Tuesday, September 30, 2014

Wheelchair Project Part Three

(Please forgive our absence...our daughter and blogmaster has been extremely busy and available the last month.  We are back online and hope to continue to provide you with regular updates and photos from the DRC).

The following are photos connected with the wheelchair project discussed and shown on this blog previously.  A major narrative follows the photos so scroll down for all the details!

After paying about $5,000 more than we should to the company that hauled the two containers of wheelchairs from the port city of Matadi to the capital city of Kinshasa, we now finally---three months late---have control of the 664 wheelchairs and accessories (canes, crutches, etc.). 

On Friday morning July 26 I got a phone call from Dr. Musafiri, program administrator for the Ministry of Public Health, advising me that two trucks hauling the two containers would arrive at the Ministry's warehouse at 2 pm that day.  I told him to call me back when he could confirm that the trucks would arrive in 30 minutes.  At 2:45 I got the call and so we drove over to the warehouse.  Neither Dr. Musafiri nor the trucks ever arrived.  I tried unsuccessfully to raise him by telephone and text message.  At 4:30 one of his assistants called to say that there was a problem with Customs and the chairs would not be delivered until Saturday.  I told her that we were busy and couldn't come on Saturday.  Later Dr. Musafiri texted me with his apologies.  I texted him back asking him to advise me when the chairs were finally delivered.

By Monday July 28 at 9 a.m. I hadn't heard from Dr. Musafiri so I called him.  He said that the chairs still hadn't been delivered but would be delivered "soon."  At 3 p.m. he called me and said the chairs would arrive at the warehouse imminently.  I set off to witness and photograph the arrival of the chairs but got stopped by a motorcycle policeman just as I was about to turn into the entrance of the warehouse.  He demanded to see my driver's license but I decided to end the farce quickly so I just showed him my missionary badge and he immediately took off.  At that time the semi pulling the container of chairs was just trying to back into the warehouse compound.  I stayed long enough to watch about one-third of the chairs unloaded from the first container.  Unfortunately about five cartons had sustained some water damage but we opened one carton and it didn't appear that the chairs themselves were damaged.  I was also disappointed that the warehousemen had not created enough room to accommodate properly 664 cartons of wheelchairs.  Although I had instructed Dr. Musafiri that the cartons were not to be stacked more than 3 deep, they didn't have enough room and so began stacking them 10 deep.  When I asked Dr. Musafiri about the second container, he said it wouldn't arrive until the next day.  So I returned the next day and verified that the second container actually did arrive as well. 



Photo with Dr. Musafiri behind container # 1 ‏

Damaged cartons of wheelchairs. ‏



Inside the warehouse.


Beginning to unlodad container # 2.

Wheel chair Projects Kinshasa 2014

                The wheelchair initiative is one of the five major initiatives of the Church’s Humanitarian Services department.  Its purpose is to provide wheelchairs to people with disabilities in developing countries according to World Health Organization guidelines through local partner organizations that directly serve people with mobility disabilities.  Humanitarian Services specialists are called to work in specific areas of the world and to develop and implement projects in which an agreed upon number of people will be assessed, fitted, trained and then receive an appropriate wheelchair free of charge.  Typically a project includes a training program in which local clinicians are taught how to assess, fit and train wheelchair recipients and local technicians are taught how to assemble and modify wheelchairs according to the clinicians’ specifications.  All aspects of the projects are carefully evaluated to assess the impact of the project in the lives of individual wheelchair users, product quality and services provided.

                The wheelchair specialists in the SE Africa Area are John and Marcia Dow of San Diego, CA.  When they learned that were called to the DR-Congo (DRC) as humanitarian missionaries they contacted us and arranged a meeting at a restaurant near our home in Roseburg, Oregon in the fall of 2013.  At that time we received our first briefing on how the program works.  We later Skyped with them and got even more information.  However, we didn’t really understand the actual program in the DRC and what our responsibilities would be until we arrived in the DRC on January 12, 2014.  The local partner is the Ministry of Public Health (more specifically the Programme Nationale de Re-adaptation d’une Base Communitaire whose chief is Dr. Willy Musafiri) but which will be referred to hereafter as the Ministry. 

