Report of a Visit to DR of Congo, October 14 to 27, 2009

Samuel Chapleau

This visit aimed at building the capacity of SD DR Congo's committee, at assessing the social projects and determining to what degree these projects meet the criteria of the Susila Dharma International Association, at organizing a workshop with Doctors of Africa on one hand, to present the principles of the type of Community-based Health Center (CSCOM) they develop and, on the other hand, to allow the participants to share questions related to their work with Doctors of Africa, and finally at knowing what SD DR Congo expects from SDI.

1. BUILDING THE CAPACITY OF SD DR CONGO'S COMMITTEE

There were several meetings with the outgoing SD DR Congo chair, sister Charlotte Ndona, and the new chair, brother Dianteza Dimpioka, in the presence of one or several Subud members including those of the new SD committee and the Subud Congo chairman. All these meetings took place in a good atmosphere.

The reading and discussion of SD RD Congo's bylaws were made in the presence of the new and outgoing SD chairs as well as with the Subud Congo chair (brother Pokoti), ex-officio member of SD DR Congo's board of directors, and the Subud Youth chair, brother Papy. The members present during this session recognized the necessity of conforming as much as possible to the bylaws by reactivating the board of directors, by preparing a budget and providing financial reports, which would be presented and approved during the annual meeting, by appointing two statutory auditors, by adding a councillor to their committee and by drawing up a list of the members of SD DR Congo whose conditions of membership include payment of their annual dues.

Although all the committee members were already chosen (with Dianteza Dimpioka, chair, Jacques Mvuezolo, treasurer, Luaka, secretary, Angélique, councillor), it was not possible to have a SD Committee meeting before my departure as I wished. The reasons were: sickness, absence, delay, and a very tight schedule.

During the discussions, it was decided that the new committee would have its first meeting with all its members to appoint the new signatories for the bank and have them recorded in the minutes. The change of signatories will be made at the bank when the outgoing chair has closed the files she has in progress (among other things, on obtaining the final ownership document of the Yenge clinic). Then, with the Subud Congo chairman, they would form an interim board until the next annual meeting and finally, prepare a budget to be approved by the Board. We worked on this budget (see addendum) which shows a shortfall that must be eliminated either by cutting expenses or by finding other sources of income, for example, through activities.

Among other points that were brought up, the most important ones are: recreate an atmosphere of serenity; hold SD DR Congo's annual meeting distinct from the national Subud Congo Congress; presently SD RD Congo's annual meeting is part of the agenda of the Subud Congo Congress and creates a certain confusion among Subud members with regard to both associations; but that will not prevent both meetings from taking place during the same weekend; explain clearly to the Subud members the criteria for becoming an associate member of the SDI Association and from this clarification draw up a new list of the SDI associate members of Congo; see that the use of the name "Susila Dharma" is used only in appropriate cases; remind the tenants of SD DR Congo about the principles which govern their lease; give support to the project managers...

The first meeting of the SD Committee should be held on October 31st and of the board on November 15th. (I'll keep in touch with brother Dianteza to monitor the points that were raised.)

2. EVALUATION OF SOCIAL PROJECTS

Fifteen projects were evaluated and classified according to their type: A) Non-profit organization, B) Private social company and C) Community-based enterprise. This temporary classification will be confirmed later by the SD DR Congo. We also saw other projects which are personal initiatives, such as a pigsty, which members were anxious to show us.

In general terms:
- The Nkembo School could be used as an example for the other schools to establish a status which would allow them to obtain subsidies from the government;
- All clinics are under-equipped, and all their equipment and materials are obsolete;
- In accordance with the American tax system, because SDI is incorporated in the United States, only the non-profit bodies can receive subsidies.

A - Non-profit Organizations (NPO)

Nkembo School Meeting (All photos are courtesy of Samuel Chapleau unless otherwise noted.)

2. A.1 The Nkembo school

Geographical situation: Muanda, approximately 600 km east of Kinshasa;

Date of creation: 1985;

Legal structure: NPO, school and land given up, in 2009, to the Presbyterian Church to ensure continuity and allow the school to obtain governmental subsidies for the salaries of the teachers. The school is managed by a board of parents;

Interviewed persons: Kiti and Marie-Claire Ki Menghi, founders of the school;

Type of teaching: nursery, elementary and high school;

Number of pupils: 665;

Number of teachers: 33;

Administrative and support personnel: 9;

Qualifications of the teachers: 50 % of the teachers are well qualified, the others are under-qualified;

School fees: 15,000 FC per quarter for the nursery and elementary school, and 16,000 FC for the high school (US $17.54 as of Dec. 5, 20);

