CONGO ENCOUNTER

by Dr. James G. Diller

The usual hot, Congo afternoon had settled around us. I could almost feel the weight of the day: the heat, the dust, the parched earth and vegetation on every hand.

The dry season had become a familiar part of the life at Nyanga where I had come with my family in 1957 to be the "munganga" at the tiny hospital and clinic of the Congo Inland Mission. There, I and one nurse represented the sole source of modern medical aid for 35,000 people.

I was a medical missionary, young and enthusiastic, not long removed from the lecture rooms of Ohio State. The compelling force behind my work in the Congo was both spiritual and humanitarian part of a widely shared effort to help the whole man, not just to cure his illnesses. But recently my zeal had waned, the basic problems seeming greater than I had anticipated.

Despite the smiles, warmth and friendliness of my patients, some of whom would walk or bicycle 80 miles for help, I had sensed a reserve that no effort of mine seemed able to penetrate. On several occasions, relatives had taken critically ill patients back to their village for ceremonial native rites rather than entrust them to me for further medical treatment.

It was not a matter of respect. There was enough of that, I knew, for modern medical science commanded a certain awe by its effective results in injury and disease.

There had been ample opportunities for dramatic work thanks to the primitive conditions. For example, on two occasions we removed nearly half a jaw and another time amputated an arm with only novocaine local and regional anesthesia. More than one Caesarean section was completed by flashlight during my first months at Nyanga. I will never forget the wonder-struck faces of the usual audience of curious onlookers while I performed the first blood transfusion ever done in that area. I remember especially the large crowd that assembled in Kasonji when I was the government’s appointed coroner for the investigation of the murder of their chief. The autopsy was done in the open air before the assembled 300 villagers!

But on this particular afternoon while uncrating a shipment of supplies from Ohio, I was wondering again what or how long it would take to gain the complete confidence of these people. There was only one incident I could recall when I had come close to reaching my patients as fully as I knew I had to, if my work was to be as meaningful as I wished it to be.

It had come at the end of a long day of operating and seeing patients. We were just finishing the evening meal when we heard excited voices at the door. A man had been brought to the hospital ill from snake-bite.

My short experience in the Congo at that time had already taught me that most snake bites were from vipers and were not lethal. The snake venom caused protracted local pain, swelling and finally ulceration despite the promptness or method of treatment. I felt compelled to respond to the call even though many times the urgency had been needless.

I pedaled rapidly over the dirt path to our hospital. There, staggering between two tribesmen, was a tall muscular native. I told his helpers to place him on our wooden examining table. When I asked him where he was bitten he answered with thick slurred speech. The bite was on his right foot but it no longer pained him. His eyes tended to drift apart and he seemed terribly feeble. His extremities were cold. He had no apprehension and was unaware of his rapidly deteriorating condition.

This was not the usual snake-bite patient and the symptoms spoke of a toxic substance on the heart and nervous system.

I decided to use multi-valent snake venom anti-serum and injected it rapidly. After observing the patient for several minutes it became obvious he was only losing ground. Then slowly I administered an ampoule from our small supply of cobra anti-serum. Within two minutes the patient's pulse quickened and was stronger. His eyes focused and his speech returned to normal.

The astonishment and gratitude displayed on the faces of my Congolese friends was scarcely greater than that I felt myself. They exclaimed they had never heard of nor seen anyone saved from the deadly bite of the cobra. And having seen the shadow of death upon this man, I understood their respect for the cobra.

They told tales of cobras racing upright at a speed faster than a man could ride a bicycle. It was reported that the serpent's bite could kill within 15 minutes. It was a fact that a year prior to our arrival at Nyanga, a native girl died at the river’s edge, less than 1/2 mile away, before she could get help from the mission station.

With thoughts like these on my mind I hadn’t gotten very far in unpacking the crate from Ohio. But I had been active enough to attract a group of six or seven lads who wanted to see what was in the big box from "mputu" the Kipende word for anywhere outside the home tribal area. The boys looked on from outside the open porch, over and around the 4-1/2-foot wall near my parked bicycle.
Suddenly there was a shout of "Toka!" — cobra! At once every child fled from the wall to a safe distance. I looked around and saw, peering over the wall, the tapered gray-green head of a mamba, an unhooded cousin of the cobra. His neck was thicker than a large man's wrist; his head movements were slow and deliberate as he took in the scene by sight and smell.

The houseboy at once slammed the kitchen door, leaving me outside. Our little girls, Jan and Collete, were playing on the other side of the house. In a matter of seconds I was very much alone with the cobra, which studied me leisurely and then sank out of sight behind the wall.

