Good Shepherd Hospital IMCK Cross  
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The Institut Médical Chrétien du Kasai (IMCK), i.e.: The Kasai Christian Medical Institute, was founded in 1954 as a nursing school at the rural Presbyterian mission station of Lubondai in the then Belgian Congo. More than 60 years later it has come a long way -- it has moved to the suburban area of Tshikaji ten miles south of the city of Kananga (1.4 million) and has added a lab tech school and a college level nursing program, a 140 bed reference hospital, programs for nutrition, public health, research and medical internships, outpatient clinics (in town as well as in village areas), a dental program, and specialized services in surgery, opthalmology, maternity and pediatrics. That only brushes the surface. Read more about IMCK's history below and its various programs on other pages of this web site.

HOWEVER, please note that in this time of economic downturn, the financial hardships are much more severe in an institution of this sort (normally non-profit even in developed countries), located in one of the poorest countries on earth. Do not overlook the need for help and the opportunities for making a contribution that are presented on these web pages. You will be doubly blessed for whatever you can do and your addition to that of hundreds or thousands of others WILL MAKE A DIFFERENCE!


Logo IMCK MISSION STATEMENT -- Approved by the Board in May, 2011
IMCK is a medical training institution that provides Christian witness by means of quality care and education and that builds trust relationships with other medical institutions, patients, staff, donors, and the community


Click on choices below for more maps and sattelite images (then click back arrow to return here).

Map of Congo showing hospital locations & overlay of U.S. states

Sat image of Kananga area

Kananga detail

Tshikaji area

Tshikaji detail

A1 and A2 Schools

Good Shepherd Hospital  

  • Early HISTORY
  • 1954 - 63
  • 1964 - 73
  • 1974 - 83
  • 1984 - 93
  • 1994 - 2003

This presentation gives a brief review of the history of Presbyterian medical work in the Democratic Republic of Congo, a country as big as the USA east of the Mississippi and a country of over 58 million people. This is the story particularly of the effort to help educate Congolese nurses, lab technicians and doctors. This is followed with information about current collaboration between Presbyterian Church USA (PCUSA) and the Congo Presbyterian Church in the following health projects: public health, teaching medical personnel, and church supported hospitals and clinics.    

In the early years when Christian missionaries arrived in the Congo, they were the preachers, teachers and healers. But missionaries realized soon that it was imperative to provide learning for the Congolese themselves to be the preachers, the educators, and the healers. From their first contact with the Congolese, medical missionaries realized that Congolese were dying of such diseases as malaria, sleeping sickness, contagious diseases, parasites, malnutrition and dysentery. Missionaries were unprepared for the power of malaria, one in four of the early missionaries themselves dying from that disease.

When Presbyterian missionaries started health service in the Kasai Province in the early 1900’s, Congolese labored in constructing the buildings for clinics and hospitals.

In the first fifty years of the Presbyterian Church’s service in Kasai, nine physicians and twenty-one nurses came, most from the USA but a few from Europe.

Early Presbyterian medical centers in the Kasai were started at Luebo  (1906), Mutoto (1915), Bibanga (1918), Bulape (1919), Lubondai (1925) and later at Moma (1943.) In the first half of the twentieth century, the Belgian Congo government had not approved any advanced medical teaching programs in the Kasai. So after periods of apprenticeship, Congolese were called aide infirmier (nurses’ aids) and they provided vital medical service. Congolese became the helpmates who assisted in organizing clinics, who watched over those hospitalized day and night, who oversaw the isolation camps for small pox and who helped administer treatment places for tuberculosis or leprosy. The Christian spirit of these pioneer American and Congolese medical workers laid the foundation for a major medical teaching center that would develop during the second half of the twentieth century in the Kasai province.

