Reference : V-P-CD-E-00956
Date : 31/01/2009
Caption : Minova. Hospital supported by the ICRC. A woman having a Caesarean section.
Photographer : HAVIV, Ron
Confidentiality level : public
Publication restrictions : reserved users only
Copyright : ICRC/VII
Description : Tharcisse Synga is the only doctor in a South Kivu hospital. He remembers those days in late 2008 when the place was besieged by the war wounded and the displaced, and he had to perform, single-handedly, up to 16 surgeries a day.

It was a bright end of January morning. The glorious view on Lake Kivu and the surrounding blue hills would have made a proud advertisement for any upscale Swiss clinic. But the cramped wards of the Minova reference hospital, with their collection of sick and wounded displaced, and the long queue of outpatients waiting for the only doctor, told a different story, as did the overpopulated camps in the background. This was a hospital in a war zone, and Dr Tharcisse Synga, 35, had not had a single day off in months.

It was a comparatively quiet day. The only surgery the doctor had to perform was a C-cut for a first pregnancy. A perfectly healthy little girl was born. Nothing to do with the up to16 surgeries a day of the past months. "Once, we even had 17. But that was too much for the material available at the hospital. The laundry had to work really fast, under difficult conditions, to recycle everything so we could operate again."

The most painful were the choices about life and death. "Many war wounded were brought in at the same time, and they were in different situations. We had to prioritize those for whom there was hope - serious cases, but with hope - and treat lighter cases afterwards. But for very serious cases, we could do almost nothing. Just be with them to the end."

In October and November 2008, the influx of displaced people and war wounded to Minova, a stunningly beautiful site in South Kivu, coincided with a strike by the hospital staff. Dr Tharcisse was left with only four trainees to do everything: the consultations, the surgeries, the ultrasounds. Rest "was not the order of the day", and nights would be spent at the hospital, "because it would have been risky to move after dark in case of a medical emergency. This is not quite what I had imagined when I had accepted this job, one year earlier", he acknowledged with a smile.

To the Kisangani and Kinshasa trained young doctor, the choice of a small provincial hospital had seemed logical: "When I started medicine, I wanted to relieve, even a little, the suffering of my brothers and sisters. I thought that this suffering is more tangible in small places, particularly in conflict areas." The Kivus, on the eastern border of the Congo, with their long history of bloody conflict, seemed thus a good choice. And the hospital at Minova is the only one for a population of 159,000. Still, the last months of 2008 were "quite dramatic".

Like the day when the fighting came too close for comfort. "As you can see, the hospital is on an eminence. The patients really panicked, thinking we could be targeted. So, with the orderlies, we had to carry them on our backs to their places, where they felt safer." All the foreign humanitarian agencies had left Minova by then. Nonetheless, the surgery kits donated by the ICRC "made a huge difference", the doctor reckoned.

Horrific trauma

The other welcome contribution by the ICRC are the post-rape kits, which, if administered less than 72 hours after the aggression, minimize the risk of contracting a sexually transmitted disease. His 18 months experience at the Minova hospital has convinced Dr Tharcisse of two things.

"First, rape is a weapon of war. One ethnic group will rape the women from another, and vice versa, often causing horrific and deliberate trauma. Like this lady of 69, who had been raped by eight armed men. Afterwards, they had filled her vagina with sand. You can imagine the damage to her body. Second, rape is a barometer of conflict. I have seen the numbers of women victims of sexual violence coming to my hospital go up and down with the fighting."

By this token, the doctor was not impressed by the recent declaration of cessation of hostilities between the main belligerents in Kivu. "In December 2008, I had 30 cases. For this January 2009, I am already at over 30, and only yesterday, we had seven new cases."

Original material : digital
Resolution : 5616x3744
Orientation : landscape
Colour/B&W : colour