Hemmed Lukonge, CRS Tanzania’s senior program officer for PEPFAR-funded projects for orphans and vulnerable children, shares his account of meeting First Lady Laura Bush and First Lady Salima Kikwete of Tanzania.

Dr. Aisha Kigoda, Tanzania Deputy Minister for Health and Social Welfare, introduces the National Plan of Action to the First Ladies. Photo by Dan Griffin/CRS

Last week I was honored to meet First Lady Laura Bush and First Lady Salima Kikwete of Tanzania. These two admirable women launched Tanzania’s National Plan of Action for Orphans and Vulnerable Children this past Sunday, February 17, in Dar es Salaam.

The event was a celebration of the significant support these children are receiving — help that is enabling them to stay in school, stay healthy and thrive even in the absence of one or both parents. Government officers, donor agencies and implementing partners joined children and their caregivers in launching the new plan, with gift-giving, singing and dancing adding to the excitement.

Funding from the U.S. President’s Emergency Plan for AIDS Relief, also known as PEPFAR, is playing a large role in Tanzania’s comprehensive strategy for protecting orphans and vulnerable children nationwide. Through PEPFAR programs, more than 200,000 children affected by HIV are receiving critical support services; as an implementing PEPFAR partner in Tanzania, Catholic Relief Services is supporting almost 52,000 of these children.

After the launch of the plan, the First Ladies toured informational booths showing the breadth of support offered to children in need. At the booth demonstrating household care, I welcomed them both and showed them how nutritional support, microfinance initiatives and income-generation activities, including food processing, handicraft making and small-scale farming, are helping families affected by HIV to make ends meet.

CRS’ Hemmed Lukonge shows the First Ladies of the U.S. and Tanzania crops grown by children and families affected by HIV. Photo by Amy Rumano/CRS

Mrs. Bush asked me about SILC, CRS’ innovative Savings and Internal Lending Communities, which she had learned of previously. I assured her that SILC is an important part of CRS’ programs in Tanzania, enabling poor families to improve their quality of life by saving small sums of money and accessing micro-loans for small business through pooled group savings.

I also shared with the First Ladies how PEPFAR-funded programs are improving the living environment of orphans in need through shelter enhancements and are increasing food supplies through home gardens. Both Mrs. Bush and Mrs. Kikwete were impressed by the pumpkins, cabbages, carrots and more grown by orphans and their caregivers.

“Through this partnership between Tanzania and the United States, we can restore lives and hope to orphans and their families,” Mrs. Bush said in a speech at the event. With the PEPFAR program now up for reauthorization by the U.S. Congress, we can only hope that this critical assistance and funding will continue for an additional five years and beyond.

Lane Hartill, CRS’ regional information officer for West Africa, describes his visit to a CRS-funded hospital in a rural area of Eastern Congo that is treating women who have been raped, an atrocity of the ongoing war.

I went on rounds with Dr. Freddy Mubuto, the head doctor at Nyamibungu Mother and Child Hospital, to see what he faces everyday. He and his fellow doctor, Faustin, are the only two doctors in an area with around 103,000 people.

Dr. Freddy Mubuto, head doctor at Nyamibungu Mother and Child Hospital in Eastern Congo. Photo by Lane Hartill/CRS

I knew seeing his patients wasn’t going to be easy. I steeled myself against the hot rush of emotion, but it came anyway. Reality, it seemed, was going to have its way with me.

One of the first women we saw had been taking her medicine religiously, said Mubuto, but she hadn’t eaten in days, causing complications. With a shake of his head, and in that calm, velvet voice, he explained to her why she had to eat, knowing all too well that she had no money for food.

A pretty woman, the wife of a gold miner, wearing clean red Puma slippers and silver earrings, had walked 25 miles to get to the hospital. She had the Congo’s flag painted on each toenail. She was having stomach pains, she said, could he help?

Mubuto suspected tuberculosis or a genital infection. She was only 25, but had already had three children. Only one was still alive. I didn’t have the stomach to ask her how the others had died.

The hospital has a sonogram machine and Mubuto spent much of the afternoon squirting gel on stomachs the size of beach balls and waving the wand over them. One lady had a scar running south from her bellybutton; it was as thick as a rope of licorice. Another physician had given her a C-section and done and awful job sewing her up. That wasn’t important, though: The baby inside looked just fine.

