In the Democratic Republic of the Congo, where as many as half the children die before their second birthday, two capsules of vitamin A per year can help stave off the ravages of malnutrition, malaria and diarrhea. But such nutritional supplements were rarely available there - until a Carroll County-based relief organization launched a project to revamp the nation's failed health care system.
One of the benefits of Interchurch Medical Assistance's project, paid for by a $25 million federal grant, is that 90 percent of the children served by 86 clinics scattered throughout the central African country received doses of vitamin A last year, organization officials reported recently.
IMA, a faith-based organization in New Windsor, also has been able to bolster or, in some cases, re-establish clinics in about a quarter of the country, which has been devastated by civil war, political instability and a crumbling economy for nearly 10 years. Halfway through the grant's four-year term, the money is being used to help to supply clinics, train health care workers, immunize children and institute educational programs.
"There are no miracles after only two years, but I definitely have hope," said Dr. Leon Kintaudi, a Congolese physician who oversees the program from offices in Kinshasa, the capital.
Kintaudi and Dr. Frank Baer, a former missionary to Congo who serves as an adviser to IMA, met in New Windsor this month to review progress and chart the future. The doctors also prepared for a 10-day national health care conference in Kinshasa next month - the first such gathering in 15 years. The theme is "rebuild."
"Without this help, the health zones would collapse completely," said Kintaudi. "The economy has begun to recover, the government is now one, and the peace process is moving along."
Dr. Bill Clemmer, an American Baptist missionary who has worked in Congo for the past nine years, described the dire conditions that existed before the IMA project. Scattered hospitals remained open but could care for only a few patients, he wrote in an e-mail this month from Africa.
Clinics lacked medicines or vaccines to cope with common illnesses. Epidemics spread as displaced populations lacked access to clean water and other basic needs.
The grant has helped revive what once was Africa's model of health care, a system of health zones and clinics - many staffed by American missionaries - throughout the country.
The organization funded by the grant "has primed the traditional Congolese health care system" and helped pay for medicines and equipment, Clemmer wrote in the e-mail.
IMA has been active in African relief since its founding 43 years ago and has a vast network of missionaries working throughout the continent. About a dozen Protestant denominations support the effort.
IMA's administrative offices are at the Brethren Service Center in New Windsor in northwestern Carroll County. The center operates a worldwide relief effort from its warehouses and offices there. On a stop at the center in December 2001, President Bush visited what he called "a warehouse full of love and decency."
Paul Derstine, IMA director, helped plan the rebuilding conference in Kinshasa with the visiting doctors. The event will focus on proven strategies to improve health care, some as simple as bed nets for pregnant women and young children to reduce malaria and others as far-reaching as prenatal care.
Participation in prenatal clinics staffed by trained personnel has increased by as much as 60 percent in the past two years and led to a decrease in maternal mortality rates that numbered in the tens of thousands annually, Kintaudi said.
"Things have improved dramatically in the last two years," said Baer. "We can't measure the impact overnight, but there definitely has been an increase in the return to health services."
A severely impaired infrastructure, sporadic communication and transportation remain obstacles in a country that is about the size of the United States east of the Mississippi River, but has few paved roads and considers a river its national highway.
"I cannot imagine how difficult it is to function in a country with such uncertainties," said Derstine. "We are very pleased with the program so far and proud of its ability to reach remote areas."
Clemmer often delivers supplies by plane and sometimes into pockets of continuing war. He usually recounts his trips by e-mail to IMA officials.
His most touching accounts are those of the young children orphaned by the war and taken in by local families.
"The illuminating smiles that come readily to their faces may not erase the memory of lost parents, but they encourage us to persevere in our work," he wrote.
Although Bush did not include Congo on his recent five-nation tour of Africa, the trip and the president's message are heartening, Kintaudi said.
"To hear the voice of someone like the president saying 'I can help' is good and very important," Kintaudi said.
If he could say anything to the American public, Kintaudi said it would be: "Never let this [program] die. It is something that is growing and so much more could be done."