SANGE, Democratic Republic of Congo - the Israeli ambassador approaching the bed of Philippe Ovomba last week gave the injured Congolese boy a look of terror. Suffering from third degree burns in a village clinic without anesthetics, Ovomba, 12, mistook the diplomat's visit last week for a doctor's call. For him, doctors meant unbearable pain.
Ovomba is one of approximately 50 victims burned when an oil tanker caught fire two weeks ago, killing more than 230 people in this village near the Democratic Republic of Congo's border with Burundi.
Last week Israel sent five medical specialists from Sheba Medical Center for 10 days to treat the wounded. They were the first plastic surgeons to arrive.
Twenty-five patients are being cared for at Sange. Most of the others are treated at a hospital in nearby Uvira. Since last week, Congolese physicians and officials have been telling these patients that Israeli specialists were on their way to treat their severe burns.
Last Monday, a team of four Israeli physicians from Sheba Medical Center, Tel Hashomer, were the first to visit the region with proper know-how and equipment to treat the victims.
They joined a crew of physicians from Doctors Without Borders that had made it to the region seven days after the tanker fire, though without proper equipment and expertise in skin transplants. Tension between the Israeli doctors and the NGO, which has been openly critical of Israel, was apparent at first, though officials said they were eventually able to work well together.
Israel's roving ambassador to Congo, Daniel Saada, had come to Sange to inspect the damage from the fire while the doctors treated victims in Uvira. Realizing Saada was no doctor, Ovomba settled back into his bed in the clean but poorly-ventilated clinic, where a team of physicians from the Spanish branch of Doctors Without Borders were treating 20 children and five adults. But his relief was short-lived. A nurse and local doctor soon approached him to clean his wounds and change the bandage.
Ovomba began whimpering as they peeled back the bandage from the raw burns covering his legs and thighs. When they applied alcohol - the only disinfectant at the clinic - to his bloody calf, he began screaming uncontrollably, as the other children in the room watched. They endure the same three times a day.
"We have nothing to give them to calm them down or numb the area," the nurse explained to Saada.
Doctors Without Borders has brought several tons of equipment and medicine to Uvira, some 40 kilometers away from Sange. Volunteers for the Dutch branch work at Uvira with anesthetics and pain-free antiseptics. But victims in Sange have no such luxuries.
Protecting the goods
Gila Garawy, an American-Israeli working with international NGOs in Congo to train local labor, said that anesthetics and a less painful antiseptic my have been sent to the clinic at Sange, "but never got there" - a frequent occurrence in this part of the world.
The Israeli delegation that came with Saada brought over a ton of equipment and medicine, which they vigilantly kept with them. Fearing theft, they carried all unused materials back with them to the hotel every night, bringing it back with them to the government hospital in the morning.
"The operating room is not equipped to modern standards," said Dr. Eyal Winkler, the head of the Israeli medical delegation from Sheba, sent as a mission launched by the foreign ministry's aid arm, Mashav. "I've never worked under such difficult conditions in my life," he said after finishing his first operation in Uvira. This is his 10th aid mission abroad.
While Dr. Gil Nardini took a break outside the makeshift operating tent, Dr. Shmuel Kalazkin, Dr. Ariel Tessone and nurse Noa Anastasia Ouchakova - all burn specialists from Sheba's Department of Plastic and Reconstructive Surgery - were treating a boy with third degree burns who needed skin grafts.
The Israeli team was the first delegation of plastic surgeons to treat the victims, 10 days after the July 3 fire. Belgium, Congo's colonialist power, also sent a team of plastic surgeons, but they had not arrived by the time the Israelis finished operating.
"Plastic surgery should not necessarily be performed immediately after the injury," said Winkler. "First the patients are resuscitated, cleaned and remain under observation to make sure they are able to survive the operation. The time that passed since the injury and our surgery is quite normal."
Fear of contracting HIV
At the hospital, the medical staff are visibly tense inside the stifling heat of the tent. They sweat profusely under protective gear - double masks and goggles. Their feet are wrapped in plastic bags to prevent their shoes from becoming soaked with blood and other bodily fluids during surgery. None of them has been to Africa before, and they are trying to avoid contracting HIV.
"I don't want anyone to rush into it on the operating table," Winkler told his team in a prep talk in Burundi, where they landed from Israel. "I want you to practice every incision three times before you actually cut, and I want you to communicate very clearly every move you make to the rest of us."
He brought instant HIV detection kits from Israel, which can be used on the patient in case theres fear of infection of one of the medical staff. But the Congolese doctors at Uvira wearing simple scrubs told the team that they have never heard about a single case of a doctor contracting HIV in Congo from a patient. The Israeli team left the kits unopened, intending to donate them to the Uvira hospital before they leave.
Officially, DRC has an HIV prevalence rate of about 5 percent of the adult population, according to United Nations figures from 2003. But a later survey among pregnant women in rural areas in the DRC, Africas third largest country, revealed a prevalence rate of 8.5 percent.
The truth is there is no way of knowing how many people have HIV here, Saada said.
Currying favor, facing ostracism
The request for Israeli assistance with the victims came from the highest levels of the Congolese government, and last Monday President Joseph Kabila called the delegation to thank its members.
You have experience with terrorist attacks, but we do not have experience or facilities when it comes to burns, said Dr. Yves Bagale, medical director of Uvira Hospital. Mweze Tchibuzi, a Congolese diplomat serving in Burundi, also said he expected Israeli doctors would share their experiences from the war with the locals and with the team of physicians from Doctors Without Borders.
