A Mother’s Race to Save Her Sons on a Remote Island in Africa

Noella Mousa's two sons have been sick for more than a week and to get them to the only hospital in northern Idjwi, an island in Lake Kivu in the eastern Democratic Republic of the Congo, the 32-year-old mother will have to walk for nearly three hours. The journey will be a race against time and the one chance her two sons stand of surviving.

"I did not have money to take them to the doctor. I just hoped they would get better, but they just got worse," Mousa says.

Mousa wakes up at 4.30am and prepares to leave, carefully stepping over bodies scattered on the floor of her one-bedroom, thatched-roof, mud-brick hut, which she shares with six other family members. She straps 9-month-old Octavien on her back using a towel, and 2-year-old Omari on her front. After slipping on her well-worn blue sandals, she grabs a solar-powered flashlight and walks out the front door into the darkness.

Mousa is one of over a quarter million people who live on the island, which has been largely isolated from its neighbors and the rest of the world. Access to quality healthcare remains a luxury — at the southern tip of the island is a small clinic that lacks even the most basic drugs and equipment, and has only four doctors. The rest of the residents trek north to Idjwi hospital, which also has four doctors and six nurses.

As the clouds break, the sun shines through. Mousa picks up speed, looking straight ahead, hardly noticing the shrubs brushing against her legs along the way. Omari has been crying most of the way. Octavien sleeps, occasionally opening his eyes when a speeding motorcycle goes by. Mousa stops twice to breast feed the 9-month old, and frequently gives the 2-year-old water for dehydration.

A cheerful chorus of "jambo" and "jambo sans" ("hello," "hello to you too" in Swahili) are repeated throughout the journey. People in Idjwi greet everyone, even strangers. Mousa passes lots of children loitering in the streets and pregnant young girls.

The island has one of the highest fertility rates in the world; it's not uncommon to find up to seven children in one household. Girls marry young and have multiple children because family planning services are largely unavailable.

Idjwi is lush and hilly, and at 44 miles in length and with an area of 130 square miles, it is the second-largest inland island in Africa. It's situated in one of Africa's most volatile regions, the eastern DRC, which has been ravaged by civil war for more than 15 years, partly due to the battle for the wealth beneath most of its ground. But Idjwi does not have much in the way of mineral resources, which spares it from the surrounding bloodshed. That peace, however, has come at a cost. The area remains underdeveloped, and residents say they've been neglected by government and NGOs alike.

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"We are told that because other parts of eastern Congo have been fighting, the people there are a priority and the central government has been promising that we would be next," Claude Sarubonga, the chief of the territory, told VICE News.

Idjwi is unlike any of the many rural places around the African continent. There is no sign of informal corner stores typical of this kind of community, nor will you see much money being exchanged. Instead, locals barter at the weekly market. Avocados are swapped for pineapples, potatoes for eggs. A one-way trip on a speedboat to Goma, one of the nearest mainland towns where storeowners would go to buy supplies, costs $50. It's expensive, and has discouraged many from venturing into business. Even mobile phones are extremely rare.

The majority of residents are jobless and survive by farming foods such as cassava and beans to feed their families. Fresh drinking water is not easily available and there are hardly any good roads. Traveling by foot or motorcycle remain the only two means of getting around, unless you want to risk paddling a wooden canoe, which are known to frequently capsize.

At 7.25am Mousa arrives at Idwji hospital. Thirty patients are already waiting. Some are there for joint pains, respiratory problems, and the flu, while others are being tested for STDs.

Mousa greets them with a smile before sitting down, and notices Omari is getting weaker. Mousa becomes anxious. She has already lost two children in the past six years.

"I had five children, the first two died because there was no hospital around," she says. "I also could not afford to pay the medical charges that would have ranged between $50 and $100 if I went to doctors far away." (Mousa's fifth child, who is 5 years old, is home with her husband.)

Every so often the worried mother looks down at Omari, brushing his cheeks and wiping his forehead. She repeats this several times before being called into the consultation room.