In the 1940s, the Presbyterian Church repeatedly addressed the request for a five year nursing school in the Kasai. (At that time, most educated Congolese had completed about seven years of general education or primary school.) The nursing school was started at Bibanga in 1947, but there were not enough teaching personnel and funds to continue beyond the first one year. Medical workers of the Presbyterian Church began to communicate with other Christian churches in the Congo regarding a collaborative effort to start a nursing school in the Kasai. In the late 40s and early 50s, new missionary physicians and nurses and the first missionary dentist arrived in the Congo. This was a time when the Presbyterian Church in the USA was eagerly supporting foreign missions work. With the increase in medical missionaries in the Congo and the increased funding from the US, attention was again focused on medical teaching in Congo.  In 1953, the American Presbyterian Church approved and the Government of Congo sanctioned the beginning of a five-year nursing program at Lubondai, in what was then the Belgian Congo. This was the first school at this level in the Kasai. Named Institut Medical Chretien du Kasai, the school was, according to IMCK articles “for the instruction of qualified medical and dental personnel, to provide a higher level of medical care, and to witness to the healing ministry of the Church.”  In those first few years, a Presbyterian team of two physicians, two dentists, three nurses, a medical lab technician and an x-ray technician worked with about fifteen skilled Congolese aide infirmiers and midwives at Lubondai to found the IMCK.

Twelve nursing students enrolled the first year of IMCK at Lubondai in 1954.  After five years of classes, clinical work and government exams, these nurses were to practice with a junior high school degree. In 1955, a dental assistant program was added to the school program, the first such program in the entire country of Congo. After five years of education and exams, they were to graduate with a junior high school degree as Infirmier Dentaire (or Dental Nurses.) The IMCK medical team and students served a rural community. The Lubondai medical program included a 70 bed hospital, rooms for surgery and delivery of babies, lab, X-ray, pharmacy, out patient clinics, tuberculosis and leprosy treatment programs, and clinics in surrounding communities. Dental facilities included dental chairs powered by electric generators, X-ray, dental supplies and a dental lab. From 1954 to 1959, IMCK admitted over one hundred nursing and dental assistant students. Their busy schooling days were filled with classes, study and patient care as well as social gatherings, music, sports and worship.         

1960 brought Independence from colonial rule. But it also brought political upheaval and inter tribal war in the Kasai. So IMCK was temporarily closed. To complete course requirements and graduate, some students transferred to far away schools. At this same time, the Presbyterian Church of the Congo, together with the Presbyterian Church of the US, reevaluated their medical goals in the Kasai. They unanimously agreed that medical education of Congolese was a priority in the church medical program. The group reaffirmed the need for outstanding medical and teaching service with Christian compassion, bringing honor to the Lord. The group realized that this would require a concentration of medical personnel at one place.
In the post independence years, dental and nursing graduates of IMCK programs filled many responsible posts, particularly in the Kasai but also at the national level. The dental teaching program has never reopened, but the 11 early graduates have provided essential dental services to the region and at the national level. Many graduates went on to higher professional levels such as doctors and dentists. Although IMCK was closed 1961-62, the medical work at Lubondai continued and medical staff assembled there to restart the school. At this time, a Mennonite physician and nurse also came to Lubondai.  From the beginning of IMCK, it was hoped that the school would be ecumenical, with attending students, with faculty or personnel, and with a board of trustees representing various Christian churches and various Congolese interests. Board representation evolved, and records show that in the 1960s the IMCK board of trustees included representatives from the Presbyterian Church of Congo as well as the US, the Mennonite Church in Congo and the US, and the Methodist Church.  Later, the Governor of Kasai or his designee served on the board. 

In late 1963, the nursing section of IMCK reopened at Lubondai with 10 newly enrolled students. By the end of the first decade, 32 nurses had graduated from IMCK, with another 13 who started at IMCK, but transferred to and graduated from other such schools during the time the school was closed.

At this same time, the Presbyterian Church of Congo and IMCK recommended that the school be moved to a more urban place. IMCK started negotiations with the government for a property called Tshikaji, which was ten miles south of the city of Kananga. Tshikaji was originally built to be a government administrative school. It was not being formally used and had been greatly damaged. The provincial government graciously offered this property and the buildings to IMCK. The facility included classrooms, dorms, a dining hall, faculty residences, and an administration building.

At the same time, another war was going on in the region. Several providential things worked in a short time: First the national army met insurgents and drove them across the Sankaru River, securing the region. Then a Presbyterian Church in Winston Salem, North Carolina in the US, without notice, gave a gift of about $38,000 to IMCK. With this money, equipment for the school was purchased, and the site was repaired over the next several years. 