Percentage of the children who pay: 66 % pay completely, 28 % pay partly and 6 % pay nothing;

Subsidy: none for 2009;

Salary of the teachers: 40,000 FC a month; (US $43.86 as of Dec. 5, 2009);

Quality of education: 100% success at the Ministry of Education exams;

The school and the community: the Nkembo school welcomes 40 orphans and deprived children. The parents follow their school closely by coming to the meetings. Very good relationship with the community;
Immediate needs: 50 writing desks for elementary and high school (estimate to be received);

Medium-term needs: construction of 6 to 9 classrooms;

Financial autonomy: not possible in the current socio-economic conditions of Congo. However, an investment for the purchase of a press to make bricks of clay would allow an improvement in the financial balance;

Other request: financial support for teachers’ trainings.

NOTES: THE SCHOOL IS MANAGED BY A BOARD OF PARENTS WHICH DETERMINES SCHOOL FEES. THE SCHOOL BUILDINGS OF THE ELEMENTARY SCHOOL ARE RENTED WHILE THOSE OF THE HIGH SCHOOL BELONG TO THE NKEMBO SCHOOL.

Kiti Ki Menghi and his wife, Marie Claire, started the Nkembo School in 1985 with 12 children and two classrooms. In 2002, this elementary and secondary school in Muanda (on the Atlantic) had 655 students and 33 teachers and staff. From 1997-2002, SD Switzerland, SD France, SD Germany and SD USA formed a partnership with Nkembo School. This partnership provided much assistance to the project– the completion of 9 classrooms, building accommodations for international volunteer teachers, a generator to provide stable electricity, teacher training and a computer classroom. The school operates today on school fees and income generated from micro-enterprises associated with the school. In 2008, the school has 650 students.

Contact: Kiti Ki Menghi
Complexe Scolaire, B.P. 88 Muanda 2, Democratic Republic Congo
Email: luzinguandre@yahoo.fr
Source: http://project-activities.susiladharma.org/location_africa/Nkembo_School_DRC.shtml

Inkisi School

2. A.2 Susila Dharma Inkisi School

Geographical Situation: Inkisi, 120 km from Kinshasa;

Date of creation: 1991;

Legal structure: NPO being a part of CDCI (center for full community development, see 2. A5), owner of the building and piece of land;

Interviewed person: Téléophore Nzeza Mbala;

Type of teaching: nursery & elementary school (high school is in its start-up phase with 5 pupils);

Number of pupils: 130;

Number of teachers: 8;

Qualifications of teachers: all the teachers meet the standards of the Ministry of Education;

School fees: 10,500 FC per quarter for the nursery and the elementary school, which is lower than other nearby schools;

Percentage of the children who pay: 40 % pay completely, 30 % pay partly and 30 % pay nothing;

Subsidy: 1,000 $ in 2008. $688.50 for salary of the professors and $311.50 for miscellaneous, no subsidy in 2009;

Salary of the teachers: 25,000 FC/month; because of their insufficient salary two teachers left;

Quality of the teaching: 100 % success at the examination of the Ministry at the end of elementary school;

The school and the community: the school welcomes about ten orphans and deprived children entrusted to it by the community. The parents are very active and participate in the assemblies of parents. There are activities between schools. Very good relationship with the community;

Immediate needs: building to be renovated $15,142, bathrooms $5,973, 120 writing desks $4,800, purchase of an adjacent piece of land with building plus repairs $15,000. Total: $40,916 (see estimate);

Financial autonomy: to help the school match its expenses, the school is offering activities, such as sewing outside school hours;

Other request: financial support for teachers’ training.

NOTES: THE SCHOOL ALSO OFFERS PROGRAMS FOR ILLITERACY AND PROFESSIONAL TRAINING. SUBUD PARENTS GOT USED TO NOT PAYING THE SCHOOL FEES OF THEIR CHILDREN (45), WHICH IS CAUSING REAL PROBLEMS. IT SEEMS THAT AS LONG AS THE SCHOOL WILL NOT BE REFURBISHED, THERE WILL BE FEW PUPILS JOINING THE NEW HIGH SCHOOL PROGRAM. THE SCHOOL BOARD WOULD LIKE TO BUY ANOTHER BUILDING TO HAVE MORE CLASSROOMS AND FEWER CHILDREN PER ROOM.

Inkisi School has been in a state of decline since the death of Joseph Toussaint Ngamba, one the three founding members. It currently has 84 students and appears to be in need of strong leadership to raise the quality of education and regain the respect it formerly enjoyed from the community it serves. Inkisi School received support from SD Canada and SD France recently to help pay teachers salaries.

