Dr. Jean Van Hauwaert, paediatrician, has been working with Medics Without Vacation already since 1999. After 10 missions, we summarise his work as paediatrician.

How was your first mission for MWV?

The first time that I went to Africa, I went to Kinshasa, Democratic Republic of the Congo. It was in the course of 'Atelier de Perfection' which was organised in the capital by professors of the university. It was the goal to give theoretical education to doctors of the country. I soon noticed that, without practice, it would be very difficult to provide a good training. Besides a great need for knowledge, there is a great need for equipment and infrastructure...

What are your motives for giving your annual vacation to MWV?

After my first mission in Kinshasa, I wanted to know in particular how the doctors treat the children in practice with the few means that they have. How can they work and improvise without the most elementary necessities like oxygen, running water and hygienic beds? In particular if you think of the serious diseases: Tuberculosis, HIV, malaria, malnutrition...

My first experience on location in an African hospital touched me in such a way that I thought: I can share so much of my knowledge and experience here with the African doctors and nurses, I must do this more often. For sure when I saw some of the children in the hospital: they were at the end of their tether, their little bodies worn out...in their eyes the pinnacle of acceptance after extreme suffering. Something like that, you will never forget again.

What projects have you done and what has stuck in your mind?

After Kinshasa, Democratic Republic of the Congo, I went to Benin, Rwanda and Tanzania. Each country has its own culture and customs, but in general, there are lots of similarities:

• lack of care for new-born children - no developed neonatal service
• no knowledge of intensive care for children (ventilation, resuscitation, treatment for shock, administering fluids via the bone)
• few technical means or usage of such (lab, radiology)
• even if there is no famine, you see a startling number of malnourished children everywhere

Also, with regard to each of the MWV projects, the Africans like to be involved in the development of the project. They can ask themselves what they need most and we try to give it to them.

What would you recommend MWV based on your experiences?

I must say that already after the first real hospital mission, I felt a lack which I could not resolve myself. As a paediatrician, you notice quickly what limitations you have when you are unable to count on a good laboratory. Without a laboratory, you are in the dark you want to treat children concretely: do I administer potassium or is there no shortage of potassium? It is so important to know whether your patient has malaria or not!

This is the reason why I am so glad that, during the 3 last missions in Tanzania, I could always count on a lab assistant. I would not know any more how I could provide a good training, how I could save children's lives when I do not have the support of a lab.

What is the most beautiful success story from your career with MWV?

I have many of them, but I want to remember the following three cases:

Niota was a girl of three years who had a completely damaged oesophagus due to the fact that she had drunk a burning poison. We found her in Kigali hospital, Rwanda. Her oesophagus was clotted in such a way that she could no longer eat or drink... She was doomed. Only an operation could save her. Thanks to MWV and support from another NPO, surgery could be performed on her in a specialised hospital in Africa. She is now a healthy young lady!

And also Safi balanced at the edge of death. In the hospital of Tosamaganga, Tanzania, no proper diagnosis was made up due to lack of means and clinical experience. During a ward round with local doctors, I recognised the symptoms of intussusception (a piece of the intestine that nests due to which it shuts down and even may die off). Without the correct diagnosis, we would not have been able to save Safi, as she needed to go under the knife urgently. This was at once also a wise lesson for the local doctors. Safi recovered and healed after a few days!

Asunta is 3 years old. This girl suffered from respiratory distress and was treated for pneumonia. During the clinical examination it was soon revealed that we were dealing with a severe asthma crisis and respiratory distress. She was treated with the equipment that was brought along and which up to this moment had never been used in the hospital of Tosamaganga. For the child, it was a great relief and liberation from her long-lasting respiratory distress. The expression on her face after her recovery speaks volumes!

What was your funniest experience seeing European culture clash with the African culture?

It was for example funny seeing a layer of mud added to the forehead of a child in order to prevent certain diseases (even HIV). But cultural clashes are not always that funny. Sometimes it is embarrassing to experience the difference in culture, as in Benin where prematurely born children and twins are ignored because they are said to be jinxed!

Yet we must try together with MWV to keep up the respect for each other's culture and habits and never try to impose our own vision. I want to continue working for these children; they are the future, also in Africa.