In 1964, IMCK students and faculty moved to Tshikaji, with no electricity, no running water, and few doors on their hinges! The December 1964 printed program for the IMCK dedication of the Tshikaji site attests to a time of thankfulness, worship, joy and hope. However, a serious deterrent to the school at this time was the lack of an immediate hospital for clinical teaching. There were dorms and classrooms but no medical training hospital!  So students were divided into groups, living at Tshikaji for classes and dispensary work and then living at Lubondai, later Bulape or Bibanga, for hospital experience and learning. These clinical sites ranged from eight to one hundred miles away. This system of transporting students to various clinical places was a great expense, but would continue for eleven years. In the sixties, small planes were used to deliver medical support to surrounding rural dispensaries. Later, due to gas and plane expenses, IMCK served primarily the Tshikaji and nearby Kananga region. But IMCK remained the major referral center for the church supported hospitals and clinics of the Kasai region. And IMCK provided a critical link to the rural church medical centers for medical supplies and continuing education.
In 1965, a site was chosen next to the IMCK School for what would become the Good Shepherd Hospital. Committees began working on the architectural plans for the hospital and a major fund raising program began. By this time, health service of many hospitals and dispensaries of the country were being provided by graduates of IMCK. Many had gone on to be leaders in other hospitals and nursing schools, leaders in forming the first dental school of the country, and leaders in government medical programs. A great number of new students were enrolling to study at IMCK. The government standards had strengthened the education of students in early years, so the period of nursing school was reduced to four years.     

In 1967, IMCK opened a large outpatient general clinic in nearby Kananga, a city with a population then of about 400,000. As the enrollment of female nursing students increased, another dorm was built. During the sixties, school public health initiatives in the community increased. IMCK conducted public health surveys on infant mortality rates and schistosomiasis.  Mobile public health teams went from village to village. Clinics for children under age five provided care of sick children, nutrition monitoring, sickle cell screening and immunizations. Many prenatal clinics were started. Nutrition centers for malnourished children were started, with an emphasis in teaching families to use the protein of local beans. 

In the late 1960s, with the help of the Presbyterian Church in the US and in Congo, IMCK set up a new dental clinic in Kananga and in the Kasai city of Mbuji Mayi. The early dental assistant graduates of IMCK served these clinics for years.

In 1970, the government and World Health Organization sent a team to evaluate IMCK. IMCK was given a rating as one of the highest of its kind in the nation. This same year, the government also granted IMCK its individual organizational incorporation, which provided IMCK with the ability to apply for and receive support from diverse organizations. Articles of IMCK organization stipulated that the Board be primarily represented by members of the Presbyterian and Mennonite Churches of the Congo, with some representation by the Presbyterian and Mennonite Churches of the US. In the same year, the Presbyterian Church of Congo began a network of rural dispensaries, using many IMCK graduates for staffing.

Even as IMCK staff and students were busy with medical service and teaching and learning, plans continued for a pavilion style hospital to be built on one level. The cornerstone laying for building the hospital was held in 1972. Under the guidance of a Mennonite contractor, work began that would last for years and employ hundreds of people. The Presbyterian and Mennonite Churches of the US and Congo worked together to raise the money. A major gift of $400,000 from the Women of the Presbyterian Church in the US, then $300,000 from American physicians and dentists given through the Presbyterian Church and through the Medical Benevolence Foundation helped propel the project. There were other major contributions from the Mennonite and Presbyterian churches, the American Leprosy Foundation, the German Protestant Church, Friends of the IMCK, the Lions Club of Kananga, and Christoffel Blinden Mission. The hard work of many Congolese builders, the assistance of many visiting builders from America, and the constant collaboration of workers at all points along the project helped to realize a community dream.

A number of young medical missionaries came to work with IMCK during the seventies, providing teaching as well as general medical service and specialties: pediatrics, surgery, ophthalmology, obstetrics, gynecology, public health and nursing with advanced education in teaching. Students did house to house surveys. They participated in tuberculosis care and prevention, census taking and nutrition centers. Students went on village health visits that taught mothers about preventing malnutrition and students assisted in providing some of the first contraceptive teaching in rural Congo. These early public health programs were later used to form fundamental programs in the Congo on the national level.
In 1973, at the end of two decades of IMCK, 87 nursing students and 11 dental assistant students had graduated. The hospital was being built, public health services were growing, and significant medical care was being provided in outlying dispensaries and at the large downtown clinic in Kananga. All medical education centers, the world over, seek to find a balance between TEACHING, providing CURATIVE CARE and advancing in PREVENTIVE MEDICINE (OR PUBLIC HEALTH). And so it was for medical personnel at Tshikaji in 1973, as they sought to balance their work in those three areas with courage, grace and Christian faith.