Relatives of those who operate the Inkisi School also run an NGO called the Centre for Holistic Community Development (CDCI). They would like to initiate several projects in the Inkisi area. They are waiting for external support in order to begin activities, but we counselled them to begin their activities first because SDIA can only raise funds for something that is actually happening, not for ideas only. (Source: SDI Website)

Albadi School

2. A.3 ALBADI: ALekke BAnza DIeta (the child is our concern)

Geographical Situation: Inkisi, 120 km from Kinshasa, largely rural population;

Date of creation: 2000;

Legal Structure: NPO, owner of the building and the land;

Interviewed person: Albert Diluambanzila, founder;

Type of teaching: nursery, elementary and high school;

Number of pupils: 166;

Number of teachers: 6 and a few assistants;

Qualifications of the teachers: all the teachers meet the standards of the Ministry of Education;

School fees: 15,000 FC per quarter for the nursery and the elementary school;

Percentage of the children who pay: 35 % pay completely, 12 % pay partly and 53 % pay nothing;

Subsidy: equipment by UNICEF, subsidy in 2008 for building more classrooms and a well (no subsidy in 2009);

Salary of teachers: the teachers have no fixed salary, but receive 60 % of the income of the school;

Quality of the teaching: 100 % of success in the examination of the Ministry at the end of elementary school;

The school and the community: the school welcomes about fifteen orphans and deprived children who are accommodated in the school. The parents have little interest in the activities of the school. Very good relationship with the local authorities;

Financial autonomy: present ongoing activities are cutting boards with a chain saw and farming to help financially;
Immediate needs: financial support for the teachers and purchase of a chain saw which just broke ($2,600);

Other request: construction of premises to accommodate the orphans.

NOTES: THE SCHOOL WANTS TO BECOME AUTONOMOUS AND HOPES IT CAN OBTAIN FUNDS TO BUILD OTHER BUILDINGS TO FORM A CHILDREN'S VILLAGE FOR THE ORPHANS. THE SCHOOL PAYS TAXES.

Albadi School and Orphanage is run by an energetic couple—Albert Dilua Mbanzila and Rose Koka, who continue to build up the school. They also take in orphans or “spirit children” who are rejected or abandoned by their families because they are believed to be possessed or inhabited by an evil spirit. About ten children and youths reside at the school, where they help with chores and agricultural work. Thanks to assistance provided by the SD Network and the Blond Trust, Albadi School and Orphanage has gone from 100 students in 2006 to almost 200 students in 2008. In 2007 the project was assisted by grants for the construction of three new classrooms, an office and toilets, and will complete the construction, water supply and electrification in 2008. (Source: SDI Website)

2. A.4 The Medical School of Kimpemba

Geographical situation: Kimpemba, 55 km from Inkisi, rural population;

Date of creation: 2000;

Legal structure: NPO; it is part of the health network of ITM, owner of the building and the land;

Interviewed person: Emmanuel Luyeye;

Type of teaching: high school and professional nursing;

Number of pupils: 50;

Number of teachers: 3 doctors, 1 dentist, 1 general-purpose nurse, 4 accredited nurses and 2 nurses A2;

Qualifications of the teachers: all the teachers are qualified;

School fees: 15,000 FC per quarter;

Percentage of the students who pay: 100 % pay completely;

Subsidy: none, but the school pays 24,000 FC of taxes a year;

Salary of the teachers: 500 FC per hour (55 US cents)

Quality of the teaching: very good because of the quality of the teachers; the school has already more than 50 graduates;

The school and the community: the school participates in community rural development; the other medical school is situated 22 km away;

Immediate needs: building to be renovated, a medical library and computer;

Financial autonomy: the school is autonomous.

NOTE: THERE IS A BIG DEMAND FOR NURSES.

CDCI Students showing their work

2. A.5 CDCI (Center for full community development)

Geographical situation: Inkisi, 120 km from Kinshasa;

Date of creation: 1991;

Legal structure: NPO, renting an office;

Interviewed person: Mr. Nossa Mbala Innocent;

Function of the CDCI: this structure aims at coordinating community development projects in the following domains: school, farming, microcredit, support of income generating activities, campaign against deforestation, empowerment of rural communities in health services;

Programs already functioning: Susila Dharma Inkisi School (see 2. A.2) and professional training programs;

Short-term needs: construction or purchase of another building for the school, launching a microcredit program.

NOTES: SOME CHILDREN RECEIVE TRAINING WITH A SMITH TO MAKE TOOLS, FOR EXAMPLE WATERING CANS WITH PIECES OF RECYCLED SHEET STEEL. AFTER 18 YEARS OF ACTIVITY, ONLY THE SCHOOL IS SHOWING RESULTS. IT MAY BE IMPORTANT FOR CDCI TO REASSESS ITS GOALS.

