Dr Jo Lusi, an orthopaedic surgeon from the Democratic Republic of the Congo, does not limit his practice of orthopaedics to the operating room and clinics of his hospital.  He uses a “whollistic” and community based model to reach out to people suffering with the HIV virus.  Christianity Today has described Jo as “being built like George Foreman and having the vocabulary of Mohamed Ali”.  This is an appropriate metaphor as Jo is a strong advocate of patients with HIV in both word and deed.  He does this with a sense of urgency.

 

HEAL Africa, the hospital and organisation of which Jo is medical director, was one of the first to recognize the link between vesico-vaginal fistula and rape.  Fistulas have become a well known problem in Africa where trained doctors and midwives are not available.  Fistulas result in this context from difficult or obstructed labours.  However, in DR Congo it became apparent that most of the fistula were due to rape.  The high rates of rape in the DR Congo were fuelled by a prolonged period of civil war.

 

HEAL Africa has sent doctors to the Abbis Ababa Hospital (made famous by Australians Catherine and Reg Hamlin) in Ethiopia to be trained in fistula repair.  The skills have been transferred back to the hospital in Goma where numerous fistula repairs are done every year.  Jo even performs this surgery (possibly the only orthopaedic surgeon in the world to be able to do this!).

 

Jo is committed to medical research.  Dr Jo and Dr Flory Cirimwamy have conducted research on the incidence of the HIV infection in women undergoing fistula surgery.  They found the incidence of HIV infection in this group was 20 % (much higher than the population standard of 4.8 % in December 2005).  This was done using innovative medical technology called a flow cytometer.  This adds extra complexity to the surgical treatment of these women. [1]  Currently a qualitative study is looking at the life experience of orphans of HIV.

 

Patients with HIV infection come to their doctor with more than just a physical problem.  The physical problem is rooted in a social context (war, conflict in the home, poverty, lack of water, prostitution).   Jo says:

 

HEAL Africa is able to provide counseling to the women who undergo fistula surgery.  This helps them to process the traumas they have been through.  The women are also empowered in other areas of life.  They learn how to read and write.  They are taught skills such as sewing and basket weaving which allows them to earn money.  Some women are given goats which assist in providing livelihood and nutrition on return to their village.  Some women symbolize their new given life with baptism.

 

A small number of women are unable to be healed despite surgery.  HEAL Africa is building special accommodation where these women can live and support each other as a therapeutic community.  The Nehemiah project (aslso sponsored by HEAL Africa) is a community engagement project which aims to identify leadership in villages and empower positive changes that will impact on quality of life and health status[2].

An education program is run in schools and villages.  Sport is promoted as a positive lifestyle choice for young people.  It is used to try and engage peer pressure that supports behaviours that protect against the transmission of the HIV virus within the African context (instead of its propagation).  This includes encouraging adolescents to refrain from sex removed from a committed long term relationship.  Harm or risk minimization is not ignored as condom use is promoted amongst sex workers who have significant pressures on them to continue their lifestyle for survival reasons.

Heal Africa is working for the transformation of society through church networks.

Heal Africa, under the leadership of Dr Jo, has utilized faith based networks to educate communities about various issues related to HIV infection.  This includes both preventative and treatment related aspects.   The incidence of HIV in the Goma region (based on CDC figures) has gradually been decreasing over this time such that it is now 4.8 %.  Mutwanga (North of the province) and not involved in the Choose Life program has found seroprevalence to be 11.6%.  So there is still much work to be done.

 

Certain groups such as village leaders, women and youth are targeted.  These networks not only improve physical care, but also reduce the stigma and isolation associated with the HIV infection by providing education about the disease.  This has reduced the suffering experienced by HIV positive people in their communities and has led to more compassionate care.  People have been equipped to pastorally care for and embrace those suffering from HIV and also to care for the families and friends of these people.  Home based palliative care is another outworking of this community concern for those with HIV.  This includes medical, psychosocial and spiritual care to 750 patients every year.  More patients receive end of life care at home than in hospitals.

 

Anti-retroviral therapy significantly lessens the impact of the HIV virus on people suffering from HIV.  Heal Africa has set up a paediatric HIV clinic which cares for approximately 200 children suffering from HIV.  Sixty of these children receive anti-retroviral therapy.  The impact on their quality of life is incredible.  One little boy was unable to walk when he first presented to the clinic.  He suffered from tuberculosis of his spine on top of the HIV virus.  The clinic has treated his tuberculosis and commenced him on anti-retroviral therapy.  He now walks, is gaining weight and has a wonderful smile on his face.  He brings great joy to his grandmother who is his primary carer (as his mother has succumbed to the HIV virus).

 

Through TEAR UK and the Geneva Global Foundation 200 families (100 in the Goma region) have been supported in their fostering of AIDS related orphans. Mamma Jeanne and Prosper (with the support of HEAL Africa) run an orphanage that looks after children orphaned from HIV or the war.

Jo has been a Senator in the Government of the Democratic Republic of the Congo for a number of years.  In this position he has influenced legislation that will minimize the spread of the HIV virus.  Through Jo’s lobbying, new legislation has been introduced into the Constitution that recognizes the gravity of rape as an offence and outlines appropriate punishment commensurate with the seriousness of this offence.  There is hope and expectancy of good things and stability in the DR Congo after multi-party democratic elections were held in November of this year.

 

Jo is acutely aware of the benefits of mobilising others, particularly the young, in the interest of promoting a cause such as better treatment of individuals with HIV.  To this end Jo acts as both a mentor and inspiration to many young Congolese doctors working at Heal Africa.  He has placed major emphasis on the training and career advancement of these doctors.  He continues his whollistic approach encouraging them to consider not just the medical aspects of their career but also issues of balance associated with faith and family. 

 

Jo is able to facilitate teams of doctors and health professionals from overseas countries such as Australia and the United States to visit Goma to provide lectures as well as hands on training of the junior medical staff.  In turn, Jo has proved to be an inspiration to many of these teams who have been challenged to consider how they can be advocates for those patients suffering in the DR Congo (especially those with HIV) in their own countries.

All of these initiatives have moved the community from a spirit of despair to engagement with the problem.  Jo continues to challenge that the DR Congo will be HIV free in 2035.

 

Religion that God our father accepts as pure and faultless is this: to look after orphans and widows in their distress and ti keep oneself from being polluted by the world.  James 1:27

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