1974 saw steady progress for the building of the hospital. At one point, the Medical Benevolence Foundation arranged for the Beckley West Virginia Hospital, which was closing in the US, to send major hospital equipment to IMCK. Medical personnel and staffing for the new hospital was formed by many who had worked at other mission hospitals, by local medical workers, former IMCK graduates, and missionaries from the Presbyterian and Mennonite churches. On January 20, 1975, the Good Shepherd Hospital was dedicated and opened in a festive event celebrated by students and faculty, the government, community, Congolese churches, and representatives from American churches and the Medical Benevolence Foundation. The four hospital pavilions had 150 beds, operating and delivery rooms, a lab, x-ray, pharmacy, dietary facility, and administration.  At this occasion, Rev. Mbiya Mulumba Bantu Balengele prayed, “Lord, let your people gather here and find help in healing, and find peace and health through your instruments which are the doctors, nurses, teachers, students, and all the paramedical personnel.”  Indeed, the Good Shepherd Hospital was composed of many people. The cooking was done outside at first and it was not until years later, when the hydroelectric facility was completed, that the cooking was converted to a system with electric cooking pots. Laundry was also initially done by hand!  And there is always staff working to keep every thing running and to repair broken things!  There are many faithful workers who worked in the operating room, managed personnel and directed men’s dorms and the school choir. When the IMCK doctors gathered here at the celebration in 1974, they knew that their medical care could never be given without all of the support staff of IMCK.
1975 was also the year that medical interns began to work at Tshikaji, following graduation from the national medical school in Kinshasa. For most years since 1975, four to five interns have come to work and study each year. This has been an enriching program for IMCK through the years. Their hard work and learning have helped sick patients, helped with preventive medicine and strengthened the academic atmosphere of medical learning.

About the time the new hospital opened, the Ecole Unie de Theologie at Ndesha began an agreement with IMCK to teach courses in clinical pastoral counseling, using the hospital setting. The program was designed in four or ten week intense courses to train ministers and seminary students to gain personal growth and pastoral skills in a clinical setting.  Through all these exercises, they were empowered to grow personally and equipped to proclaim the gospel of Jesus Christ more effectively. Through the years, pastors with this training have served patients and staff, held daily chapel services, and provided vital counseling and spiritual needs.

In 1976, Dr. Benoit Nzengu was the first Congolese physician to come to work at IMCK. He had been an early graduate of the IMCK nursing program, then proceeded to college and medical school. He worked on the faculty, provided medical care, and worked particularly to help set up a central pharmacy in the late 70s for the net work of IMCK dispensaries and of Presbyterian Church hospitals and dispensaries of the region. Because of financial and organizational problems, this centralized system did not last to the present. Other methods of procuring drugs for both IMCK and for Congo church hospitals and dispensaries have developed over the years.

A lingering problem in medical work in the 70s was the lack of medical lab technicians educated in a formal program. Workers, who learned by apprenticeship to make lab diagnoses of such diseases as TB, diabetes, malaria, sleeping sickness, anemia, and renal diseases, were doing most lab work. In 1975 the government requested that IMCK open a medical laboratory technician section and IMCK opened such a section in 1976. The first five graduates finished their three-year program in 1979. As part of their education, these students did clinical work at IMCK, at dispensaries, and at Presbyterian hospitals in the Kasai. This was one of only two such schools in the Congo.  Graduates from this program went on in the next decade to be critical staff for hospitals and clinics in the Kasai and throughout the Congo.   
A continuing problem for IMCK in 1978 was the need for electrical power. Generators were being used for short periods of the day, using fuel, which cost a great deal. An engineer came to IMCK to write a proposal for a hydroelectric dam to be built close to the hospital on the Lubi lua Mpata River. This was a project that would be funded by the Medical Benevolence Foundation, USAID, the German Protestant Church, and the Presbyterian Church. This was a nine-year project that would require the work of hundreds of people.                                 
Dr Walter Hull, the medical director, cited the following IMCK activities as of 1979, the 25TH year of IMCK:

