquired from the Ministry of Health, students depend primarily on lectures and class notes for training.
Today, the reality is that the IMCK Hospital and Nursing Schools remain in the most basic day-to-day survival mode. Much of the previous financial support from U.S. organizations has dwindled, and there are few international visitors or teams. There has been a recent brief period of reduced violence, but unrest and uncertainty remain. Economic development and commerce are slow and tentative, with a fear of a return of rebels and military intervention at any time. The entire country seems to be on hold awaiting what will happen next.
It is humbling to see the faith of our dedicated Congolese colleagues who persevere in the face of so much adversity and constraint. Despite the extensive difficulties faced, the IMCK Hospital continues to operate and the Nursing School serves as a framework for student practices. We need to continue to pray for them and support their health care programs as much as possible.
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