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Butoke update, March 1-3, 2009

Dear Brothers and Sisters,

Already  March 1.

February has been a whirlwind of visits and report writing, and planning meetings with the Office of Coordination of Humanitarian Activities and UNICEF, while still trying to take care of emergencies and continuing the monitoring of ongoing programs. 

We heard all the cogent reasons why Congo/Job is visited by so many ills and why we may be on the verge of a worse famine.  At the same time there was stillness in this storm, as Butoke for the first time in almost a year looked at its programs through the eyes of sympathetic visitors.  We saw more clearly the beauty of the accomplishments, the sadness of missed opportunities, the immensity of the task ahead and the call to labor on, and we could but be still and absorb.

We had first the combined visit of Julia Trotter of Africa Inland Mission and Sheldon Gilmer of Help the Aged (HTA), both Canadian.  Julia is the program officer responsible through AIM for our CIDA grant 2006-2007 in food security and nutrition.  Sheldon administers our new CIDA grant for integrated human development through HTA.  This grant covers food security and nutrition and some activities in health, education, and human rights. 

Together, we reviewed current and past activities in qualitative and quantitative detail and composed reports and documented them with photos. Their visit was very encouraging to us, as both are very deeply understanding of the challenges and multiple obstacles we face, and of our motivation. Canadian support has been extremely important to the growth of Butoke’s activities both in diversity of actions and geographic coverage and for maintaining the integrated nature of our actions. We are very grateful to Julia and Sheldon as well as the supporting NGOs and CIDA that they continue to be our warranty that we have resources to express Butoke’s mission without restrictions or imposed priorities.

Both the OCHA and UNICEF planning exercises are bittersweet. Sweet, because one can feel the honest attempt to understand and tackle problems. Bitter, because our ability to actually tackle problems is hampered by considerations of a diplomatic nature. Bitter, also, because the programs have their own limits and frustrations due to lag times between planning and execution, and a tendency to go for a blueprint approach rather than dealing with the specifics of each case. Moreover, there is a tendency to overly trust quantitative measures as triggers for priority action rather than a combined qualitative judgment and quantitative analysis.

An example of our frustrations is the massive erosion in Kelekele Kananga, discussed on Feb. 1stst, and photographed by us on Feb. 2, 2009.  But the only action proposed was to provide the victims with household items and plastic sheets as tent material.  Even that little has not yet been done, for lack of a local stock of these items. 

As an example of the blind adherence to statistics: the territory of Dekese will probably be excluded from some actions for safe motherhood because the hospital reports zero maternal deaths. But that is because they have no hospitalizations for delivery!  So the worst-off territories are refused actions because the health system does not reflect the problems and one relies on triggers for action based on health system utilization!

Still, through arduous field work, repeated discussions, and our own data gathering, we achieved three major victories.

·        First and foremost in nutrition, both UNICEF and OCHA will probably permit us to extend considerably our nutrition activities. We are slated to develop a program of nutritional supplementation in 27 health centers in three zones: Tshikaji, Luiza and Luambo as well as six therapeutic units for severe cases. The prospect is both frightening in its tremendous challenges and attractive in the prospect of moving closer to early treatment and maybe prevention.

·        Similarly our program in water and sanitation will also be expanded to cover more of Luambo, Mueka Tshibala, Bena Leka, and yes, finally Tshikaji.

·        UNICEF will expand through BUTOKE its assistance to unaccompanied children coming from Angola.

The finalization of these probable projects depends on negotiations with the political and health authorities and production of proposals, so there are still quite a number of hoops to jump through.

In the meantime, the emergencies keep coming, such as the child that came to the office on 3rd February photographed by Julia, who unfortunately died in hospital the next day at IMCK.

3 March, 2009

This letter was interrupted by the arrival of seven people bitten by a rabid dog:  a pregnant woman, two boys of about seven years, and four young men. We have, in the month of January and February, cared for another seven, similarly bitten here in Kananga. The ones that just arrived came on foot from Lake Mukamba at 80 km, bedraggled and frightened but hopeful as they had heard what we were able to do for the others. We tried WHO and the Ministry of Health and got only a hearing – no promises, no serum. So we took the people to Tshikaji to feed them and lodge them and borrowed money to buy the serum, at least the first two doses. We will need 5 doses each for a total of $1750. We know this approach is unsustainable.  As the word spreads, we risk having a constant flow of such patients.

We do need to get going again with vaccination of dogs to limit the damage.  Treatment of one person bitten costs USD $250. The same money can buy 250 vaccines for dogs. It is overwhelmingly sad to see seven people walking to a sure death if one doesn’t help now, so we help, even if it doesn’t correspond to the biggest bang for the dollar.

In His love,


Also attached is a recent photo of (left to right), Dr. Jean Lumbala, Rev. Lazare Tshibuabua, and Cecile

Contributions to Butoke in Canada can be sent through Real Lavergne, Canadian International Development Agency, 200 Promenade du Portage, Gatineau, Quebec, Canada, K1A  0G4. 


Contributions in the USA can be made payable to H. Branch Warfield, 13801 York Rd., V-3, Cockeysville, MD, 21030 marked “for Butoke” or to Maryland Presbyterian Church, 1105 Providence Rd., Baltimore, MD  21286, USA, also marked “for Butoke.”Contributions to Maryland P C for Butoke may be tax deductible in the USA.


Contributions in the U K can be sent through Paul Evans, 5 Westville Ave., Ilkley, LS29 9AH, United Kingdom.