                In 2011 the Dows developed a program in which some 350 wheelchairs were manufactured in China, packaged , placed in a shipping container, and shipped to the DRC, arriving in the port city of Matadi in about June 2012.  Because the Congo River is not navigable from Matadi to Kinshasa, the container was then loaded onto a truck and transported to Kinshasa.  Our predecessors, Elder and sister Moon, had problems but ultimately were able to get the chairs released from Customs and transferred to the Ministry’s warehouse in time for the  Dows and four trainers from the USA to train some twelve clinicians and twelve technicians (one each from the same health clinic).  The Ministry then began prescribing and dispensing wheelchairs and providing monthly reports to the Moons and the Dows.

                As the project appeared to be going satisfactorily, in 2013 Humanitarian Services entered into a contract to deliver six containers of wheelchairs to the Ministry, with the first two containers to arrive in the DRC in the first half of 2014.  As part of the project the Dows and four more trainers were slated to arrive to provide two days of retraining for the clinicians and technicians originally trained in 2012, and also to provide five days of training to a new cadre of clinicians and technicians.

                However, during the latter part of 2013 the Ministry stopped sending reports.  The Moons received tried but never really got to the bottom of the problem.  Three days after we arrived in Kinshasa Elder Moon took me to the Ministry’s warehouse to physically inventory the number of wheelchairs remaining from the 2011 project.  We counted 40 chairs.  Over the next few months I had numerous meetings with Dr. Musafiri and his assistant, Nadine, to try and determine why we weren’t getting detailed reports and to explain to them that the reports that we had gotten were often  unsatisfactory.  I learned that the Ministry allowed other organizations to distribute some chairs; that the Ministry occasionally turned over chairs to clinics without any record keeping, assuming that the clinicians would provide the record keeping when they prescribed and distributed the chairs, but in some cases the clinicians failed to do so, and as a result the Ministry had some major gaps in its data base; and that for some reason the Ministry distributed almost no chairs in the last few months of 2013 and the first few months of 2014.

Later I learned that Dr. Musafiri’s boss, Dr. lllllllllllllll, the actual Minister of Public Health, had asked Dr. Musafiri to make some of the chairs available to him to distribute to his political base in Katanga in the eastern part of the country.  When Dr. Musafiri declined to do so, stating that he had a protocol on chair distribution that he had to follow, the Minister told him to stop distributing chairs.  So  there were still 33 chairs left in April 2014.  At that time Dr. Musafiri unilaterally lifted the ban on distributing chairs.  In the meantime we continued to have our translator Felix interview a few wheelchair recipients to get some data on how people were actually benefitting from their chairs.

In March 2014 we received a bill of lading indicating that a ship with two containers of wheelchairs for the 2013 project had left China bound for the DRC.  At that time we contacted the Dows and asked them to give us much more specific information on our duties with respect to this shipment.  They indicated that our duties included:  securing a training venue for May 24-31; purchasing a number of supplies including Crescent and/or open wrench sets, hack saws, hand saws, tire pumps, hex wrenches and clipboards; ordering polo shirts with the Church’s and Ministry’s logos; ensuring that the Ministry invited the correct number of clinicians and technicians to attend the training sessions, providing us with detailed information about them, and then ensuring that they would show up for the training; ensuring that the Ministry would arrange for handicapped people to attend the training sessions so the clinicians could actually have experience assessing needs and prescribing chairs and technicians could have experience building chairs, all under the supervision of the trainers; ensuring that the Ministry would have the 33 wheelchairs at the training venue; working with the Ministry to order assessment beds and foot blocks for the clinicians; working up a closing ceremony with speakers from the Church and certificates to honor the trainees; and perhaps the greatest duty of all, providing lunch and two snacks for about 40 people over seven days of training, plus a closing ceremony. 

