Safety first. Every decision on this trip has started with ensuring that we have a safe and secure environment. This is actually a big challenge considering that fistula is prominent in the most desperate places and that getting to such places usually means piling into overcrowded rust boxes that zip around corners and over potholes at breathtaking rates.

After hearing Lyn Lusi describe HEAL Africa’s innovative approach last April in Accra, I really wanted follow up my enlightening encounter with a visit to the Democratic Republic of the Congo. But because Shannon spent last semester researching this region, specifically atrocities committed against women there, I had reservations about crossing into this wild and war-torn region. To mitigate what I considered our greatest exposure, I set two security conditions: (i) someone walks us through the border and (ii) we stay within the HEAL Africa compound. We didn’t immediately hear back from the HEAL Africa team and as we waited, both Shannon and I started to question whether or not we should follow through with the visit. But a chance meeting with a Belgian midwife who had just returned from a remote part of North Kivu combined with the affirmative response we heard from HEAL team finally pushed us over the edge.

I wasn’t actually sure how any of us were going to fit into the battered, red matatu (read minivan), but the three men sitting in the back row of this crowded Nissan seemed to manufacture a place for me to sit. Despite sardine seating, the ride to Congo was magnificent. The growing height and scale of the hills was only countered by the severe depth and drop of the valleys. The road seemed to float around sharp turns, but the turning forced a collective sway of the four grown men pressed shoulder to shoulder in the back row. On every hairpin twist, a view down the steep slopes or across the valley revealed endless swarms of banana trees attacking the hills like angry, green-winged dragon flies. Gasping from the ride, my breathing was further challenged by the shear beauty of Lake Kivu, which abruptly presented itself just before the border.

After a short walk through a no-mans-land that doubled as a vegetable garden and the near-theft of our yellow fever cards by an alleged official, we were bouncing through the volcanic ruins of Goma en route to HEAL Africa. Goma was destroyed in 2002 by a volcanic eruption and the shattered state of the Congo meant that very little was rebuilt. This left a dusty ramshackle of lean-tos partially rebuilt on the flowery curves of hardened lava. The molten rock destroyed many roads as well, but over time, the unceasing flow of traffic pulverized the jagged black remnants into a fine dust that, when mixed with car exhaust, formed a sinister cloud that ominously hung everywhere cars dared to venture. The chaotic jumble of movement seemed to expand and contract at will, encompassing every type of transport as well as people carrying everything you could imagine. The direction of this mass movement had no order whatsoever and the only factor potentially limiting the blob was the mass of buildings at its margin.

When we pulled into the grounds of Maji Matulivu (HEAL’s resident compound), I was amazed at the stunning contrast to the streets outside the gates. Lyn and her husband Dr. Jo Lusi built an oasis on Lake Kivu and the place was teeming with young people working on a wide variety of projects or doing nursing rotations on a semester break. With a clear energy in the air and dusk approaching, we sat down at the lakeside for a group dinner. Eager to discuss the fine points of how HEAL Africa had been so successful creating service structures in the complete absence of stability, I launched into a series of questions. As he humored my queries, Jo (who is an orthopedic surgeon) told me about his passion: club foot. I had never heard of this highly correctable congenital birth defect that makes feet grow in unnatural directions, but Jo showed me some incredible pictures of what his intervention had produced and I could not believe my eyes. Jo went on to describe the process of correction and some of the challenges he faced helping children with this devastating disorder. Our passionate discussion gained so much momentum that time evaporated and we were eventually the only people at the table. Given the late hour and our 6am start, we agreed to continue the dialog the following day

But trying to sleep was no use to me. Like a kid at Christmas, I anxiously waited for slumber to pull me into its grasps, but the promise of an electric week full of inspiring surprises filled me with anticipation and kept me just beyond the nocturnal world for what seemed like an eternity.