  • The new Good Shepherd Hospital, because it had a regular supply of drugs, materials, and personnel, was functioning as the principal inpatient facility for the region, with a population of about 400,000.      
  • The IMCK Kananga Polyclinic was seeing about 40,000 patient visits a year.
  • A mobile public health team, which traveled with students, was providing preschool clinics at 34 different locations 44 different visits/month. The program was registering 8,000 new children each year.
  • IMCK was housing a central drug depot for the purchase and distribution of drugs to some 35 rural CPZa dispensaries in the Kasai.
  • The nursing school and medical lab technician schools were running, filled to capacity.
  • The Internship training program for medical school graduates was in effect.
  • The only ophthalmologist in central Congo worked at IMCK
  • The previous year, staff physicians had spent over 250 days visiting outlying church hospitals in consulting capacity.
  • IMCK was conducting the only cervical screening program outside the capitol.
  • The IMCK medical lab was one of the best in the region, rendering consulting services to the area.
  • An X-ray tech-teaching program was functioning sporadically.
  • A pathologist was visiting 6 months a year, providing the only such service in Congo outside of the capital.
  • Periodically visiting orthopedic physicians were performing major corrective surgery. A Catholic rehab program in Kananga, called Jukayi! (Meaning stand up!) Was helping with IMCK orthopedic rehabilitation programs.
  • One to two week continuing education courses were being offered once or twice a year to graduate nurses from Protestant, Catholic and government medical facilities.

The early 80’s marked a period in which Congolese began to take over the leadership of IMCK. In 1980 Pierre Shamba became the first Congolese named Hospital Administrator. He would serve in that position for over twenty years. In the early 80s, Dr. Mulaja Mukendi, an IMCK nursing student, who later went to medical school, returned to Tshikaji to join the medical staff. During the 80s, Dr. Ngoyi Andre, a surgeon, became the first Congolese to become Medical Director at IMCK. In 1982 Musamadi Lushanga became the first Congolese Director of the Nursing School. These early Congolese health care givers and administrators provided examples of commitment, leadership and pioneering.

In 1981, IMCK purchased the old Pax Hotel in Kananga and turned it into a medical facility with multiple clinics: medical, obstetrics, gynecology, pediatrics, surgery, and a special eye clinic. Called the Polyclinique or PAX, it was also equipped with a lab, a new X-ray machine, and a dental clinic. Solar power was used for various aspects of this clinic. The physicians and dentists were Congolese, Europeans and American. The Congolese physicians, dentist, nurses, dental assistants, lab techs and other staff in this clinic were dedicated and well trained. People from all over the region came, still come, to Kananga for service from this clinic.
IMCK’s example in community health was one of the models used to develop the national Sante Rurale (SANRU) project, a government sponsored project that began in 1982.  Funded by USAID and administered by the health office of the Eglise du Christ au Zaire, SANRU assisted the Ministry of Health plan 306 Health Zones throughout the country. This program placed emphasis on village clinics, where nurses lived and physicians visited regularly. Tshikaji Health Zone already had maps on the wall, dispensaries managed by local committees, regular Zone meetings with the different providers and donors, emphasis on nutrition, immunizations, and family planning. These activities gradually became routine as many other health zones in the country developed their programs.

The curriculum for nursing taught over the years included the following: physiology, anatomy, pathology, pharmacology, lab skills, fundamentals of nursing, medicine with emphasis on tropical medicine, surgery, public health, obstetrics and gynecology, and many hours of clinical or stage. The course work was and still is demanding and is conducted in French. The curriculum for the Medical Technology Laboratory School, also demanding, includes the following: Chemistry, parasitology, urinalysis, hematology, blood bank, virology, and fungi.
1983 marked the end of the third decade.  By this time, IMCK Congolese doctors, nurses and lab technicians were providing much of the medical care, teaching, and public health. The total graduates for these first 30 years: nursing school 268, med lab tech school 16, and dental 11 and medical interns and residents 27.

Students of many decades at IMCK remember having breaks and going to Lake Munkamba for a retreats. IMCK's graduates continued to work all over the Congo in nursing and lab positions that delivered vital medical service to the country. The physicians who completed internships at this time were regarded in Congo as having one of the best preparations for practice.