In April and early May we enlisted our translator Felix’s assistance in ordering monogrammed shirts and purchasing tools, and we spent much time sampling the wares of possible food vendors such as grocery stores, restaurants and caterers.   We were happy to discover that we could get tools, shirts and food for considerably less than the Dows’ stated budget.  We even decided to provide jugs of filtered water and reusable cups in order to save money on beverages.  We continued to work with Dr. Musafiri as problems and misunderstandings arose.  For example, for the new trainees, the instruction to Dr. Musafiri was to simply invite 24 people, one technician and one clinician from 12 different facilities and to provide us with a list.  Instead, he invited 33 people, invited unequal numbers of clinicians and technicians with sometimes only one and sometimes three or four from one facility, and identified people as both clinician and technician for training purposes whereas a person could only be trained as one or the other.  So we asked for changes, and the list was still being changed on the first day of training.

But since a wheelchair project without wheelchairs isn’t much of a project, we also attempted to track the progress of the ship and its valuable cargo of wheelchairs.  The ship arrived in Matadi weeks behind schedule, but still there was plenty of time to get the chairs delivered to the warehouse in time for the training, particularly since the chairs were exempt from customs because the Ministry of Public Health was identified as the recipient/owner of the chairs.  So we just continued to query Dr. Musafiri about the progress of the chairs.  In the meantime, the Dows were doing projects in other countries in the SE Africa area, and so communication was sometimes difficult.

But by early May we and the Dows were getting quite concerned because Dr. Musafiri was reporting that: (a) Necotrans, the local shipping company, was demanding payment of about $10,000 in order to release the chairs, whereas the Church was insisting that everything had been paid in advance; and (b) he couldn’t get his boss to write a letter to the Minister of Finance to request issuance of a letter of exoneration to the Director-General of Customs.  I frantically contacted Elder Kyungu, an Area 70, who is the brother-in-law of the Minister of Health, to try to arrange for a meeting in order to urge the Minister to send the letter.  Then we heard that he had finally sent the letter but that the Ministry of Finance had lost the letter.  Then they indicated that they had found a copy of the letter but not the original and the original was required.  Then we were told that the copy would suffice but the people surrounding the Minister of Finance were keeping the letter from him, perhaps in hopes of getting some extra compensation.   

In the meantime our schedule had gotten very difficult.  In early May we did a three day trip to Brazzaville, capital of the Republic of Congo, and then did an eight day trip to Johannesburg for our SE Africa Humanitarian Conference.  At one point the Dows indicated that they were going to cancel the training session because we could not guarantee that the chairs would be liberated before the training was to begin.  In the end, however, they decided that they could do the training with the 33 chairs that the Ministry had from the 2011 project plus the two chairs that they could bring with them from the US.  So we had limited opportunity to work with Dr. Musafiri and his chair problem until we returned from Johannesburg and got to our office on May 19. 

On that day I had a meeting with Dr. Musafiri to determine his level of preparation for the project.  I reminded him that he needed: to get the clinicians and technicians that had been invited to participate in the training to arrive at the Seminary & Institute (S & I) building no later than 8 a.m.;  to get all of the wheelchairs that had not yet been distributed from the 2011 project to the building before Friday morning (I also got from him a precise list of the sizes available); to get the assessment beds and foot blocks built to the venue ( I also gave him $500 to offset his cost of building the beds);  to get disabled people to the training venue on Saturday morning May 24 and again on Friday morning May 30 for assessments; and to get me the phone numbers of all of the participants so I could have Felix call them and remind them of their commitments.  I also had to rewrite the contract with our food vendor to make her happy.

On May 23 I went to the S & I building to meet with the vendor to get her signature on the new contract and to carefully go over the layout and furnishing of the rooms with Crispin, the Church’s contractor who is responsible for the building.  Eventually the van hired by Dr. Musafiri showed up to unload the boxes of wheelchairs that were still in the Ministry’s warehouse.  The workers would not carry the 15 boxes into the building and stack them in the designated room, so Crispin and I did it.  They then declined to go pick up another 18 boxes that Dr. Musafiri had delivered to a clinic but that had not yet been given to handicapped people until I paid them $15.   Of course I could have refused, but that would only have hurt our trainers coming later in the day from the US and ultimately the handicapped people, so I gave them $10 and they took off to fetch the chairs.  All the while Crispin was reminding me that hauling boxes of chairs was not in his job description and so I should pay him something extra.  He also continued to remind me that normally he doesn’t work on Saturdays so I would need to pay him something  Saturday after the training session.

