The doctor who stayed behind to save babies in his long-suffering homeland

Dr Jean Chrysostome Gody bounds down a stench-filled hallway in the Central African Republic’s only paediatric hospital, his daily soundtrack the high-pitched crying of dozens of babies in the malnutrition wing.

>>Dionne Searcey and Ashley GilbertsonThe New York Times
Published : 1 June 2019, 07:50 PM
Updated : 1 June 2019, 07:50 PM

The sickest of infants lie silent and listless. One baby’s skin is grey and splotchy. A nurse pokes at his head to make sure he’s still alive.

Yet amid all the suffering, Gody offers something rarely heard in this conflict-plagued country: optimism.

The hospital is no longer filled with children suffering from gunshot wounds and missing limbs from bomb blasts. A fragile calm has settled over Bangui, the capital of the Central African Republic, where the government recently signed a peace accord with rebel groups it had been battling for years. The agreement seems to be holding for now, despite an apparently isolated attack in the countryside in May that killed more than two dozen people.

In May, Gody congratulated the first-ever class of paediatricians to graduate from the country’s only medical school. The hospital has just opened a new multimillion dollar malnutrition wing, doubling the number of beds and offering clean rooms with fresh paint and new mosquito nets. More patients than ever are coming through the doors — a sign not that more children are sick, Gody said, but rather that word finally is spreading that treatment there is free.

“It is not the time and place to be pessimistic,” said Gody, director of the Bangui Paediatric Hospital for the past 16 years.

Nearly seven years ago, Muslim rebels fed up with a lack of government services in rural areas — basics such as schools, roads and hospitals — invaded the capital and clashed with Christian militias in fighting that slid toward genocide, the United Nations said at the time. Armed groups have been battling over turf ever since in this mineral-rich nation, which has suffered regular upheavals since independence from France in 1960.

The conflicts have left this country, with its lush forests and butterflies flitting about, in absolute tatters.

Most of Bangui, situated along the banks of the wide Ubangi River, hasn’t had running water for more than a year. At night people spill into the streets in search of water, lugging empty yellow jerrycans on bikes and motorcycles. Men strip naked and lather up in the gutter, where runoff flows from the country’s only water treatment plant.

Infant mortality rates here are some of the highest on Earth; 1 in 5 children won’t live to see their fifth birthday. Malnutrition rates are rising.

About 40% of the nation’s health budget is supported by international funds, said Dr. Pierre Somse, who is minister of health. Government revenue supports just 20%, and the rest comes from patient fees in a nation where few can afford them.

If peace holds, people will flow back to their homes, Somse said, and such gatherings can launch disease outbreaks, especially for babies who went without vaccinations while their families were in hiding. One region suffered a measles outbreak in April.

“It will get worse before it gets better,” Somse said.

But the country has made progress.

A vaccination program that required cooperation from militias has succeeded in immunizing 74% of children, Somse said. And a new program has been created to offer free care to pregnant mothers and children younger than 5, based on Gody’s model at the paediatric hospital.

Gody, 60, already has executed the first step in his plan to revive health care: He stayed.

Doctors who graduate from the University of Bangui’s medical school must go abroad to complete their specialty degrees. Most never come home. Gody thought about doing the same when he was in Ivory Coast completing his degree. Shame overtook him for even considering the notion.

“For a doctor — a real doctor,” he said, “should we flee the people who are suffering?”

“I could have waited for everything to be fixed here and come back, but how could I look them all in the eye?” he said.

One of Gody’s professors in Ivory Coast had created more specialty degree programs at a university there to encourage students to stay. Gody decided to do the same with paediatrics in Bangui, and designed the program at the medical school.

This May’s graduating class will more than double the number of Central African paediatricians in the country, to a total of eight. Ten more are in training.

To boost the ranks, Gody has helped lure health professionals from global organizations to Bangui. UNICEF provides support, and after Pope Francis visited the hospital in 2015, the Vatican announced a donation to help pay for the new malnutrition wing.

The paediatric hospital treated 72,000 children in 2018 and admitted 18,000 of them. The old critical care malnutrition unit was so full that two babies, along with their mothers, all shared a single bed. Many of the children’s conditions are complicated by malaria, HIV or other illnesses.

Overall, administrators say, the hospital’s mortality rate has declined from 14% in the early 2000s to 9% now.

Gody wants to replicate the hospital throughout the countryside. Doctors Without Borders operates a hospital in the capital and several clinics in rural areas, but only 35 local health centres exist in 230,000 square miles of territory.

© 2019 New York Times News Service