June 19, 2019
KISANGANI, DEMOCRATIC REPUBLIC OF CONGO — When Agatte Kimoto’s son contracted malaria, she knew she couldn’t afford to take him to a hospital.
But there was another option to ensure her son received the same care he would get in a hospital, for a fraction of the cost: Call a nurse.
“The way nurses offer healthcare in our homes is no different from the manner in which treatment is offered in hospitals,” Kimoto says. “The only difference is the setting.”
Nurses and other health workers in Kisangani, a major city in this central African country, say they’re poorly paid for the work they do in hospitals and clinics. The Congolese Nurses Association sets the monthly salary for nurses at 160,000 Congolese francs ($97). To make ends meet, some nurses say they provide medical care to people in their homes. Their fee is often between 2,000 and 3,000 Congolese francs (about $1.21 and $1.82) – a small price compared to what patients might pay at a hospital, but enough to make it worthwhile for a nurse to practice medicine outside of a formal setting.
Suzi Aruna Feza, a nurse who has worked at Mapendo Health Center in Kisangani since 2015, says her paycheck is far from adequate. To survive, she says, she makes house calls.
But nurses making up for inadequate formal paychecks aren’t the only ones who make house calls.
According to Congolese law, anyone who practices as a nurse must be registered with the Congolese Nurses Association. To join that association, nurses must hold a relevant university degree, says Jerome Bonui Boliaka, the association’s chief representative for Tshopo province, which includes the city of Kisangani. The association has 1,405 nurses registered in the province, he says, but there are many more people than that who make house calls to provide medical treatment.
Those people exploit a loophole in Congolese law, which fails to directly provide regulations for home-based healthcare, says Dr. Rodrigue Abedi, who practices at l’Hôpital Général de Référence Makiso-Kisangani, the city’s general hospital.
Aristotle Mbala was trained as a nurse, but he says he can’t find a paying job at a clinic or hospital. Instead, he treats people in their homes to earn a living.
“It’s just a matter of having the materials and knowledge of the job,” he says.
But Jeannine Aridja, 42 years old and a stay-at-home mother of six, says neither she nor any of her family members seek or receive home-based medical care.
“I know full well that the hospital is the only place where people can get proper medical treatment,” Aridja says.
Not once did the lack of money force Aridja to ask a nurse to come to her house to provide health care.
“Even when I don’t have a lot of money on me, I must first go to the hospital to find out about something going on inside my body. I’ve never been tempted to ask a nurse to come to my house,” Aridja adds.
Ndahayo Sylvestre, GPJ, translated the article from French.
Correction: This story has been updated to correctly identify Dr. Rodrigue Abedi. Global Press Journal regrets the error.