Friday morning, May 24, we left the apartment at 7 a.m., picked up four dozen rolls from the neighborhood vendor, stopped at the Leon Hotel to meet the trainers, and then set off for the S & I building.  The trainers had a driver and van to get them where they needed to go during their stay in Kinshasa.  The training sessions planned for Friday and Saturday were for people who had received the training in 2012, so it was to be a refresher course.  Surprisingly, three trainees actually arrived before 8 a.m. so Glo put their names in a basket to draw for a prize on Saturday (a motivational trick she used on her Sunday School class in Roseburg to encourage them to come promptly to class and to behave).  Dr. Musafiri arrived about 8:30 a.m.  All the while I was running around madly trying to make sure the rooms were set up the way we wanted and to get all of the supplies (tools primarily) out of the closet where Crispin had locked them up for safekeeping.

The clinicians’ trainers, occupational therapists by training, were Lara and Steve; the technicians’ trainers were Chris and Steve.   It was fascinating to observe the trainers in action and to see the peoples’ reaction; they seemed to absorb the instruction like sponges.    We also had arranged for four translators each day, two for the clinicians and two for the technicians.

We had planned on putting the clinicians and technicians in adjoining classrooms, but when the technicians saw that we had put the boxes of wheelchairs in the large multi—purpose room, which is normally used by the S & I students as a game room and the room where we stored the chairs, they indicated that they wanted to use that room so they would have easy access to the chairs. 

As for food, every day we planned on serving morning and afternoon snacks consisting of rolls (with tubs of butter, peanut butter or Nutella available) or cookies and then a beverage, water or soda.  We had a caterer hired for four days but the other days we planned on picking up sandwiches.  For each meal or snack I counted on 40 people to make sure I had enough for the trainees, the trainers, the missionaries, the translators, some ex-pat friends who came by occasionally to see if they could help us in some way (one woman brought us huge containers of water for us to serve), and Crispin who  continually reminded me that he had arrived at 5 a.m. (instead of his normal 6 a.m.) to make sure that the building was clean and the chairs and tables were all set up for us.  Fortunately I was successful in getting a cash advance from our supervisors at the SE Africa Area offices in Johannesburg so I had plenty of funds to use without having to dip into my own pocket. 

We set up one of the classrooms as the primary snack and meal room, with beverages on one end of adjoining tables and the food on the other end.  Gloria was in charge of the food.  On Friday I left around 11:15 a.m. to drive to Chez Victoire where I ordered 40 huge chicken baguette sandwiches for only $2 and change.  As for water, initially we dispensed plastic cups to everyone, and put their names on the cups so they could reuse them to access our water jugs, but the cheap cups started to crack.  So we bought plastic water bottles, again hoping that people would reuse them to access the water jugs.  However, one woman in particular complained that it was unsanitary to reuse a plastic bottle and that we should supply as many fresh bottles as people wanted.  Ultimately we resolved the issue by just start buying fresh water bottles for everyone.  As a result I had to make daily trips to Shop Rite, the grocery store across the street from the church, to refresh our supply of bottled water. 

I also had to make sure that the tools and supplies were in good working order.  Two days prior to the trainers’ arrival I was asked to find a projector because the clinicians wanted to do power point and video presentations, and when we showed up at the venue Friday morning we discovered that an extension cord was needed.  I scrounged a cord so they could get started, only to find out that the projector didn’t work.  So I had to run over to our office to find another one, only to determine that the problem was with the extension cord, not the projector.  After that I just brought an extension cord from our apartment.  The technicians also announced that they needed a hack saw and an electric drill, so I bought a hack saw and was able to borrow a battery-powered drill from Elder Gates, the construction missionary.  The clinicians brought heavy plasticized posters, but they wouldn’t stay up on the heavily textured walls properly despite my best efforts.