Kimpemba Clinic under construction

2. A.6 The Health Center of Kimpemba

Geographical situation: Kimpemba, 55 km from Inkisi, rural population;

Date of creation: 2000;

Legal structure: NPO; the Health Center is part of the health network ITM, land and building belong to ITM;

Interviewed person: Emmanuel Luyeye, chief nurse;

Services offered by the Health Center: general and prenatal consultation, delivery, curative and preventive care, dentistry, minor surgery;

Qualifications of the nurses: meet the standards of the Ministry of Health;

Number of nurses: 6;

Other: 2 doctors twice a week, dentist on request, 2 administration staff;

Number of consultations: 210 a month

Cost of consultation: opening of file 200 FC + 300 FC for child and 450 FC for adult;

Percentage of the patients who pay: 60 % pay altogether, 25 % partially, 15 % pay nothing;

Subsidy: a new health center is under construction with a SDI grant, the center pays taxes to the Government;

Quality of care: good quality, but the infrastructure is inadequate; at present the clinic is classified 7th on 10, but with the new center under construction it will be classified 2nd; the orphans and widows are looked after;
The Health Center and the community: very good relationship with the local authority (the préfet);

How to improve the quality of the care: more equipment;

Immediate needs: to complete the new health center under construction;

Financial autonomy: by creating a non-profit community-based mutual health insurance company;

Other request: because of the very bad roads, the need of a motorcycle.

NOTES: A NEW HEALTH CENTER IS UNDER CONSTRUCTION WITH A SDI GRANT. THE CONSTRUCTION IS NOW AT 2/3 OF COMPLETION AND CANNOT BE FINISHED BECAUSE OF LACK OF FUNDS ATTRIBUTED TO INFLATION (ESPECIALLY FOR CEMENT AND TRANSPORTATION). ACCORDING TO DOCTORS OF AFRICA THIS SITUATION SHOULD NOT OCCUR. THE INFLATION IS A KNOWN AND CALCULABLE ELEMENT IN THE ECONOMY OF RD CONGO.

The Centre de Développement Rural Communautaire (CEDERCOM), led by Subud members in Inkisi, started the Kimpemba Medical School. It is now supported by a Health Centre, ELEGANCE, functioning under regulations from the Health authorities. The Pharmacy functions within this centre. The agricultural activities and the low fees paid by the students' parents help support some administrative and educational costs.

The local community benefits from getting medical care for a reasonable cost. In addition, the Kimpemba Medical School provides training that leads to job opportunities in the health sector. The school fees are lower than those demanded by the Public Health political authority. 16 people work for the CEDERCOM and its related activities.
Kimpemba Medical School trains nurses to work in the urban and rural areas of DRC, where a trained medical personnel is urgently needed.

B - PRIVATE SOCIAL COMPANIES

Lemba Imbu School - Photo: SDI

2. B.1 Susila Dharma School of Lemba Imbu

Geographical Situation: in the suburb, southeast of Kinshasa, largely rural and poor population;

Date of creation: 1995;

Legal structure: private company recognized by the state (it is possible that there is a transfer clause which the owners have to supply to SD DR Congo), owner of buildings and land;

Interviewed persons: Santu Ntendi Paul-Gaston and Ndonna Muini Charlotte (founders of the school);

Type of teaching: elementary school;

Number of pupils: 485;

Number of teachers: 9;

Qualifications of the teachers: several teachers are under-qualified and the school is giving them their training;

School fees: 7,000 FC per quarter;

Percentage of the children who pay: 44 % pay completely, 43 % pay partially and 13 % pay nothing;

Subsidy: for construction of latrines;

Salary of the teachers: during the interview, some teachers complained that they were not regularly paid, no exact amount for the salary of teachers;

Quality of the teaching: 74 % success for the examination of the Ministry at the end of elementary cycle; every quarter the school gives its own examination;

The school and the community: the school welcomes 64 children entrusted to it by the community, among which are 19 orphans. 189 parents came to the school annual meeting. The school organizes days for the community: African day, open day, a teaching day with debates. The parents participate actively in the day-to-day operation of the school. Very good relationship with the community and the local authorities;

Immediate needs: an additional building is needed to have classrooms with fewer than 40 pupils and to offer high school and a professional training for sewing, mechanics, electricity and woodwork;

Financial autonomy: the economic situation of the country makes the current conditions very difficult, but with the shift of the populations ─ from Kinshasa to the suburbs ─, we can expect that the new clientele of the school can more easily pay the fees. Gardening activities are organized to help the school financially;

Other request: can SDI present the situation of the School to ECOSOC or other international bodies?

