The South African Medical Health Service (SAMHS) personnel deployed to Goma in the Domcratic Republic of Congo (DRC) are being kept relatively busy treating civilians and soldiers alike, with nearly a hundred medical evacuations in the last three months alone.
The United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (Monusco) has a large contingent of SANDF personnel at the Composite Helicopter Unit (CHU) next to the Goma airport ready for helicopter related missions such as medical evacuations. Dr Tebogo Seape is from 3 Military Hospital and is currently based at CHU in Goma under the Aeromedical team evacuation (A-Med). Seape states that the A-Med team has completed almost 70 medivacs in the three months she has been stationed at CHU.
Casualty evacuations (Casevac) from the combat zone are taken to SAMHS unit level one at the CHU, then once stabilized. A-Med is part of the helicopter transport that takes the patients from SAMHS unit level one to the relevant hospital. Seape said that they see both trauma and medical cases: “The last one was a patient with myocardial dysfunction. So, we had to move that patient from one of the villages, Bukavu, to Entebbe in Uganda.”
Seape said that her team (A-Med) in Goma are mostly treating medical cases such as malaria, other illnesses and strokes. The most stressful part of the job for Seape is extracting patients in the surrounding villages at night, leaving her wondering about the security of the area. “Before we can go in, they [Force Intervention Brigade] make sure that the place is secure but that little fear is still there.”
The Ebola outbreak in the DRC that has lasted 19 months seems to be coming to an end and there have been no active cases for over 20 days – the last patient treated for Ebola was discharged two weeks ago. Seape said that although there have been no cases of Ebola in Goma, vaccinations are still being done to SANDF personnel that volunteer.
“I’m just proud of my team, myself and my country, this is a life changing experience, very profound,” Seape said whilst in reflecting on her time in the DRC.
Captain Mogano is a qualified doctor who is also based at CHU. Mogano started working in Beni for four months and then moved to Goma for the past three months. Mogano states that gunshots and machete injuries are the most common wounds they find themselves treating. “Injuries from bomb explosions, gunshots, AKs [AK rifles], so it’s different types of injuries,” stated Mogano. The most volatile area for armed rebel force activity is Beni, in eastern DRC, where Mogano said when he was stationed there, he saw his highest number of gunshot and machete wounds.
“When I was in Beni, they woke me up at around 1 am and we had to go and evacuate patients in a village, in Bugado [A village bordering DRC and Uganda]. The area was quite volatile. We left Beni to Bugado with some of the Tanzanian platoon. We had to evacuate WHO [World Health Organisation] staff members who had been shot. Their ebola treatment centre was attacked. It was at night; the flying conditions were not good and the area itself was quite volatile,” recalled Mogano.
For healthcare facilities, there are levels one to four. Level one is a primary health care clinic, community health care clinic and district hospital. Level two is a regional hospital, level three is a provincial tertiary hospital and level four is central and specialised hospitals. If the patient is in need of level four care, they are sent either to a level four hospital in the DRC capital, Kinshasa, or to a level four hospital in Uganda. Goma has a level three hospital, which is where the Armed Forces of the Democratic Republic of the Congo (FARDC), the military of the DRC, are commonly taken.
Injured civilians are common patients for SAMHS personnel, as Mogano stated, “sometimes we even assist small kids as young as six months from machete wounds, gunshot wounds, so we see locals as well. It’s quite sad but it’s a lifetime experience, I’ve learnt a lot.” Mogano went onto talk about the challenges that a doctor would not have in a hospital, mainly treating patients inside a moving aircraft or having to resuscitate someone inside a moving helicopter. “When the aircraft lands, you scoop the patient and you go. The other stuff you do inside the aircraft. That is a very challenging thing, to put up drips, to listen to the heartbeat and everything, you can’t hear anything in the aircraft. So, you just have to be on the ball.”
The DRC is unforgiving with the Ebola outbreaks and other serious health concerns such as haemorrhagic fever, polio, cholera and typhoid. In addition, North Kivu is notorious for armed rebel groups carrying out heinous attacks in the province’s villages, attacking not only soldiers but also leaving men, women, infants and children wounded or dead. As long as the SANDF is a part of Monusco, SAMHS doctors such as Seape and Mogano will continue to make a difference providing the best healthcare in harsh conditions.