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Butoke update, July 2010

July, 2010

Dear Brothers and Sisters,

I arrived in Kinshasa on June 25th after a fruitful tour of Canada, USA, and England. The friends of Butoke are organizing in national tax exempt non-profit groups in the USA and England, and in Canada, they hope to work through Help the Aged (postcript – now replaced by World Hope Canada – see below for coordinates). 

Kinshasa was preparing the 50th anniversary of Congolese independence, in the midst of many questions about its future. So, with many efforts from Dr Jean Lumbala and his friends, we managed to take an unknown airline to Kananga on June 28th, just as the airport was being closed at least until 1 July.

This is the dry season with little or no agricultural activities. Schools are closing or already closed. We convinced school directors to let our kids take exams and the results that have come in are encouraging.

On June 29th, I visited the urban Kananga clinic that we took over in March. It has 3 doctors (part time) and 11 nurses, and  20  beds. Dr Jean Lumbala has taken over the leadership as a volunteer. It is run as a walk-in clinic with low fixed rates that cover consultation as well as drugs and small surgery or maternity, where indicated. The clinic has, in two months, already done 100 operations ranging from hernia to Caesarean, to transfusions for adults and children.  Care is free for rape, and admission is free for emergencies, but the clinic tries to recover its costs. The care given is of good quality and follows WHO guidelines for quality at low cost.

So far, the clinic is very accessible for the poor lower middle class and above consumer, which is progress but it is not accessible yet for the absolute poor. We are devising a sliding scale for the poor. For the poorest care will be free. We are also developing preventive care. Both rebate and free care will introduce a new challenge. The principle of the Bamako initiative which we developed in Nigeria and Benin in the 1970s may help. It consists in increasing the very modest curative fees a little (50 cents to $1) and setting aside 15% of curative fees to compensate for care of the poorest.

We need urgently to add a separate maternity home with 20 beds (initial minimum  $6,000 and optimal $10,000). Mixing infectious patients and new born is a very dangerous practice; the available space in the clinic is overcrowded already, and operations and delivery are done in the same limited space. The sliding scale and a new building may further increase attendance and therefore the generation of surplus funds for more complete services. Butoke thanks the family of Dr. Lumbala to have ceded free of cost to us this clinic where we can try to develop a model  urban clinic serving all strata of society at low cost in the absence of government support.

On June 30th, I returned to the orphanage and remain in residence there. Dr Jean has made all efforts to maintain as good services as possible. We have had one death in the hospital of a three year old malnourished orphan boy and one new child of about 11 years has a severe osteomyelitis; our 10 year old HIV+girl  has developed opportunistic infections. Both these children are under antibiotics.

Two groups of siblings have been reintegrated into their respective families. We are studying what the motivation has been.  May be families after months or years realize specific orphans are not witches?  May be additionally my prolonged absence was interpreted as definitive departure, which may have shaken confidence.  Let us hope but follow up whether these are happy solutions for those that chose to leave us.  Let us also hope we can understand the mechanism. At the moment, the struggle is on to keep all orphans well fed and warm at night.

We have currently no nutrition rehabilitation activities either on our own funds or UNICEF. They have a debt to us for the nutrition project of Tshikapa of 34,000 USD. They have finally recognized 14,000 USD but we still try to have them acknowledge the other 20,000 USD.  When and if they finally pay, we can clear all debts and hope to restart the activities on a modest scale.

My travel fatigue and edema has receded. I am grateful for your prayers and loving support.  I am working on a draft flyer.  Hope it can inform many and help widen the regular support so that we can secure good support of our orphans and expand the urban clinic as well as reopen the nutrition center in Tshikaji.

 We hope that this update finds you all in good health and able to continue mobilizing wider regular support.

In His love,



How to help (updated to year end 2010)


Friends of Butoke, Inc. is now incorporated and application has been made for 501-c-3 status in the USA.  Until it is granted, contributions in the USA can be made payable to Maryland Presbyterian Church, 1105 Providence Rd., Baltimore, MD, 21286, USA, marked “for Butoke.”  These contributions may be tax deductible in the USA. 

For those not interested in a USA tax deduction, contributions can be made payable to H. Branch Warfield, 13801 York Rd., V-3, Cockeysville, MD. 21030, marked “for Butoke.”


Contributions to Butoke in Canada can be sent through World Hope Canada, Box 21082, RPO Ottawa South, Ottawa, ON K1S 5N1


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