Winkler a stout energetic man not in the habit of mincing words dismissed the awe of Israeli wartime experience with burns as nonsense, saying New York or Chicago have more burn victims from house fires in one month than all Israeli wartime burn victims in recent years.
Israeli doctors unique contribution is in motivation, speed of arrival, smart equipment and the ability to improvise in difficult situations, Winkler said.
The Israeli delegation was happy to respond to the DRCs call for help. Israel closed its permanent embassy to the DRC in 2005, though Israeli businessmen such as Dan Gertler and Lev Leviev have extensive business interests there. DRC is potentially a hugely important place for Israel, yet we have limited means to curry favor with the administration, said Saada. Speeches are nice, but an aid delegation is much more effective.
The doctors were able to cross the border from Burundi within a few minutes, though this can sometimes take hours. Congolese foreign ministry officials and the staff of Jean-Claude Kibala, the acting governor of the South Kivu province, where Sange is located, negotiated the crossing.
While the Israelis were treated well by the host country, the Doctors Without Borders team was apparently less receptive to their arrival.
The relationship between the Israelis with the NGOs staff at Uvira was tense at first. This is an emotional time, there are obvious political sensitivities, said Dr. Geert Morren, a doctor from Belgium who arrived at Uvira with Doctors Without Borders Netherlands, after meeting the Israeli delegation.
Doctors Without Borders has repeatedly accused Israel of war crimes and obstruction of the organizations efforts to help Palestinians. They also accused Israel of devastating disregard for civilians during its 2009 Gaza invasion.
I wanted to come here to show that Israel is not the Flotilla country its painted out to be. Its part of the vision of Professor Zeev Rothstein, the head of Sheba Medical Center, Winkler said. But beyond the political game going on, we saved lives and instructed local MDs. It makes me feel I chose the right profession.
Winkler and the other members of the delegation said they felt the Doctors Without Borders staff treated them coolly and suspiciously at first, but added that the volunteers proved to be helpful and professional later on.
If you want to know the effects of occupation, come see how doctors from international aid organizations treat a delegation of volunteer Israeli doctors to Congo like occupiers, Winkler told Nati Harush, the foreign ministrys deputy chief security officer who accompanied the delegation. Harush replied he wasnt convinced this was the result of occupation.
Morren, a surgeon, and the rest of the Doctors Without Borders team declined to be interviewed for Haaretz about their experiences working with the Israelis, explaining they needed authorization from the head office, which has not replied to Haaretzs request.
Poverty adding fuel to fire
The fire at Sange started after locals broke open a truck carrying fuel which had overturned on a road on July 2. The oil leaked for an hour, attracting villagers who rushed to collect it, according to Kibala. The liquid ran through the village and many houses were encircled by a ring of fire, he told Haaretz during a tour of the village. Many victims were burned inside their homes as they watched the World Cup. Others, like Marie Okavo, 18, were severely burned while trying to rescue the children who ran in panic across the burning village.
I saw a small boy near my house and I thought he was my son, but it turned out he wasnt, so I took him away and my legs got burned, she said. Her children were not injured in the fire. Kibala, the acting governor, said he visited the site of the accident at Sange before it caught fire and that the authorities were investigating who broke the trucks locked fuel compartment to steal its content, and also how the fire was started.
He rejected media claims that the fire was ultimately the result of extreme poverty, in a country where the average worker earns around $2 a day, according to World Bank figures.
Its a case of disobedience that led to a disaster, he said. South Kivu has no firefighting force, and Kibala says he and rescue forces had to watch helplessly as the fire consumed the village and wait for it to die down on its own.
Gerard Lanu, a representative of the Congolese ruling party, says that there is much resentment among the Congolese population toward the authorities for not blocking all access to the site of the crash. It is after all their responsibility, he said.
The truck, according to Kibala an engineer overturned after parking on the partially collapsed asphalt of the shoulder. The asphalt caved from the weight, and the drop rocked the rear part of the truck. This threw the truck on its side, but the fuel compartments remained sealed until people broke them open, he said, standing by the trucks charred remains.
Pakistani peacekeeping UN troops stationed near Sange arrived at the scene of the overturned oil truck before it was engulfed in flames. According to some accounts, the peacekeeping forces soldiers told villagers to stay away from the truck, but did not prevent access to it.
To Jean-Michel Bolima, a social activist from eastern Congo, the oil truck incident represents many of the endemic problems faced by the vast, mineral rich and war-torn country with a population of just under 70 million which just last month celebrated its 50th Independence Day.
It is perhaps difficult at first to understand why a normal person who doesnt suffer hunger, who even has a job perhaps, would risk his life and go near an overturned oil truck spewing fuel around, he said. But we are talking about a country where government officials sell stationary paper from their office to make something extra. Its deep, deep corruption and its the heritage of the kleptocracy of Mobutu Sese Seko, Congos dictator from 1965 to 1997. The people are conditioned to pocket anything they can, an they will even risk being shot by police to do it.
Bolima, a former student activist, had misgivings about the Israeli delegations reliance on the Kinshasa in arranging its aid operation. Any resource given to the government is for naught. Medications, funds all will be siphoned. Aid needs to be done through the NGOs in the region, he said.
When the doctors return on July 19, they will leave materials they brought with Kibala, a soft-spoken man who fled his country in the 1980s and returned to Congo six years ago with his children and wife, whom he married in Germany.
Saada says that Kibala who drives his own car, an extreme rarity among African officials can be trusted to administer the material to the people who need it.
I came back to help make my country a prosperous place, Kibala said. Many people dont understand why I did it, but I suspect you Israelis will understand very well.