Meanwhile, the project to build the hydroelectric dam continued for much of the 1980s. During the course of construction, over 250 Congolese were employed to building the dam. A project emphasis was for the nationals, the Congolese, to have excellent teaching and training throughout the building of this massive project, so they could assume the future maintenance of this hydroelectric dam.

Carol Swanson and Bill Swanson, an engineer from the US, came to Congo in 1983 to continue the project. Employees and volunteers helped support this project with blasting/removing rocks, building the dam, book keeping, feeding the staff, installing electrical wiring, or just making ladders to reach the top of the dam. Procuring equipment to build this project was difficult. Material arrived from other countries by barge or was found as junk in the area but welded into use. Dirt was often hand dug by Congolese, singing as they later pounded the dam with bare feet.

Carol Swanson wrote in 2004:
“Every needed part and every needed person arrived on God’s schedule and at the time it or they were needed. The Zairians were so much a part of the building of the project that even today they are able to keep the hydro working and provide the much needed electricity for their people. We can never forget that this was God’s project for God’s people. As people were called, each came to give their special talents and gifts. It has now been 17 years since the hydro was finished and it is still providing light, water and health to a part of the world that would have none. In the Swanson’s lives, it has been a beacon of God’s love of his people. Most would not know where Tshikaji and the Good Shepherd Hospital is, but God knew and wanted the people there to have hope and faith of his presence and love. We are grateful for being a small little part of that plan.”
In 1986 the MBF provided funds for a graduate dental clinic in Kananga. Seven dental chairs were installed along with new X-ray and sterilization equipment. For years, the dental clinic has been ably administered and staffed by Congolese. The dental clinic is still operating as a teaching and service clinic, one of few in the country.
A new IMCK project in the 1980s (funded by the World Population Council) aimed to increase family planning practice in Kananga.  IMCK helped clinics around the city to publicize and offer more user-friendly family planning services, also being the first place outside Kinshasa to sponsor social marketing of contraceptives, including condoms.  IMCK conducted two citywide surveys, which showed that modern contraceptive use increased from 4% of the women in 1987 to 17% in 1990 - a remarkable accomplishment.

During this same period, IMCK personnel organized an extensive AIDS information campaign through churches, schools, radio, videos, dramas and written materials.   The students in the lab technician school conducted clinical trials on four types of tests to decide which one to use to screen blood for AIDS. After deciding which test to use, all blood donors at the hospital were tested for HIV, and AIDS patients were diagnosed and followed, both as inpatients and outpatients.  As the AIDS epidemic increased steadily, IMCK pastors assumed major work in counseling and visiting AIDS patients and their families.

In 1987, Dr. John Miller and his wife Aurie retired from work. They had been missionaries with IMCK since it’s beginning, making their service of 33 years at IMCK one of the longest of any missionary or Congolese.          

In February 1988, the hydroelectric dam project was dedicated in a festive event that celebrated harnessing water for good cause. At this event, Rev. Richard Derksen said, “Whatever your function or your place in society, you are invited to use all of the material, intellectual, and spiritual resources at your disposition together with those of others, as did all of those who participated in the construction of this dam, in order to bring life to others and create a better society.”

A new program started at IMCK in 1988, a residency program in family practice. Seven hospitals in the Congo were chosen to work with a Medical School in South Africa to make this residency program function. Physicians who had completed medical school and internship could apply to be in this program. Their participation in the learning and medical work of IMCK brought a new level of academia.

During the late 80’s and early 90’s the Congolese leadership and medical service of IMCK accelerated. Dr. Tshitenge Muboyayi joined the medical staff. Dr Mpoi Jacques was the first Congolese named school director, and still serves in that capacity today.  Dr. Tshiboko Kapumbu joined the staff to assume leadership of the public health program. Some Presbyterian missionaries from the USA continued to provide vital service during this period.      