Lemba Imbu School is a primary school for boys and girls without social, financial or other restriction. It provides a great service to the local community which, owing to the geographical and economic conditions, is also undereducated. With a population of over a 16,000 inhabiting a nine villages area, the region has more than 6,000 children who have to go to school each year.
The region has a critical and chronic poverty condition: most of the parents are doing market gardening, and see their gardens destroyed by floods during the rainy season. It is so difficult to produce crops to make a living that life in Lemba-Imbu can be lived only on a day-to-day basis. Nobody can be sure what will happen the tomorrow.

We are trying to sensitize the parents so that they try to find perhaps only a little something to contribute to help the school find summary ways to survive... But with the present situation, as long as the solution to fight against poverty has still not been implemented within our country, we are condemned to live this suffering without being able to know for how long! We are keeping on encouraging the parents to get together and organize into small saving and credit associations to make it possible to our communities to develop with hope.

When no pupils leave school for financial reasons and all complete their September to July school year, when there is no more group resignation of teachers, then we can say that conditions have improved. (Source: SDI Website)

Lemba Imbu Clinic
2. B.2 Community based Health Center of Lemba Imbu

Geographical Situation: in a suburb, southeast of Kinshasa, largely rural and poor population;

Legal structure: is part of Lemba Imbu school, but the status must be modified to make it possible to have a Community-based Health Center;

Interviewed person: Santu Ntendi Paul-Gaston and Ndonna Muini Charlotte (founders of the Lemba Imbu school);

The infirmary of the school: it provides care to the community and also to the pupils. In its report, it is mentioned that the infirmary treated 1,230 cases from January to July, 2009, the largest number being malaria, typhoid and sexually transmitted infections;

Subsidy: the school received $6,582 to equip the future Community-based Health Center building;

Fixing the new building: the building for the new health center is vast and offers the possibility of establishing a good health center.

NOTES: AN AGREEMENT OF PARTNERSHIP BETWEEN THE SCHOOL, SDI AND THE DOCTORS OF AFRICA WAS CONCLUDED FOR SETTING UP A COMMUNITY-BASED HEALTH CENTER (SEE # 3. WORKSHOP)

2. B.3 Health Center NANDORA-VUNGUTA

Geographical situation: in a suburb east of Kinshasa, poor urban population;

Date of creation: 1988;

Legal structure: private enterprise of Oscar Diakabana Mantshia, tenant of the building which belongs to SD RD Congo;

Interviewed persons: Oscar Diakabana Mantshia and chief nurse;

Services offered by the Health Center: general and prenatal consultation, delivery, preschool, curative care, vaccination, minor surgery by outside doctor, and dentistry;

Qualifications of the nurses: meet the standards of the Ministry of Health, nurses attend training courses;

Number of nurses: 4;

Other: 1 assistant + 1 doctor once a week;

Number of consultations a day: 10 to 12;

Cost of consultation: opening of file 200 FC, + consultation 500 FC for adult, 300 FC for child;

Percentage of the patients who pay: 15 % pay completely, 80 % pay partially, 5 % pay nothing;

Subsidy: none;

Quality of care: good;

The Health Center and the community: good cooperation with the community, but cannot satisfy emergencies. It provides weekly and monthly reports to the Health Zone;

How to improve the quality of the care? with new material and equipment;

Immediate needs: electrical connection to be made, water leaks to be solved;

Medium-term needs: scanner, new mattress (see estimate), partitions to create more rooms;

Financial autonomy: financially autonomous;

NOTES: THE RENT HAS NOT BEEN PAID FOR THREE MONTHS, BUT ACCORDING TO OSCAR DIAKABANA MANTSHIA, THE MONEY IS THERE AND WILL BE PAID AS SOON AS THE SD NEW COMMITTEE IS IN OFFICE. THE HEALTH CENTER OCCUPIES A NICE BUILDING WHICH HAS A LOT OF POTENTIAL, BUT WHICH SEEMS TO ME NOT TO BE USED TO ITS FULL POTENTIAL. I FEEL IT IS NECESSARY TO EVALUATE THE WAY IT IS USED AND SEE IF IT IS POSSIBLE TO USE THE BUILDING MORE ADEQUATELY.

