Friday, August 23, 2013

DR Congo,Tanzania, Zambia and Burundi: A hospital ship for Lake Tanganyika.

The Telegraph reports 

Meet Amy Lehman, the woman bringing a floating hospital to the Congo

Three years ago, Chicago doctor Amy Lehman was shipwrecked in Sub-Saharan Africa. Stranded for 36 hours on a remote beach on the shores of Lake Tanganyika, she made a decision.

"I decided to get a tattoo of the lake on my back, so I'd never get lost again," she laughs, putting down her cup of tea, throwing her waist-length salt and pepper hair over her shoulder and starting to unzip her polka dot dress in the middle of the London private members’ club where we meet.

"Would you like to see it?"

Lehman, it’s safe to say, is no wallflower. A former exotic dancer, her motto is purloined from fellow American and soul singer James Brown: "you gotta use what you got, to get what you want" – which she shouts across the table at me in a gravely voice.

Not often lost for words but I am at the moment.

What she wants is $30 million.

Saving the world

Five years ago, Lehman, 39, left her home in Chicago and moved to Tanzania. Her big idea? To provide adequate health care for three million people living on the shores of the longest lake in the world by raising enough money to build a fully functioning hospital. On a ship. It might sound bonkers. But this ambitious idea hasn't been developed in a whim.

It doesn't sound bonkers at all. Although I am starting to think Amy might be.

Lehman had been interested in Sub-Saharan Africa since her teens and saw Lake Tanganyika as a "mythical adventure designation in the heart of Africa." Then – while studying business and medicine at the University of Chicago (not to mention single-handedly raising her son) – a Tanzanian friend asked whether she'd like to go on holiday there.

It was the chance Lehman had been waiting for.

"I told him that I wanted to visit Lake Tanganyika," (pictured) she says. "He was like, 'What? No, I'm not going there. It's in the middle of nowhere!"'

So she went alone.

What she found, was a vast and poverty-stricken community, cut off from the outside world. The lake is surrounded by four countries – Congo, Tanzania, Zambia and Burundi. There are 12 million people living in its basin and no basic healthcare or services.

That is not true (The healthcare bit ), I suspect Amy didn't say that. Journalistic licence is fine but don't mislead people. Never paint a picture that demeans. My daughter is Congolese and she has read the story and that pissed her off. It may come as a surprise to some, but Africa has schools, microwave ovens they even have computers.  

"During the trip I got stuck in a typhoon,” explains Lehman, "and the air strip where I was supposed to be picked up had been washed away.

"Sitting there, in the shadow of the Eastern Congolese mountains, it dawned on me that I was in a very interesting place; somewhere with lots of geopolitical significance and millions of people living in it – yet totally unknown to the rest of the world. I found that deeply intriguing."

The ignorance of the world about central Africa is quite astonishing. 

Lake Tanganyika: a 'biodiversity hotspot'

There can be no denying that Lake Tanganyika is intriguing. It contains a fifth of the world's entire supply of fresh water, as well as mineral rich oil and gas reserves. It's also a biodiversity hotspot with hundreds of unique species. Then there are the people: the percentage of refugees and internally displaced people is very high, thanks to 20 years of regional conflict and civil war.

"So when people say they don’t know where Lake Tanganyika is, it’s like there’s a huge gap in our understanding of the world,” shrugs Lehman.

To many, her decision to leave behind a comfortable life in Chicago to work in a deprived part of the world, under physically touch circumstances and – on occasion – under protection from armed bodyguards, might seem inexplicable. Self destructive, even. But Lehman is no stranger to overcoming adversity. As a child she suffered from an autoimmune condition which forced her to spend years in a wheelchair and left her with nerve damage in her right arm. This ultimately threatened her job as a surgeon.

Following a botched operation, Lehman was forced to reconsider her career. What else could she do? "All I could think about was going back to Lake Tanganyika," she says.

So, leaving behind friends and family – “they weren’t that shocked – I’ve never taken the well trodden path in my life” – she did just that.

Quality of life on Lake Tanganyika is a perfect storm. Malaria is still the number one killer. There's incredibly high maternal mortality. And the under five death rate is a staggering 25 per cent.

"If a quarter of the children in London died before the age of five, civil society as we understand it would come to a screeching halt," says Lehman, throwing her head back and roaring with laughter at the absurdity of it all (she does this a lot).

There is a lot of truth in that. I wouldn't describe it as absurd though, criminal maybe.

The list of life threatening conditions includes typhoid, malnutrition, cholera, and measles. The few health centres dotted around the lake offer only basic care and the lack of infrastructure makes referral to hospital impossible.

Lehman is working to change that – albeit under the gaze of various sceptics.
A hospital ... on a ship?