In 1989, a new IMCK unit, the Centre d'Etudes et de Recherche (Center for Training and Research), was set up to coordinate IMCK's research and continuing education activities.  This was funded by MBF and USAID.  Numerous short training courses were held for health workers from institutions throughout the two Kasais.  The SANRU Project called on IMCK to house and organize courses on health zone management, family planning, vehicle maintenance, etc. Using this building, IMCK organized courses in neglected topics - plastic surgery, neurology, research methods, and making clay pots for water storage. IMCK research activities included a citywide survey of hearing and vision problems, an onchocerciasis study, surveys on AIDS knowledge and attitudes, intravaginal substance use, testing of HIV-AIDS educational materials, and a dental survey in primary schools.  Many of the studies resulted in published articles or oral presentations. IMCK personnel were also called to serve on national teams planning and evaluating health zone development, onchocerciasis campaigns, AIDS activities, and family planning programs.

As the fourth decade of the school drew to a close, the Congo entered a turbulent time. Political instability brought increased economic problems and eventually a civil war in Congo that would last for years and would draw in over six other African countries.  In 1991, as looting and strife spread across the country, missionaries and foreigners evacuated. The Congolese took over the work and kept IMCK programs functioning. Yet as they continued the work, financial resources and the infrastructure of the country deteriorated. This made the procuring of medicines and medical supplies limited.  The war brought famine and increased malnutrition and disease. Many IMCK students could not return home for years. But classes continued. And the school kept graduating students year after year.  And IMCK kept providing medical care to the community with what resources they had.

In 1992 the missionaries and many foreigners returned. Despite the war, there were signs of progress, such as construction of lodging quarters for the doctors in the residency program.  And in 1993, Dr. Mvita Bakatubia, a former professor of pediatrics at the University of Lubumbashi, joined the IMCK staff. By the end of this fourth decade, 447 nursing students had graduated, 96 medical lab technicians had graduated, and 11 previously graduated dental assistants were at work. In addition, over 52 interns and residents had completed their clinical training at IMCK.

The fifth decade at IMCK brought hard times, as the war continued. At staff meetings, IMCK leaders struggled to make decisions about how to continue with the resources they had. The system for collecting and distributing drugs to IMCK and church hospitals and dispensaries broke down from lack of money and problems with delivery. The SANRU public health program floundered. The under five prevention programs that included immunizations floundered.

Amidst these hard times, the hydro continued under the able care of Congolese. American engineers and missionaries periodically visited to assess the hydro and procure needed parts; they also wrote a French/English instruction manual for maintaining the hydro plant. The water flowed and the electricity continued.  The Tshilala Benyi was built in the early 90s, an overnight waiting facility and TB/outpatient treatment center across from the hospital. In the US, it might be called a Ronald McDonald House. There was joy in 1996 when the Tshikaji or Bon Berger Primary School (CSBB) was built with funds from Meyer’s Park Presbyterian Church and Lynchburg.

1997 was an uncertain year as President Laurent Kabila took control of the country. As former President Mobutu’s troops retreated, there was looting of IMCK vehicles. Destabilization, starvation, and disease spread on a massive scale. Old diseases resurfaced and new diseases increased: TB, sleeping sickness, AIDS. The human suffering index of Congo, according to the WHO, was one of the highest in the world at 88. Staff morale at IMCK was low. 

And yet, through all of this time, the work of IMCK continued. The Lab School continued to be filled with students. The students continued to learn. The patients continued to come, especially the children.  

IMCK Administration conducted a committee review of IMCK original goals, current performance and future goals. The final report submitted to the Board stated the need to set high standards and continue to improve at IMCK. Private nursing schools and medical schools were springing up in Congo, contributing to diminishing quality as resources were diluted. Good practical experience and good supervision of students and new graduates remained a rare and critical factor in quality health care. Continuing education programs broke down during the war. But there were positives for IMCK. Renovation of hospital and school buildings began. American medical missionaries still came to serve.
In 1999 the administration began to consider having an A1 level nursing program, a higher degree. The community grieved the death of pioneer medical staff, some from aging and some from AIDS.
In 2000, poverty remained a major barrier to good health, preventive health and access to health.  Malnutrition, communicable diseases, and transportation to health facilities were problems. Many people could not pay the 15 cents for entry into the health system. But staff with the public health team, continued their work to try to prevent diseases. And the nutrition program continued to teach families to feed children nutritionally in a time when protein is often hard to procure.
Dr. Kalumi served as the practicing and teaching surgeon at IMCK, providing distinguished service.  Dr. Leon Mubikayi was the OB/GYN doctor at IMCK and also the director of the health zone. Dr Mike Haninger and his wife Nancy, a midwife, came to Tshikaji in 2001, providing valued health service, helping to reinvigorate several programs and starting new ones. Nancy Haninger helped Dr. Mubikayi and others in expanding community health care.

