At breakfast the next morning, Lyn and I chatted through some ideas regarding developing an expansion of her cleft palate program and preparing a grant application to The Smile Train to fund it. Lyn wanted me to get a deeper understanding of HEAL Africa’s outreach mechanism and arranged an agenda for the day.

I started out learning about the Safe Motherhood Program. This community-based prevention program very cleverly leverages local competency in order to make motherhood safer. The trick is that the HEAL Africa program embraces all elements of the service chain. Working in 82 health centers in 4 territories, HEAL Africa engages community leaders to gain support to start training – first, the health workers and then the traditional birth attendants (TBAs). Often, these TBAs are left out of planning and action because they are not qualified health workers, but the reality is that many rural women turn to these TBAs as their primary source of obstetric services. Finding a way to work with these TBAs is critical to reaching rural woman, yet paradoxically, it is an element often left out of public health systems planning. This exclusive structure pits health workers against TBAs and results in the two groups working against each other. But by training the TBAs with the health workers and creating inclusive structures, HEAL Africa facilitates a symbiotic relationship and a deeply-reaching referral mechanism.

After training people, HEAL Africa provides health workers with basic equipment including plastic tubs and mattresses and TBAs with kits containing buckets, lanterns and blankets. While these items cost very little, they make a remarkable impact on motivating the health providers (both trained and informal) and improving the safety of childbirth. HEAL Africa has also set up over 130 Solidarity Groups, essentially clustering over 4,000 women of motherhood age into income generating teams. In addition to producing profit that acts as a maternal health insurance fund, these groups also create an empowerment bond that has women looking out for each other amidst the calamity of war. Of all the projects these groups do, I thought making baby clothes was the coolest. In most parts of North Kivu, newborn babies are wrapped with dirty blankets or left uncovered all together. But the Solidarity Groups make baby clothes that HEAL Africa buys and offers free to any baby born at a participating health center. Women who would have had their babies in villages trek well out of their way to get this $1 perk and deliver their children in supervised environments that are safer for mother and baby alike. Now that is social innovation!

That afternoon we hopped in a jeep and headed out to a school partially funded by HEAL Africa. I tagged along on this visit, mostly just to see a bit of the area surrounding Goma. The school was situated a couple miles off the main road and directly adjacent to an enormous UN Refugee camp that had moved there about a year after the school had been built. As we slowly crept down the lava road that ran along the camp, I peered down the endless rows of rounded straw huts wrapped in white plastic tarps that almost looked like a neighborhood of igloos. The displaced people had lived in this “temporary camp” for several years and there was really no end in sight. I saw sad, empty faces, weighted down from the struggle for survival and the absence of hope. I couldn’t help thinking about how awful it would be to grow up in such a desperate environment. These unsettling thoughts stayed with me even after we arrived at the school, which provided quite a contrast in terms of possibility. As I watched the singing children play happily in their school yard, I couldn’t take my eyes off of the white plastic valley of hopelessness in the background.

We stayed at the school a couple hours and then headed back over to Grounds for Hope, the long term fistula care center we visited earlier in the week. In this day, I had already travelled from the excited lightness of the morning’s safe motherhood discussion to the dark heaviness of the refugee camp. I wasn’t talking much as we bounced down the dirt road in the HEAL Africa jeep, but I was thinking as I stared out the window. That’s when I saw him. We turned a corner and there stood a man on the side of the road. His wide eyes were completely focused on our jeep and his dusty hands cradled a Kalashnikov assault rifle. I don’t recall how the rest of the car reacted or if anyone even noticed, but this site took my breath away. Here stood a man in a sleeveless black t-shirt and tattered green shorts – not a soldier, but a farmer - too poor to buy shoes or a shovel, but armed with immediate and deadly force. Time seemed to abandon us as we passed this man, returning only as we turned the corner and escaped his gaze. This sight shook me up and I outwardly wondered why the gunman allowed us to pass. The other passengers told me that because HEAL Africa is a Congolese organization and so well respected in North Kivu, they had never had any incidents when traveling in marked vehicles. I began to understand why every HEAL Africa car had the logo hand painted on the doors and usually flew HEAL Africa flags out the window in addition. Even with the explanation, I still hoped we wouldn’t run into our machine gun-toting friend on the way home.

Luckily, we didn’t see anymore gunmen on the ride home, but instead we had the good fortune of some stunning views of the volcano. The events of the day dominated my thoughts. Seeing exactly how tough the outside environment was in a relatively safe area made HEAL Africa’s work even more impressive to me. I resolved to understand more about how they established such a presence amidst so much instability. Over dinner, I quizzed Lyn about their outreach process and discovered HEAL Africa’s outreach enabler: the Nehemiah Committees. Like other groups doing good work in the chaos of conflict, HEAL Africa is a faith-based organization. To build a network, HEAL Africa approaches community leaders, most of whom are religious leaders of various faiths, and invites them to a workshop to read the Book of Nehemiah, an account of the rebuilding of the wall of Jerusalem. Since its part of the Old Testament, all Abrahamic religions recognize the Book of Nehemiah and are willing to discuss it. This important detail enables HEAL Africa to engage both Muslims and Christians, alike. The reading workshop is intended to create a Kumbe Moment in which the community leaders commit to developing a cross-faith committee that works to protect the rights and interests of the society’s most vulnerable people. Through these committees, HEAL Africa is able to offer services to the most needy people in the most isolated places.

After a volatile day of intense emotions, I fell into bed feeling really good about our trip to the DRC. Though we would be leaving soon, the trip had been an incredible success. We learned volumes about holistic services and creative outreach mechanisms and we were even able to lend a hand with the Smile Train grant application. I fell asleep wondering what was next.