"People get fixated with the idea of a hospital on a ship – it seems so crazy to them," she admits. "But it's really just a case of rethinking access to one of the most remote places in the world."

Remote ? I certainly don't think of it like that.

When enough money has been raised for its construction, the ship will travel around the lake, stopping at each community for a couple of weeks and responding to emergencies with the help of an ambulance boat and radio system. It will also act as a teaching hospital, with rotations for local volunteers lasting for 4-6 weeks.

Although realising the boat is still some way off ("if somebody plonked the money in our laps today, it would take eighteen months to build"), Lehman and her dedicated team have started a number of outreach programmes.

It depends on the specs of the boat. One of the traps with projects like this is that things are over specced it is often better to use simple easy to fix technology, navigation and safety systems. In the South Pacific we have learnt this lesson the hard way. Hi tech seats often don't float but wooden seats do it can be that simple and it can be the difference between life and death. 

They've already succeeded where some larger organisations have failed – delivering drops of mosquito nets, vital supplies and footballs to small communities around the lake.

They've also tackled some of the problems experienced by the female population.

“Life for women on Lake Tanganyika is hard,” says Lehman. “The day consists of hauling water and fire wood. There's no access to family planning and the birth rate is high. Education levels are low in general, but even more so for women, as they’re busy running the home. The physical work a woman has to do on a daily basis is pretty astonishing."

Most serious among the health issues affecting them is Obstetric fistula; an injury that occurs after obstructed childbirth. With no access to appropriate medical care, they are often left with permanent tears, which – to put it delicately – cause embarrassing symptoms that damage their quality of life.

Often very young (the average age of first motherhood is around 13) they are then shunned by the community – seen as shameful and hidden away. More often than not, their husbands abandon them, too. Their lives effectively come to an end.

“Think about it,” says Lehman, shaking her head. “You’re a young woman – sometimes not even a woman yet – you’re pregnant and your baby gets stuck. It’s painful and awful. There’s no help. 99 per cent of the time your baby dies. Then you’re left with terrible injuries. And no one has even explained to you what’s happened.”

She arranged for some of the women to travel to Tanzania for surgery.

All but one was operated on successfully. But, explains Lehman, this 19-year-old Congolese woman was actually the person who taught her the greatest lesson.

'Emotional repair'

“After the crushing disappointment of not being able to do the surgery, we had to find a way to help her," says Lehman. "We didn’t want her to sink back into the dark recesses of her hut.

“I realised she had information and experience that could help others. I spoke to the Relais Communautaire – a group of women from the southern Congo who teach basic health care – and asked whether she could join them. And so, in the space of a week, we watched the transformation of this girl into a leader. Although we couldn’t physically heal her, she had undergone emotional repair. It just goes to show that a pill or an operation isn’t the whole story.”

Where Lehman's own story ends is anyone's guess. She's devoted her life to raising funds for the floating clinic and is determined to see the project through ("I made that choice and I've no one to blame but myself").

Her fundraising takes her all over the world – she currently only spends about 40 per cent of her time on Lake Tanganyika – and has brought her to the attention of the press. In 2011, she was named by American magazine Newsweek as one of '150 Women Who Shake the World' and by Elle magazine as one of nine women who are 'fixing the world'.

How does she feel about being heralded as a role model?

"It's not why I do it," she says. "But I'm humbled and proud. I hope I can demonstrate something that can lead people in interesting directions in their own lives."

Any advice for budding social entrepreneurs?

She pauses. "Having a big idea is the first part of a very long path. You need the passion and inspiration to get people to believe in you. But you have to be ready for a slog. It takes discipline and flexibility. You've also got to be prepared for constant learning. I've had a lot of education and gone to good schools, but I don't feel like I know it all."

Throwing down the gauntlet

There can be little doubt that Lehman is constantly learning. From tackling the language barrier to winning over officials from all four countries that border the lake and facing issues such as shipping, customs and immigration – she's thrown herself headlong into understanding a different culture. Not to mention the arduous journey just to travel to the lake itself – which can take days, aboard a series of uncomfortable modes of transport.

All things considered, it's no wonder this brave woman is more than happy – indeed, proud and delighted – to show off the detailed tattoo of rocky headlands, rippling water and sea creatures that run from the base of her neck, across her shoulders and down to her hips. It took 18 hours to complete and, to Lehman, represents more than just a way of overcoming further shipwrecks.

"It's a pledge of how important the region is to me," she says. "I carry it on my back, wherever I go. It's me throwing down the gauntlet. I'm the one who has to live with whether I'm successful or not."

Somehow, it's hard to imagine her hospital won't be up and floating before too long.

Good luck and safe passage.

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