The Biamba Marie Mutombo hospital is an attractive, modern facility which opened its doors to patients on December 4, 2007.   It has a capacity of close to 150 beds and it is supported by a state of the art emergency room, an intensive care unit, a well stocked pharmacy, and a modern radiology department.

The hospital facilities and services encompass several dimensions which make it unique in the context of health care delivery on the continent of Africa and in other underserved areas.   These offerings include the following, for example:

• An industrial laundry facility (families do patient laundry by hand on site in most hospitals in the Congo.)
• A full meal service for patients , which is  supported by  a well equipped, hygienic kitchen with automated dishwashing and sterilizing facilities.  (Families are usually responsible for bringing food from outside in other hospitals.)
• An  environmentally conscious  multi-system for utilities and ancillary services including:  incoming and outgoing water purification, a new water well, a large generator, a capacious incinerator to dispose of medical waste, and a state of the art morgue. 
• Landscaped gardens to provide esthetic and spiritual support to patients and families.  (Unusual)
• A modern pharmacy  well-supplied with reliable medications for in-patients and outpatients.
• A patient-friendly approach from the first contact to the final services provided.

 Impact

Several dimensions  of the quality of life of the population of Kinshasa are influenced by the hospital’s activities.   These include:

• Delivery of quality health care to all, especially the under-served. 
• Employment opportunities for more than 400 people.
• Capacity building and health care force development through partnerships with the Kinshasa School of Public Health, a nursing school, a new private medical school, the School of Medicine of the University of Kinshasa, etc.
• Economic development through procurement at the local level whenever possible.
 

Culture Change and Empowerment

Despite many challenges, the hospital is committed to changing the health culture both from a quality of  care delivery perspective as well as an innovative  managerial approach.  These feature:

• A cadre of Congolese senior managers and staff
• Transparent management   (First year external audit in progress)
• A rigorous human resources systems  (recruitment, evaluation and retention of staff)
• Ongoing staff training to promote professional development
• Partnership development

 Accomplishments and New Initiatives

The last two years have been marked by a number of exciting accomplishments which continue:

• Integration in the national program of health planification and designation as reference hospital.  In that capacity, the hospital implements the directives of the Ministry of Health for the response to diseases such as HIV, TB and malaria.
 
• Pre-installation work in advance of the reception of a 64-slice CT scanner (the first in the DRC) donated by Freeport McMoran with other radiology equipment.   This equipment will be in place by the summer 2010.
 
• Partnership with Medisend International and 6 month training program in Texas from which 2 of the BMMH biomedical engineers and technicians graduated in December 2008.  They can now do all basic maintenance of medical equipment in the hospital.  The program is ongoing.
 
• Water –well donation by the Church of Latter-Days Saints.   The well has significantly helped with the cost of utilities from the public systems.
 
• Training of 100 hospital staff on basic life support by Operation Smile staff in early 2009.
 
• Vaccination days at the hospital for community children and distribution of insecticide impregnated bed nets donated by UN Foundation.
 
• Visiting faculty program from the USA.   (Several surgeons have visited and performed surgery on site.)
 
• Sabin Vaccine Institute partnership about combating neglected tropical diseases.
 
• Creation of a tripartite research alliance with the Swiss Tropical Institute and the University Of Kinshasa School Of Public Health in 2008.  Training and capacity building efforts in progress.   The new research laboratory will be inaugurated on March 27, 2010.
 
• Partnership with Becton Dickinson (BD) under the aegis of the Clinton Global Initiative to create a Center of Excellence on Occupational Health and Immune Surveillance.   Started in December 2008, the Center is exploring many avenues to prevent workplace injuries among hospital staff.
 
• Creation of a pain management clinic to serve patients with chronic pain conditions such as cancer, sickle cell anemia and post stroke pain.
 
• Evolving partnership with the United Nations Family Planning Agency (UNFPA) for the comprehensive treatment of women suffering from vaginal fistulae.
 
• Exploration of collaborations with UNICEF and PEPFAR.
 
• USAID program for in-hospital and community-based interventions to prevent, identify and treat HIV.
 
• Collaboration with Opportunity International on their initiative to open a bank in Kinshasa and to provide microfinance opportunities to the population.
 
• Ongoing conversations with private foundations concerning the creation and development of comprehensive health services in the DRC.  Specific conditions under consideration are:  infectious diseases such malaria, HIV, tuberculosis, gastrointestinal diseases; chronic diseases such as hypertension, diabetes, cardiovascular diseases; emerging diseases such as cancer and end stage renal disease.   Finally, needed interventions for mental health and gender-based violence are under discussion.

 Pre-planning  for the creation of a center of excellence on Women’s and children’s health.   The center of excellence will have the following major areas of involvement:  health care delivery, professional training, public education and community outreach, advocacy and research.

CHALLENGES

In its quest to provide high quality care and to promote the health and well-being of the population, the Biamba Marie Mutombo Hospital confronts challenges which fall into two broad categories:

Medical Challenges

The medical challenges although very serious may be easier to wrestle because scientific solutions and models exist to meet them, and our ongoing initiatives already address some of them.  The challenges may be listed globally:

• Lack of diagnostic equipment to identify and appropriately treat many diseases which are successfully addressed in medium and high income countries.  Examples:
 
• Many patients come with acute strokes.  A CT scanner is critical to give appropriate treatment.
• Breast cancer is on the rise.   Cancer screening is not available due to lack of mammography machines.  Cancers are usually detected too late for effective treatment.
• The arrival of the CT scanner and imaging equipment will help with the diagnosis and treatment cancers and strokes, but these advances represent only an additional step in resolving these persistent challenges.
• Lack of histo-pathology services to properly diagnose cancers and to guide therapy.   Finely tuned and focused  intervention for cancer treatment , for example, is often difficult because of a lack of clinical information from tumor specimens.
• Diabetes is poorly treated with terrible outcomes of amputations, blindness, renal insufficiency, cardiovascular disease and early deaths.
• Maternal and infant mortality are very high.  There is a pressing demand for facilities to follow and deliver pregnant women, and to provide adequate care to well and sick newborns.   Despite the progress being made, much more is needed in terms of prevention, early intervention, treatment and follow up.
• A lack of laboratory equipment limits the quick and effective diagnosis of infections and the accuracy of treatment decisions.   This is particularly acute for infectious diseases where the timing of the diagnosis and the quick start of proper treatment can make a difference between life and death.