Yenge's Clinic

2. B.4 YENGE Health Center

Geographical situation: in a southeast suburb of Kinshasa, poor urban population;

Date of creation: 2001;

Legal structure: private enterprise tenant, the building belongs to SD RD Congo;

Interviewed persons: Zola Ferdinand (chief nurse and manager of the Center), the director of the health zone, the chair of the health area development committee, 2 women of the community;

Services offered by the Health Center: general and prenatal consultation, delivery, preschool and curative care; vaccination, minor surgery, physiotherapy, anti-tuberculosis centre;

Qualifications of the nurses: meet the standards of the Ministry of Health; nurses attend training courses;

Number of male nurses: 5;

Other: 2 administration staff;

Number of consultations: 200 a month;

Cost of consultation: approximately $1 (average income $2 a week);

Percentage of the patients who pay: 30 % pay completely, 40 % pay partially, 30 % pay nothing;

Subsidies: for construction of the incinerator ($300) and for the purchase of a motorcycle ($1,800);

Quality of the care: according to the director of the health zone, the Yenge Health Center is classified the best of nine Health Centers of the zone;

The Health Center and the community: good cooperation with the community; runs a campaign against poverty, a monthly meeting on health education; the Yenge Health Center is an experimental Health Center for its health zone;

How to improve the quality of the care? With better equipment;

Immediate needs: construction of a wall around the Center to ensure safety;

Medium-term needs: construction of a shed, a library (computer);

Financial autonomy: there is good staff stability, that will allow the Center to reach financial autonomy within 3 years;

Other request: strengthening building capacities

NOTES: THE RENT HAS NOT BEEN PAID BECAUSE YENGE HEALTH CENTER HAD TO FIX THE SEPTIC TANK FOR $465, ALTHOUGH THIS COST SHOULD HAVE BEEN AUTHORIZED BY SD DRC. THE SD DRC FORMER CHAIR SAID THAT SHE HAD NOT BEEN INFORMED OF THE SITUATION. THE MOTORCYCLE IS IN THE WAITING ROOM OF THE CENTER AND IS NOT USED, BECAUSE ZOLA FERDINAND HAS STILL NO LICENCE. IT IS UP TO SD DRC TO SEE IF THE DEMAND FOR CONSTRUCTION OF THE WALL IS JUSTIFIED AND TO MAKE IT CLEAR TO THE TENANT THAT IT IS THE OWNER WHO HAS THE RESPONSIBILITY FOR DOING THE REPAIRS.

2. B.5 Health Center of Luwawu (Nkandu / Inkisi)

Geographical Situation: close to Inkisi (120 km from Kinshasa), poor rural population;

Date of creation: 1995;

Legal structure: private Health Center, belongs to Padu Lawawu, son of the deceased Dr Luwawu;

Interviewed persons: chief nurse Yampasi Tusevo, and the following day the manager Mr Philipe;

Services offered by the Health Center: general and prenatal consultation; delivery, curative and preventive care;

Qualifications of the nurses: meet the standards of the Ministry of Health;

Number of nurses: 5;

Other: 1;

Number of consultations: 40 - 50 a month

Cost of consultation: opening of file 200 FC + 1,200 FC for a child and 2,200 FC for an adult; rates are approved by the zone of health. The Belgian Cooperating Agency asked for a reduction in the cost of consultation to facilitate access;
Percentage of the patients who pay: most pay;

Subsidy: none;

Quality of the care:

The Center and the community:

How to improve the quality of the care? Improve the infrastructures

Immediate needs: renovating the Center

NOTES: THE HEALTH CENTER IS IN AN ADVANCED STATE OF DISREPAIR. THE MANAGER IS FULL OF WILLINGNESS AND REALIZES THAT THE CENTER SHOULD CHANGE ITS PRESENT STATUS TO HAVE ACCESS TO GRANTS.

2. B.6 Health Center Adisea of Boma

Geographical situation: Boma, 485 km from Kinshasa, urban population;

Date of creation: 1972;

Legal structure: private Health Center, belongs now to Jeanine Nsingi Mpungi, daughter of the deceased Dr Nsingi; buildings and land belong to the Health Center;

Interviewed persons: Jean Liema Ntedika chief nurse, and the doctor on visit;

Services offered by the Health Center: general and prenatal consultation, delivery, curative and preventive care; surgery;

Qualifications of the nurses: meet the standards of the Ministry of Health;

Number of nurses: 4 + 1 assistant;

Other: 4;

Number of consultations: 450 a month;

Cost of consultation: 2,000 FC for opening the file and consultation + 600 FC for prescription;

Percentage of the patients who pay: 65 % pay completely, 35 % pay partially;

Subsidy: none;

Quality of care: this Health Center is the best of the two Health Centers of the area;

The Health Center and the community: holds meetings onto hygiene, very good relationship with the local authorities;

How to improve the quality of the care? By improving the infrastructure;

Immediate needs: latrines;

Medium-term needs: laboratory to be equipped, bedding to be renewed;

NOTES: THE DOCTOR MENTIONED THAT HE HAD ASKED THE OWNER THAT THE PRIVATE HEALTH CENTER BE CHANGED TO A COMMUNITY-BASED HEALTH CENTER, BUT THERE WAS NO RESPONSE TO THE SUGGESTION. THIS DOCTOR VISITS THE PRIVATE HEALTH CENTER VOLUNTARILY EVERY DAY. THE BUILDING IS IN URGENT NEED OF RENOVATION. THE CHIEF NURSE IS FULL OF ENERGY AND DEDICATION. OWNER LIVES IN KINSHASA AND RECEIVES 45,000 FC A MONTH.