The medical center was founded by Dr. Jacques Sebisaho of Amani Global Works and built with the help of community members. Sebisaho is a DRC native who grew up in Idjwi in the 1970s. At the time, people were dying from preventable causes. Illnesses went untreated and women were giving birth at home without the help of a midwife. Then, four years ago, after completing his studies abroad, Dr. Sebisaho raised funds and returned to his homeland with his wife Mimy, a registered nurse.

When Dr. Sebisaho first introduced the idea of building a hospital to his community members, many said they did not believe him. They had heard many promises before from people who come from far-away lands only to leave and never return. When the doctor told them they would have to physically be involved in the project without getting paid, many laughed him off. But one by one, he won them over by convincing people that if they waited for outside help to come and build a hospital, it might never happen. Dr. Sebisaho also told them that what they mostly required — mud and sticks to be used as building materials — was something that the people of Idjwi already had on hand.

"The community we serve is vulnerable," Moise Bahati Bulimachi, a nurse who has been with the hospital since the start, told VICE News. "When Dr. Jacques came to Idjwi, there was no good healthcare. Now we are giving a much needed service to the people and saving lives."

As you walk through the gate of the medical facility, beaming solar panels greet you in the far distance. The building is approximately 6,000 square feet and made up of two single-story blocks with 32 rooms.

Pregnant women, the elderly, and others who are considered the most socially vulnerable members of the community receive free healthcare. For those who pay, children are charged 500 Congolese francs (50 cents); adults 1,000 francs ($1). Already the hospital serves some 3,000 patients a month. They want to help more, but a shortage of medical equipment, lack of government support, and an inadequate supply of vital medicines limit their efforts.

Idjwi hospital sees a variety of diseases — intestinal worms (caused by consuming contaminated food or water), cholera, typhoid fever, and anemia, to name a few. The health facility's main success to date has been curbing severe malnutrition of children with a daily nutrition program that feeds more than 100 families in two villages. The medics' main challenge has been the inability to perform surgery. Equipment donated by a medical foundation in the US has been lying idle. The hospital only recently received permission from the health ministry to begin surgical operations but government bureaucracy has stalled the process.

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It doesn't take long for the doctor to diagnose Octavien and Omari. The symptoms of nausea and diarrhea point to malaria. They will both have to stay in the hospital overnight. Malaria, which is caused by parasites transmitted to people through the bites of infected mosquitoes, declined by 34 percent in Africa (and malaria deaths by 54 percent) between 2000 and 2013, according to the World Health Organization. But it remains a significant problem on Idjwi as there has not been a mass distribution of nets that protect people from mosquitos.

Nearly four hours after arriving at the hospital, Mousa emerges from the doctor's room. Her boys were submitted to various tests and their tiny arms have been injected with the first course of medication. The family is led to a dining area to receive a lunch of fried beans and boiled sweet potatoes. The hospital has a fresh produce garden on the premises and provides nutritious food for all patients. The meals are basic but for the people who receive it, it can sometimes come after days of little to no food.

By 6pm the heat begins to cool off and Mousa is rushed into a tiny room with a single bed and a window, in time to see the doctor working the night shift begin his rounds. There she will spend the night with her sons. The hospital is far from world class but it does have the essentials, a laboratory and a pharmacy. It is solar-powered because there is no electricity in Idjwi.

As the sun sets, Mousa sits on the bed and a glimmer of light comes through the lace curtain shining on her round face, and her big brown eyes have a slight glow. Omari and Octavien appear to be reacting positively to the medication. Omari, who had been crying for most of the day, had stopped crying and was even smiling a little when his mother tried to make him laugh.

"I am relieved, I was really worried," Mousa says. "The doctors are helping us. I have seen too much suffering here, too many lives have been lost in Idwji but things are slowly getting better."

Mousa picks up her boys one after the other, gently places them on her lap and covers them with a mosquito net. It has been a long day. She closes her eyes, stretches her neck left, then right, then left again. She will need the rest to make the long journey back home after being discharged, this time with healthy boys.

Follow Ntshepeng Motema on Twitter: @nmotema

All photos by Ntshepeng Motema