Saturday even more trainees showed up on time, as the word had gone out that a prize would be offered at the end of the training but only to someone who had arrived on time.  At the afternoon break we offered sodas instead of water to those who showed up on time, and one of the technicians won the drawing: 5,000 FC cash to help with the cost of his transportation.   The trainees had a great time getting into the chairs themselves and taking them outside to the parking lot to test them.  The driveway down to the church had a fairly substantial incline, so the people got to test the chairs by going both uphill and downhill.  We took some great photos.

In the afternoon some handicapped people arrived to be fitted for chairs.  The clinicians assessed the condition of the patients and then ordered chairs to be assembled or even rebuilt from the technicians.  Some of the chairs come with four wheels, and are more suitable for indoor use on flat terrain.  Other chairs come with three wheels for rugged terrain and better maneuverability.  But all chairs require upper body strength and mobility so quadriplegics and others without the use of their arms cannot be issued one of our chairs. Also the chair sizes vary but are only for adults.

The first patient was a young man about 20 years old suffering from the effects of childhood polio; not only were his legs useless they were only about 1 inch in diameter.  The second was a woman who had limited upper body mobility but also needed to travel some distance each day to sell her wares.  That posed a challenge for the clinicians; some thought she needed a # 4 wheel chair; others thought a # 3 wheel chair.  The trainers were able to guide the trainees through the evaluation process to help them better understand that fitting a chair requires a lot of analysis.  The third was a beautifully dressed tiny mature woman who obviously was a polio victim.  She had actually been carried to the venue by her devoted younger sister.  We were drawn to these people and took a number of photos.

Sunday of course was a day off to attend church.  After church we had dinner guests—all six of the wheelchair people, Hugh Matheson (American land developer who spends much of his time in Kinshasa), Ryan and Larry (the temple construction men), and our single Congolese friend Eloi.   

Monday May 26 began week two of the training, which is for working clinicians and technicians who did not have the Church’s training program in 2012.  They were advised that if they completed all five days of training they would receive certificates from the World Health Organization.  As per our daily custom, I ran down to the street and bought five dozen rolls for our morning snack.  When we got to the training venue we discovered that most of the people to be trained were waiting for us.  On the other hand, the trainers got off to a late start, got stuck in the Monday traffic jams, and arrived late.  Fortunately, there was a bit of an afternoon lull and I was able to escape for a couple of hours to the office to try and get caught up on some of our accumulating other business. 

On Tuesday we still did not have the benefit of the 664 wheelchairs sitting in the transporter Necotrans warehouse.   However, Elder Kyungu was finally able to get me an appointment with the Minister of Public Health to see if he could persuade the Minister of Finance to issue the necessary letter of exoneration to give to the Director-General of Customs so we could liberate our chairs once the dispute with Necotrans was resolved.  The Minister who promised to do what he could to help.

We also spent quite a bit of time this week discussing the contractual dispute with Necotrans with Dr. Musafiri and emailing with the Church employees in Salt Lake and their contacts with CMA, the Church’s shipping company that transported the chairs from China to the DRC.  I also helped Dr. Dow create French language certificates for the trainees and the Ministry and planning the closing ceremony in which the certificates would be presented.  We invited a counselor in the Kinshasa Stake presidency to conduct the meeting and give a speech.  Gloria and I also went to a pastry shop to select and pick up a variety of pastries for the closing ceremony.  So we spent every day at the training venue but at least I got to leave from time to time to take care of office business and to pick up food and beverages 

On Friday May 30 we had a very nice closing ceremony attended by our Mission President Bryce Cook.  The trainees were delighted with what they had accomplished and with the polo shirts we provided.   They took multiple pictures of each other.  I’m sure they developed some wonderful contacts among their peers that will be of benefit to them professionally.  And of course we benefited many handicapped people.   In the evening we got together with the Dows and the trainers for a final pizza party at the apartment of the Westland Construction people who are building chapels for the church in the DRC and who have the contract to build a temple in Kinshasa.  However, as of the date of this report, June 29, the new shipment of chairs was still unavailable to the Ministry and the clinicians due to various Customs and shipper disputes.  It seems that nothing is easy to accomplish in the DRC.

No comments:

Post a Comment