Kimvumu Health Center

2. B.7 Health and Maternity Center of Kimvumu

Geographical situation: 36 km from Kimpemba, rural population, approximately 2000 inhabitants plus some neighbouring villages;

Date of creation: 1977;

Legal structure: private Health Center belongs to Sylvain Kidimbu, but he wants the new Health Center be a community-based health center;

Interviewed person: Sylvain Kidimbu;

Services offered by the Health Center: general and prenatal consultation, delivery;

Qualifications of the nurses: meet the standards of the Ministry of Health;

Number of male nurses: 2;

Other: 3;

Number of consultations: 300 a month;

Cost of consultation:

Percentage of the patients who pay:

Subsidy: none;

Quality of care: inadequate infrastructure;

The Health Center and the community: very good relationship, the request for a new Health Center comes from the community;

How to improve the quality of the care? By improving infrastructure;

Immediate needs: build a new Center;

Financial autonomy: by the creation of a health-community mutual insurance company;

NOTES: THE PRESENT HEALTH CENTER CONSISTS OF 2 SMALL CRAMPED DARK HOUSES AND IS UNDER-EQUIPPED AND CAN GIVE BASIC CARE. A NEW HEALTH CENTER IS NECESSARY, BECAUSE THE CLOSEST HEALTH CENTER IS SITUATED AT 36 KM, IN KIMPEMBA. THE TOTAL COST OF THE PROJECT IS $12,846, (SEE ESTIMATE).

2. B.8 Technical Training Center for Apprenticeship in Electricity and Rewinding

Geographical Situation: district of Lukaya near Inkisi, rural-urban population, targets approximately 2000 young people who dropped out of school;

Date of creation: 1977;

Legal structure: NPO created by Sylvain Kidimbu;

Interviewed person: Sylvain Kidimbu;

Offered services: apprenticeship in rewinding electric engines as well as in the assembly and maintenance of manioc grinders; there is also a carpentry apprenticeship;

Instructors: 3;

Administration staff: 2;

Number of apprentices: 8;

Costs: none, but after their apprenticeship, the apprentice has a debt of recognition to his instructor;

Subsidy: none, the center is self-financed by farming and repairing electric engines;

The center and the community: good relationship;

Request: subsidy of $6,695;

NOTES: IT IS AN INTERESTING TRAINING PROJECT, BUT I HAVE SOME DIFFICULTY SEPARATING THE INDIVIDUAL COMPANY FROM THE TRAINING CENTER.

C – COMMUNITY-BASED ENTREPRISE

Nsalani Credit Union

2. C.1 Mutual Insurance Company Nsalasani of Savings and Credit

Geographical situation: head office in Inkisi (120 km from Kinshasa), rather well off rural population as compared to the rest of the region;

Date of creation: in March, 2009;

Legal structure: non-profit organization which possesses two branches, one in Kikonka near Inkisi and another one in Lemfu, approximately 20 km from Inkisi;

Interviewed persons: Albert Diluambanzila (founder) and the managers of the branches;

Purpose of the mutual insurance company: savings in RD Congo are not a traditional feature of life. It intends first to offer the community a means for savings, then, when the number of members and the available cash is sufficient, to offer microcredit to its members.

Functioning: there are several types of savings, including the "tontine" into which the members commit themselves to put a certain amount over a period of 30 days. When they withdraw the saved amount, the mutual insurance company keeps 1/30th. There is also a notebook for savings which can be used, for example, to save for future school fees or buy seeds or any other purchase; in that case the mutual insurance company takes a 2 % commission on any withdrawal.

Logistics: the mutual insurance company of savings and credit employs 2 permanent cashiers in 2 branches and 6 mobile cashiers to recruit new members and receive the deposits. At present the employees are paid by commission, but they all hope to have a basic salary soon. For this kind of mutual insurance company, the bank offers services and the possibility of renting a safe.