At the PAX Clinic in Kananga, IMCK opened a new maternity ward, and the moringa tree project was started. The leaves of this tree serve as a nutritional supplement. IMCK is hoping to start projects growing these trees at all the health centers in the health zone that is supervised by IMCK.

In 2001, Dr. Shamba Manenga after years of distinguished service at IMCK was honorably retired and Dr. Bernard Kabibu Bimvulu was named to his position as IMCK Administrator. About this time, Mr. Sabastien Katumonanganyi was named Associate Business Manager.  2001 marked the year in which a non-Congolese held no key leadership position. 
By 2003 IMCK had access to the Internet.  A new oxygen generator machine, a gift of Rotary Club International, was installed to concentrate oxygen. This is used for patients who need to breath oxygen. Autoclaves and x-ray machines have been addressed for repair. An incinerator is functioning. In 2003, as African nations came together to form a fragile peace in Congo, hope increased for the future of Congo.
The Public Health Outreach expanded again to thirteen sites under Dr. Mubikayi and a dedicated staff. A new primary school was built for the village next to Tshikaji.  The Alex Booth Foundation, a Presbyterian Outreach Foundation, funded the school building. A new health center was also built in this village. These were projects arranged through IMCK coordination and public health activity. Dr. Cecile DeSweemer; a public health physician with an esteemed background, arrived at Tshikaji to work with IMCK and CPC.
In 2004, after years of work as Director of IMCK, Dr Mulaja Mukendi took the position as Medical Director of Good Shepherd and Dr Mwala Bady was named Director of IMCK.

That brings the story through fifty years. In those years, 606 nursing students have graduated from IMCK, 153 lab students have graduated from IMCK, 11 dental assistants. Also, 109 interns and 22 residents have completed their rotations at IMCK.   These students serve through out the Congo and also in surrounding African countries. And they serve in Europe and the USA. Fifty years of medical teaching that started at Lubondai and Tshikaji and rippled out like a pebble in the water through the Kasai, through Congo, and beyond.

This story cannot end without information about the Kasai region that surrounds the town of Tshikaji, where IMCK is situated. For twenty-five years, the Congo Presbyterian Church has assumed more and more administrative responsibility in various medical programs previously provided by PCUSA. Currently, seven church hospitals in the Kasai region are administered by the Congo Presbyterian Church with major support from PCUSA: Bibanga, Bulape, Lubondai, Luebo, Mbuji Mayi, Mutoto and Moma. In addition, this church medical program provides primary care for outlying dispensaries in key rural centers. Fine young Congolese physicians, nurses, medical technicians and support personnel work at these rural sites with minimal supplies. Their clinics and hospitals are filled with sick and with families bringing children for preventive programs. Short of medicines, lab and surgical supplies, they manage trauma injuries, TB, AIDS, delivery of babies, and the age old battle against malaria. But the fundamental problem among children is malnutrition. With so many orphans left from war and AIDS, the Congo Presbyterian Church has started a major nutrition program at the above medically served rural areas. The work of Christian service through medical work in less developed countries is a constant work in progress.

 People who contributed memories, reports and oral history or participated in the writing:

Bote-Tshiek, Etienne
Brown, Richard and Judith
Culbertson, Margie Neuenschwander
DeSweemer, Cecile
Dickson, Anna Kay
Donaldson, Paul
Farrior, Hugh and Ellen
Flores-Cabrera, Frances
Goodrum, Garland
Haninger, Michael and Nancy
Hillsman, John
Hodel, Paul
Hull, Walter and Nancy
Johnson, Glenice
Johnstone, Donald and Kathy
Kabibu, Bernard
Kang, Ed
Marks, Sandy
Miller, John and Aurie
Nelson, Henry and Kathryn
Norman, Nancy
Nzengu, Benoit
Rambo, Birch
Reinhold, Bill
Rule, Effie
Rutherford, Ann
Shannon, Ralph
Sthreshley, Larry
Stringer, Ron and Linda
Swanson, William and Carroll
Vandegrift, Catherine
Washburn, William and Annette



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