These were the easy cases. It’s when the rape cases come in – and the women who were forced to stay in the village to give birth – that things get complicated.

Mubuto sometimes finds himself facing complex emergencies he doesn’t know how to handle. He looks at reproductive systems so mutilated that he has to try something even if he’s never seen the problem. If he doesn’t, he says, they’ll surely die.

Like the time he worked on a woman - the surprise and disgust still registers in Mubuto’s voice – who had toxic leaves forced deep into her birth canal. So far, in fact, it punctured her uterus and the leaves entered her abdomen, causing her intestines to become infected.

Dr. Freddy Mubuto on his rounds. Photo by Lane Hartill/CRS

After surgery, piles of pills, and a three-month stay, “She didn’t pay a single cent,” he said. Instead, she went to the court and brought a suit against the feticheur, the traditional doctor who had prescribed the treatment. She accused him of premeditated murder. Many women, Mubuto said, sneak out of the hospital at night, avoiding payment. He has no recourse.

He says the women rely on feticheurs out of ignorance. It bothered him so much, he visited a few local villages to persuade women to come to the hospital. He also talked to village chiefs who agree with him and promise the village women will go to the hospital from now on. He says he’s seen a slight uptick in the number of women coming to him first, but the feticheur problem is still overwhelming.

You’d think all this would get to Mubuto, that he too would sneak out of a window at night and escape. But he doesn’t. He stays because it’s in his blood. His father was a well-known doctor and several of his siblings are also in the medical profession.

He politely asks me about how he can get additional training. He says a good anesthesiologist is needed at the hospital because many gynecological operations can’t be done with a local anesthetic. But if that’s not possible, maybe $75 a month to buy fuel for the generator is.

When I got home, I emailed my college roommate, now a respected anesthesiologist in Seattle. I told him how some men in the U.S. smirk and giggle at the mention of gynecology, how it’s a punch line, not a profession.

That’s not true. Definitely not in Congo.

Jerusha Ouma, CRS Kenya project officer for The Children Behind project, received the update below from partners working with CRS to assist 19,000 orphans affected by the HIV pandemic and other vulnerable children.

For the residents of Migori district in western Kenya, life has radically changed since the announcement of the disputed results from the presidential election held on Dec. 27, 2007. The violent reactions of people, especially the youth, led to substantial destruction of property and loss of life. The youths barricaded the roads and burned down property belonging to people from other ethnic groups. Almost everything came to a standstill in the community.

Those who bore the brunt of the crisis included people living with HIV as well as orphans and vulnerable children. Due to inaccessible roads and the ongoing violence, people living with HIV could not access health facilities to collect their antiretroviral medications. They also couldn’t travel safely to collect food supplements provided by CRS through The Children Behind (TCB) project, a privately funded CRS initiative that provides care and support to 19,000 orphans and vulnerable children as well as their caretakers in Nyanza province.

Partner staff on the ground had to quickly come up with ways to ensure that HIV-positive project participants wouldn’t miss any of their prescribed drug dosages. Using cell phones, partner staff quickly mobilized the project’s network of community volunteers. These dedicated volunteers were asked to head out to surrounding villages to collect treatment cards from clients on antiretroviral therapy, to use the cards to pick up the drugs from area health facilities and to then return to the village to deliver the drugs to respective clients.

Using bicycles as the only mode of transport, the volunteers rode up to 20 kilometers roundtrip along small village paths to avoid the main roads blocked by rowdy youth. Volunteers used the same means to also distribute food and provide other psychosocial services to project clients. This cadre of good Samaritans demonstrated an extraordinary commitment to service by risking their own lives to ensure that clients had the medications and food they needed for survival.

“I was so scared of the rioting group youths. I could not walk to hospital to get my drugs,” said one ART client named Mary. “Thanks to the TCB volunteers who worked hard to ensure I did not miss out on the drugs. I am praying that the political problems in our country will soon be solved so that we continue to live in harmony like before.”

Children were also not spared during the crisis. They missed school for three weeks due to insecurity reasons. In one village in the Karungu area, three orphans supported by the project were also beaten up when police broke into their house searching for rioters who had just escaped from the nearby shopping center. When project staff heard of the incident, they rushed to their rescue and took them to the nearby St. Camillus hospital. The children have since been discharged and are well.

Now the situation has improved and calm has returned in the villages. And thanks to dedicated staff and volunteers, project services continue.