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Mission Co-Worker Larry Sthreshley is fighting the pandemic on the front lines in Congo

The response to the attack is under way

by Kathy Melvin | Presbyterian News Service

Red Mongana soap is a popular brand in Democratic Republic of Congo and will be purchased for health facilities in the fight to protect the Congolese from the coronavirus. (Photo by Crystal Stafford)

LOUISVILLE — Larry Sthreshley, a mission co-worker for more than 30 years in the Democratic Republic of Congo (DRC), once more finds himself on the front lines combating a global pandemic. For years it was Ebola. Now it’s COVID-19.

He directs one of the largest church-run health programs in Africa, assisting the government to provide medical care to more than 9 million people in 870 health centers and 50 hospitals in four provinces of the country.

What impact COVID-19 will have in Congo is a big question.

“The impact is not proportional,” said Sthreshley. “As hard as it seems in the U.S., it’s going to be harder for the Congolese here. On a micro-level, they just don’t have the margin to absorb something like this. They can’t even shelter in place for more than a couple of days without going out and risking their lives.”

The response to the attack is under way.

As of late April, there were 350 identified COVID-19 cases in DRC and 25 deaths. Fortunately, the government took action early to close borders, schools, gathering points of more than 20 people and non-essential stores. These actions are giving the health sector time to prepare.

UKAID has given IMA World Health, a global, faith-based nonprofit, $6 million to provide health facilities with personal protection equipment, messaging for medical staff and the general population on how to protect against COVID-19, and training on how to treat COVID-19 patients who do not need intensive care.

When the government authorizes drug treatments, the funds will be used to supply drugs to the health centers and hospitals in the current ASSR (Health Systems Support Program). Kinshasa, the capital city, is a priority for UKAID, so the COVID-19 response will also include health facilities in Kinshasa, covering 40% of the population. The nine health facilities managed by the Presbyterian Community of Kinshasa (CPK) will receive assistance through this COVID-19 funding.

The experience Sthreshley has in fighting Ebola has been remarkably helpful in planning the COVID-19 response.

“You identify the case, track down contacts and isolate those contacts. We aren’t doing that as intensively with COVID-19,” he said. “We had a big network of people going from home to home, taking temperatures twice a day for all the Ebola contact patients. With COVID-19, we will identify the cases and distribute masks and educational materials to the contacts, but we won’t be going on a daily basis to their homes. That would actually increase the risk, because it’s so much more contagious than Ebola. A lot of things like the hand-washing and other protocols are also very similar.”

In rural areas of Congo, children haul water everyday for household use, which makes hand-washing even more challenging. (Photo by Crystal Stafford)

The population in Congo is very young compared to western countries. About 62% of the population is under 25. Only 2.7% of the population is over 65 years. But there are a significant number of adults with diabetes and hypertension, not to mention the thousands of vulnerable children under five who suffer from acute and chronic malnutrition. The health system is already insufficient. For people living on $2.00 a day, with no cash reserves, a lockdown makes survival more difficult and sheltering in place for many is not really an option.

Sthreshley’s wife Inge’s work centers on nutrition for vulnerable children. DRC has about 1.7 million children six months to five years old who face chronic malnourishment. They have a higher morbidity and mortality rate than other children and are more susceptible to the spread of disease. That makes it all the more urgent to get nutrition messaging that’s widespread. She is working with UN and UK Aid to distribute Plumpy’Nut, a peanut-based paste for the treatment of severe acute malnutrition.

Larry and Inge Sthreshley both felt they could not leave the DRC to return to the U.S.

“This is what we signed up to do. We have more work now. We have to run our old programs and respond to COVID as well. Leaving would interrupt this important work and also be demoralizing to the staff that I’m asking to risk their lives. Inge and I have been preparing for these types of situations most of our lives, whether it is political unrest or disease. We are all set up. If necessary, we could be here for months and not have to leave the house. If we went to the U.S., we would actually be more exposed,” he said.

Their daughter is in Atlanta, and her husband works for the Centers for Disease Control and Prevention, so they have good access to information. Their son is in a rural area of New York but works in an agricultural laboratory where they take turns coming into the office, so he has limited contact with colleagues.

Both Larry and Inge Sthreshley grew up as children of missionaries in Congo. His parents were Presbyterian missionaries who served in the two Kasaii provinces in the south-central region. Her parents were Methodist missionaries who served in Katanga province in the far southeastern section of the country.

Larry Sthreshley’s long experience in Congo as well as his academic training make him a good choice for protecting the public health in DRC. He holds a doctorate in international health systems management from Tulane University, a master’s degree in public health from UCLA, and an undergraduate degree in public health from the University of North Carolina.

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