NOTES: THE MUTUAL INSURANCE COMPANY OF SAVINGS AND CREDIT HOPES IT CAN SOON OFFER MICROCREDIT. THE MUTUAL HAS 1,200 MEMBERS. I RECOMMENDED TO ALBERT DILUAMBAZILA TO GIVE THE BOOKKEEPING TO A PROFESSIONAL ACCOUNTANT SO THAT THE ACCOUNTING FOLLOWS THE USUAL RULES AND WOULD BE TRANSPARENT.

3. WORKSHOP ON HEALTH CENTERS WITH DOCTORS OF AFRICA

Eighteen persons (including four representatives of Doctors of Africa) were present at the workshop on Community-based Health Centers given by Théophile Bansamba of Doctors of Africa. This presentation was held in the national Center for blood transfusion (perfect premises for such a workshop).Doctors of Africa is a Non-Govermental Organization which works in Africa in the field of community-based health centers which transfer health responsibilities to the communities.

Dr. Théophile Bansamba, General Secretary of Doctors of Africa, presented the Community-based Health Center (CSCOM) which Doctors of Africa developed and which is based on the following points:- Coverage of health care by the community;- Health center is prepared in consultation with the community;- Mobilization of resources;- Creation of the community-based health center;- Training of the staff;- Creation of the community-based health mutual insurance company to provide the health centre with financial autonomy which should occur within the first year of functioning.

The Community-based Health Center depends on the degree of participation of the community, represented on the board of directors. It is the Board which indirectly governs the health center through the head doctor and the accountant who, in turn, coordinate the medical activities and the management of the center.

A solid management is needed: 1) to keep a balanced budget and to avoid any diversion of money; 2) to avoid any shortage of stock, 3) to motivate the staff and follow their activities with performance indicators.

During the debate that followed the presentation, the discussion stayed most of the time on a theoretical level.

With regard to the work Susila Dharma could do with Doctors of Africa, it may be possible to work in partnership with them in the health projects, as far as they are community-based projects. On Virginia’s advice, I asked sister Charlotte Ndonna if she was willing to have her Health Center become the first Community-based Center of SD and work in partnership with Doctors of Africa. She accepted enthusiastically (see letter of agreement). Doctors of Africa was contacted and is to give SDI an estimate for setting up such a center in Lemba Imbu.

I also asked Doctors of Africa to prepare an estimate for the Children's Vision project. On this subject, I met Zola Ferdinand and Doctor Etienne Maweja who studied the request of SDI about examining the sight of the children. The most important cost is $35 per child for the ophthalmologist.

4. WHAT SD DR CONGO EXPECTS FROM SDI

SD DR Congo wishes to have a healthy relationship with SDI by avoiding misunderstandings on projects or imprecise interpretation of documents relative to Susila Dharma. Improving communications can ensure this: by making sure, for example, that the requests or messages received by SDI are also sent to SD DR Congo. That, in some cases, would allow SD DR Congo to play a more active role by asking, if need be, for clarifications from the applicant or in some cases by requiring another estimate or by giving SDI their opinion of the request.

5. CONCLUSIONS

The application of SD Congo bylaws should improve understanding within the Subud Congo membership and create transparency for the SD DR Congo organization.SD DR Congo, as owner of two buildings rented to private health centers (Nandora-Vunguta and Yenge), should see that the leases are respected.

It is necessary to remind ourselves that, as a non-profit body, the SDI association cannot make donations to a private company, even if it is a private enterprise with social content. Moreover, in the annual form which we file with IRS, we answer the question: "Does the association donate to organizations others than non-profit organizations?” It is necessary to avoid putting the association at risk because of confusions created in the past. I believe that Doctors of Africa is going to be able to offer SDI an inestimable help in starting projects proposed by Subud members of Congo, because they know the country and its customs very well. On the other hand, I suggest that the projects, before being approved, be tested so that the Board of SDI is capable of judging their merit.

Because of their important responsibilities, SDI and SD DR Congo have to make sure that information flows freely between them.

THANKS

In spite of certain apprehensions about my health, everything worked out quite well and, if I was able to do the work, I owe it largely to all those who helped me and whom I thank very sincerely: to brother Dianteza Dimpioka, to sister Charlotte Ndonna, to brother Pokoti, to brother Rida who drove us in many places, to the International Helpers, Héloise and Jorge, and to all my sisters and brothers of Congo who were kind enough to tell me about their ideas and projects. Thanks to all.

ADDENDUM

Susila Dharma DR Congo's Budget

INCOME

Rents (to be increased) 1,650

Project Dues 200 Activities

TOTAL 1,850

EXPENSES

Bank Charges

Board Meetings 90

Rent 600

Visit of projects (2/year) 400

Communication/internet 500