COVID: not whether but when

montage: doctors; carer; new equipment

Aru, DR Congo: Doctors visit a COVID patient hastily isolated on a sofa; the patient’s carer waits next door; a new oxygen concentrator is on order (Photos: Patricia and Peter Wyard).

Dr Patricia Wyard, working with her husband Peter in Aru, DR Congo, reports on how the first signs of COVID arrived in their town. Her pictures show the reality of facilities available for COVID treatment in many parts of the world, where the virus is only just beginning to affect daily life.

ARU, SEPTEMBER – It was June when we first became aware that there were patients in the hospital who had air hunger and no oxygen to give them. Most of them tested positive for COVID-19 and some were transferred to the general hospital where the COVID Treatment Unit and testing centre is based.

Dr Patricia Wyard and her boss, the medical director Dr David Emmanuel, outside Centre Hospitalier Aru Cite

It was then that it really dawned on our local team how ill prepared we were. Sadly, the official centre seemed even less well prepared, and they ended up referring very sick people to our hospital. It got all very unsettling.

We had someone on the sofa in the palliative care building sharing an oxygen concentrator with the man next door who needed much more than we could give him.

A family member who is a midwife was looking after him (without face mask) and some relatives arrived, planning to visit him in his small room, close up. I managed to stop them entering and I insisted on opening the window (which the midwife-carer later closed because it was fairly cool and windy).*

The same midwife-carer asked me to come and ‘say hello’, which I tried to do by waving at him from some distance. A few photos give you an idea of the precarious electrics of the generator which powered the oxygen concentrator, and you also get an idea in what circumstances the patients were looked after.

Having worked in the UK during the pandemic, it is baffling and frightening to me how light-hearted some people treat the pandemic or, worse, question its existence.

A few panicked emails were met with a very generous offer of a grant from Semiliki Trust to improve the hospital building and get some essential equipment. Thank you also to Congo Church Association who support our work in the hospital but also in palliative care and Christian education.

montage: dialpidated building is transformed to clean and new-looking building
Now ready for COVID patients, the old dentistry transformed

We are also very grateful to Primary Care International who referred Dr David Emmanuel (the medical director of the hospital) and me to a very experienced Egyptian physician who is both a COVID expert and works in the UK, but who also understands the challenges of working in a country with limited resources.

We are now trying to become COVID-ready, and have started the renovation work on a rather dilapidated building which we will use to host future COVID patients.

With so few people vaccinated it is not a question of whether we will have more COVID patients but when

UPDATE: ARU, OCTOBER – The work is going well and we have not had any more known/suspected COVID cases. It is impossible to know what is going on but, for now, all seems calm from the COVID perspective.

In Eastern Congo, conflict rather than healthcare draws most of the government’s attention.

Our approach is:

  1. protect staff first
  2. train staff in safe practice
  3. improve the care and environment for the patients
  4. improve the equipment necessary to, in particular, offer oxygen

In any case, our hospital should and will be much better prepared when the next wave of COVID cases (or other disease requiring isolation and ventilation) hits.

Every member of staff will have a set of theatre scrubs and two washable face masks to use at work and I am involved in the teaching of good practice and standards to reduce infections.


Let the insights into the situation faced by Patricia and the team in Aru inform your prayers for them and for the many other places around the world where both vaccines and necessary hospital equipment are in short supply.

*In Congo every patient needs a “garde-malade” (a generic word for the person who ‘guards’ the sick person), who will cook for you, feed you, stay with you even at night. You will go hungry if you do not have one!

Published 7 October 2021

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