Transforming Communities Through Health Zone in Congo

Congo Health Zones: Space for Radical Community Transformation

A few years ago I met Milo and Laura Shantz in Saint Jacobs, Ontario, Canada when I was attending Mennonite World Conference Officers meeting. They were living in more than a century old home they had transformed into a bed and breakfast. They arranged for me to stay in a room reserved to their special family guests. I was impressed by their hospitality and sensitivity toward my needs. Since then, I have stayed with them each time I was in the Kitchener/Waterloo area for meetings. With time, I discovered how visionary this couple was. Milo saw opportunities where others saw obstacles. I discovered through our conversations about how he turned failed businesses into learning lessons rather than being reasons to stop him from undertaking other business adventures. He would tell me that if one is always driven by fear then one would never accomplish anything in life. He also believed that people needed to be given a chance.

My friend Milo died in January 2009. I spent one week in Saint Jacobs at the end of October and beginning of November 2009. I went through a binder of newspaper and magazine articles, obituary, letters and sympathy cards from friends that Laura had put together. The information contained in the binder confirmed what I had already suspected. The town of Saint Jacobs which was a little village was transformed into a thriving tourist center thanks to the vision and passion of this one man – Milo Shantz.

I read the content of the binder seating on a chair purchased for Milo as his health condition was failing. In the middle of the night, while Laura was already sleeping and as I sat alone where Milo sat during his last few days on earth, I prayed to God that he would grant me the wisdom this great man of God had in always looking at the larger picture in life and yet always figuring out how to implement the little steps needed to reach the larger picture.

I realized during that night that it is possible to be catalyst of a radical community transformation. Just as a long journey starts with the first step or just like to move Saint Jacobs into what it is today required Milo to believe in his village, his people and to take the first step, I felt compelled to start putting down my dream of the Kajiji Health Zone as a base and catalyst for radical change for a people being served by the Kajiji Health Zone.

Why the Health Zone Structure?

As I think of all the structural systems in the Democratic Republic of Congo, I believe that one of the most stable infrastructure through which community transformation may be initiated, promoted, and nurtured are Health Zones. In Congo, decentralizing health care has been shown to be an effective way to move planning, budgeting and management of primary health care closer to the communities served. During the 1980s, with assistance from projects, like SANRU I Basic Rural Health, DR Congo was successfully decentralized from the bottom up creating 306 health zones. They are now 515 health zones although many of them are not very functional at the moment due to past economic, social, and political instability in the country.

Each health zone is geographically defined and services a population of around 125,000. Health zones include a reference hospital for referral services, a health zone office for technical coordination and supervision, and typically 10-20 health areas depending on population density.

Each health area includes a health center to provide preventive and curative services and is run by a public health nurse. Outreach activities from the health center in collaboration with the community strive to provide immunizations and growth monitoring for every child. Inside each heath zone one will also find other structures such as schools, churches, road, and government offices that can be used to promote or initiate community development activities.

Years of war and turbulence have had a catastrophic effect on health care in Congo, but health zones have survived. In 2001, a WHO/UNICEF mission reported that “The health zone system… is possibly the only system in the country still recognizable as a nation-wide quasi-state structure. And even with critically little or no support, it commands allegiance and support from health workers.” The postwar period in Congo might seem to be challenging but it also provides opportunities for new ideas, new cultural practices, mourn the old and create a new present and new future for individuals, local communities and the nation as a whole.

What Will It Take?

It will take an organization of 10 to 12 dreamers for each health zone to create a think tank team with the mandate of planning, strategizing, and motivating others to join in the development of the health zone. The critical areas of dreaming would include education, health, agriculture, infrastructures, communication, water, and alternative energy. Now can you imagine what will happen in the whole country if each zone would develop a system of community development? Take the example of road, can you imagine what would happen if one health zone would work at improving say 270 KM of road within its service area and the other health zones picks up from where the other left off?