What happened next was just as unpremeditated as it was decisive.

In my hand I held a solid four-foot slat that I had just pried up from the crate. At any moment my children might come around the house to see what the excitement was about. I was vividly aware of everything I had ever heard about this terrifying reptile and in a memory flashback I saw my muscular African moribund from his cobra bite.

I thought of shouting to the houseboy for my .22 rifle but quickly gave up the idea. I was not a marksman and wounding the cobra would only bring instant retaliation on his part.

Finally I steeled myself to look cautiously around the corner of the wall.
The snake was studying my bicycle. He arched his huge body and slid his head exploringly between the spokes of the shiny wheel. At once, without further thought, I smashed his back against the stone wall with the heavy slat. Crippled, the snake thrashed around viciously for several hours and finally died. Even though it was obvious the eight-foot reptile was dead, no one would touch it.

And then the miracle that seemed unattainable began taking place.

Word that the "munganga" had killed one of the superstitiously dreaded "tokas" and a huge one at that spread with the speed of a jungle telegraph. All the next day we had visitors investigating this rumor and confirming the identity of this deadly reptile.

According to the African mind, every unusual happening or illness results from interaction between the spirit world and their living descendents. So the native populace was speculating on the significance of the new healer's ability to destroy a cobra, and were readjusting my status in that light.

On the second day an old, wizened man with an authoritative bearing came to our door. His golden-knobbed cane, crimson cap and many bracelets showed he was a chieftain. Our wash boy, Kiyonga, excitedly whispered that this was Fumu Nyanga, the most influential, wealthy, and wicked chief in this part of the country. He was also a witch doctor to his people, and had kept himself distinctly aloof from the hospital and mission.

Now he was here asking for the cobra's head for his medicine bag!

To present it to him might be a means of bringing him on closer terms with the mission. On the other hand, it might appear to him and to all as an act of surrender to his demands. The decision seemed of momentous importance for the future of my medical work in Nyanga.

I realized I had to keep the cobra's head, and that was the turning point.
As the number of my patients began to grow, it was clear the cobra’s head was able to do for me what nothing else had done. It meant more to my Congolese patients than any amount of diplomas on the wall. It was a symbol of the power of medicine in its simplest terms: something the people could accept without question, something they could respect and trust completely.
In my mind the whole event was part of the providence of God in making me one with these people I wanted to serve.

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About Dr. Diller

No one has to tell Dr. Diller about multi-tasking; he was living it long before the term existed. The retired reconstructive surgeon was practicing plastic surgery in Toledo while he was a fellow of both the American College of Surgeons and the American College of Plastic and Reconstructive Surgeons. Years later, as former president of the Academy of Medicine of Toledo, he didn’t allow a quadruple coronary bypass to halt his work; he began a new career as medical director of several HMOs and PPOs, including Aetna Health Plans and MedChoice. His subsequent fellowship with the American College of Physician Executives and his certification in the American Board of Medical Management were simply a few more steps in a professional journey.

The journey began for the Michigan native with a bachelor’s degree from Wheaton College and medical degree from Ohio State Medical Schools, with specialization at the Institut de Medicin Tropicale in Antwerp, Belgium. He’s quick to point out, however, that what he terms his first career began as a medical missionary in the then-Belgian Congo. His experiences there inspired his later organization of medical mission trips to Haiti, which by 1982, found 80 people working at several Haitian sites and attracted national attention via CBS’s Charles Kuralt.

The Dominican Republic was the next field of operation for Diller’s medical missionaries; since 1990, they’ve been joined during spring break by medical students of the then-Medical College of Ohio, now The University of Toledo College of Medicine. Partnerships with the Solid Rock Mission and other Midwest mission teams resulted in some 50,000 patients seen, 3,500 surgeries performed and 3,000 malnourished children helped by 1998. A school built in 1995 enrolls over 1,000 K-12 students. Even the devastation of Hurricane George in 1998 didn’t stop growth, which most recently is focusing on a new teaching hospital in the poorest sector of the Dominican, with special emphasis on reducing the twin scourges of maternal and infant mortality.

Now a medical consultant, he’s been honored with awards that include the Service to Humanity Award from the Sertoma Club, the Voice of Conscience Award from Aetna and most recently, Health Advocate of the Year 2006 from ProMedica. And, of course, there’s the Diller Foundation, created to provide a more effective international distribution system of medical supplies and equipment to countries that need them most.  Diller serves as chairman of the board of directors.

James and his wife, Jean, raised five children and from their home in Ann Arbor, Michigan, are enjoying their seven grandchildren.