A team of 11 Chinese doctors faced threats of diseases, volcanoes and political instability during its mission to offer much-needed help to patients in the poor African island country of Comoros, as Chen Zhiyong finds out

After spending 34 hours in the plane, Dr Tang Chuanqi finally brought home all 10 members of his medical team last month. The team had safely returned to China from a two-year aid mission to southeast Africa's island country Comoros.

Reunion with their families was particularly sweet, with their experience in Comoros providing many unforgettable memories.

Looting and burning rampage

The day of September 28, 2005 was one of the most unforgettable days for the medical team.

The dramatic increase of oil price resulted in armed conflicts in the country. Some people went on a looting and burning rampage as they rushed into the houses of the vice-president and ministers.

That day, the National Central Hospital in Moroni on Grand Comoro Island, capital of the country, dispatched a car to send Chinese doctors back to where they lived. But due to road barriers, the car could not go through.

"So we suggested going on foot. On the way to our residence, we were quite close to the scene of gun fights," said Tang, who still has a lingering fear of that experience. Luckily, Tang and his colleagues were able to safely reach home.

But despite the dangers, Tang and his fellow doctors did a good job, gaining the respect and friendship from the local people.

Tang, 41, is the backbone of the orthopaedics department in the People's Hospital in Yulin, South China's Guangxi Zhuang Autonomous Region. Two years ago he entered his name when the African medical service recruiting notice reached his hospital. But his wife was very much against his decision.

"Many reports say that deadly epidemic diseases are prevalent in Africa," said Li Lin, a doctor in Yulin Women and Children Hospital.

In fact, Li's worry is reasonable. The island country Comoros is one of the poorest countries in the world. There are just more than 90 doctors in the country with a population of 560,000.

Owing to its poor healthcare service, epidemic diseases such as cholera and malaria prevail. Cholera contributes to one in four deaths in the hospital. The ratios of HIV carriers and syphilis patients are respectively 0.12 per cent and 7.6 per cent.

Tang himself also knew the risk of contracting infectious diseases in Africa was high. "But being a doctor, working in Africa would be a special and memorable experience," he said. "I wanted to challenge myself."

To ease her worries, he brought home a set of protection equipment provided to the medical aid team, such as protective clothes and glasses. He swore to her he would be careful and would return home safe.

Stubborn Tang finally won in assuring his wife that going to Africa was the right decision.

In March 2004, Tang led the 11-member medical team recruited in Guangxi Zhuang Autonomous Region to their temporary posting in Comoros. Tang and five colleagues were stationed in the National Central Hospital in Moroni.

"The tough working conditions even went beyond my imagination," Tang said.

Though the hospital was the best one in the country, medical equipment was in great shortage. Most of the equipment came from foreign donations, but with poor maintenance, they barely worked.

"Even the most basic ones for an operation, such as electric aspirator and a complete set of operation tools, were not available," Tang said.

Later, he could only apply to the Chinese Ministry of Health to donate this basic medical equipment.

Health threats

For the Chinese medical team, operations involved a high risk of contracting blood-borne infections like HIV. To protect himself, Tang slipped on two sets of hand gloves. But they often broke when he was repositioning the bones.

What's more, the protective clothing the medical team brought there seemed to be useless because the temperature in the tropical country is high and it is unbearable to wear the thick suit while doing an operation.

Cleaning their hands after an operation was sometimes a luxury for the doctors. As the island country is facing a severe shortage of fresh water, water cut-off to the hospital is common. At that time, the doctors could only give their hands an alcohol rub for sterilization.

The longest water cut-off the medical team ever experienced lasted eight days. So they have to store water in every container they could find, such as barrels, pots and empty mineral water bottles.

Malaria is the most common disease in Comoros. The mosquito's sting could transmit the disease. Nearly all members of the medical team got infected. Luckily, they quickly recovered.

A bigger threat comes from chikungunya virus infection. Though its symptoms are similar to that of malaria, it can leave the infected feeling pain in their joints after standing for a long time. One in four Chinese experts or embassy workers got infected with the epidemic disease.

Long hours of boredom

If contracting diseases is the biggest enemy for Chinese doctors at work, boredom would be another foe occupying their spare time.

"It was a common feeling shared by all members of the medical team," Tang said. "The first half of the year was the hardest time for most of us."

All six doctors on Grand Comoro Island lived in different houses far away from each other. "I could find nobody to talk to in Chinese," said Tang.

For Tang, the best way to dispel the boredom was communicating with his wife through telephone and e-mails.

"I was always feeling curious for his life on the mysterious land," Li said. "I often asked him how he washed his clothes and had a bath, whether he had vegetables to eat there."

In Comoros, meat and vegetables are in great shortage in the market. But the local people have formed special dietary customs by picking tender tree leaves for dishes.

Doctors Li Xue and Li Jianbang, a couple working on the Moheli Island of Comoros, spent most of their spare time planting Chinese vegetables, such as towel gourd, leaf mustard, sword bean and cassava, in a small patch of field near their hospital.

However, snails and mice often came to steal the couple's fruit of labour, so they only had a poor harvest and had to plant new crops again and again.

The most abundant vegetables in their field should be sword bean. The couple pickled the bean in bottles to be their side dishes.

"Every day we were rushing between hospital, residence and field," the couple wrote in describing their life in Comoros in a letter to loved ones back home.

The medical team displayed the unique advantages of traditional Chinese medicine to the Comoros people.

Doctors Li Xue and Li Jianbang were once asked to treat the Moheli Island governor's protruded disc, which had been afflicting him for the past seven years. The couple applied massage therapy for the governor. Soon, he felt his backache was much relieved and said his body had never felt so good.

Devoted doctors

With their excellent medical skills and willingness to help the locals, Chinese doctors enjoyed a good reputation among local patients. The doctors' regular working hours, however, could not satisfy the demand for their service. So it was common for them to work overtime.

At 4 am, doctor Liang Shaoyu, for instance, delivered a pair of twins. Only resting a few hours, he then went to the outpatient department to see patients.

The Chinese doctors' superb operation techniques often stunned both the patients and the local medical community. One day, the hospital received a patient with serious comminuted fracture on the right arm. The local doctors could usually only sew up the wound or have an amputation for such kind of patients because the hospital could not perform the complicated hand surgery.

So they invited Tang to handle the case. He used stainless steel plates to fix the broken bones internally and repaired the injured tendons, blood vessels and nerves. After the operation, the patient's right arm could move and feel normally.

Such kind of difficult cases were common. Even during their leisure time, Chinese doctors were on call to help.

Though the work was always hectic and tiring, Tang said that he got the best reward upon seeing patients raise a thumbs up to him after a successful treatment.

"The people there are quite simple and sincere," he said. "They trust and feel grateful to our doctors. Even in the streets, they would send friendly greetings to us."

Still, the Africa experience was full of harrowing challenges. In 2005, the Chinese medical team experienced two volcanic eruptions in the island. "Volcanic ash was flying everywhere, even penetrating through the windows," Tang said. "For days, it was hard to breathe."

The volatile political situation in the country can also pose threats to the safety of foreign experts at any time. Declaring its independence from France in 1975, Comoros experienced 29 coups in the past 30 years.

It is common for Chinese doctors to sacrifice their lives on the African continent during their missions. But Tang felt much relieved that he brought all his teammates home, safe and sound.

"I do not regret my decision to join the medical team," he said. "The experience itself is the most valuable treasure for myself."

(China Daily 05/10/2006 page14)