The Doctor Who Couldn't Leave Goma: A Story of Unwavering Resolve in the DRC

Dr. Thierno Balde, a 44-year-old physician from Guinea, found himself at the heart of the humanitarian crisis in Goma, the capital of North Kivu in the eastern Democratic Republic of the Congo (DRC), leading the World Health Organization (WHO)'s response amidst intense conflict and disease outbreaks. His story is one of profound personal sacrifice and a steadfast commitment to aiding populations in peril, even when faced with immediate danger and overwhelming challenges.

The Fall of Goma and a Reluctant Departure

In the days preceding the fall of Goma, Dr. Balde faced an escalating crisis, sleeping with a helmet and bulletproof vest beside his bed as shells frequently rattled his hotel walls. Gunfire was a nightly occurrence. Despite clinging to hope that the besieged city would endure, an evacuation order came in late January, necessitating his immediate departure along with other international staff. He recounted taking "the last flight out". Just hours after his evacuation, Goma fell into the hands of the M23, a Tutsi-led rebel group reportedly backed by neighbouring Rwanda.

For most, this would have marked the end of their involvement, a narrow escape from a mission cut short. However, as his aircraft departed, Dr. Balde was already determined to return.

An Insistent Return to the Eye of the Storm

Back in Dakar, where he serves as the head of the WHO emergency hub for West and Central Africa, Dr. Balde grew increasingly restless. Reports of civilian massacres from North Kivu deeply affected him, and the thought of his colleagues left behind haunted him. His conviction that his place was with them only deepened.

Just two weeks later, on his 45th birthday, he was appointed to lead the WHO's response in eastern DRC. To spare his parents dread, he kept the assignment secret until he had already arrived in the country. His wife and two children, accustomed to his frequent departures for dangerous crises, learned to live with his absence.

Goma in Ruins: A City Under Siege and Disease

Reaching Goma was a five-day journey, with the airport closed and roads dotted with checkpoints. The city he found upon his return was profoundly changed, described as "hollowed out". Power lines were down, hospitals were overwhelmed with casualties, and there were reports of bodies littering the streets. A pervasive fear had settled over the inhabitants, likened to ash after a blaze.

Dr. Balde's team of about 20 Congolese staffers was exhausted from their efforts to maintain the fragile health system. Recognizing their immense strain, he granted half of them time off, despite the critical need for every available hand. Amidst the devastation, a small stroke of luck emerged: unlike other UN agencies, the WHO warehouses remained untouched by looting, becoming crucial lifelines for fuel, surgical kits, and communication devices for emergency coordination.

The immediate aftermath brought crushing numbers, with initial reports indicating as many as 3,000 dead, necessitating intense burial efforts within a specific timeframe. The WHO even engaged local gravediggers to collect the corpses.

On the very day of Dr. Balde's return, a new threat emerged: cholera. The first cases were confirmed in a MONUSCO camp, where hundreds of disarmed Congolese soldiers and their families had sought refuge. The camp's inadequate sanitation conditions, designed for peacekeepers rather than a large civilian population, allowed the disease to spread rapidly. Dr. Balde recalled seeing 20 to 30 patients with only one doctor, and two individuals already deceased. His team tirelessly worked to contain the outbreak using chlorine, protective gear, makeshift triage, and quickly recruited and trained staff, with vaccines rushed in from Kinshasa. Rumours of an "exploding" cholera situation and the WHO being "overwhelmed" further complicated matters. The ghost of the 2010 Haiti cholera outbreak, where the UN had played a role, loomed over his decisions.

Compounding the crisis, Mpox, previously confined to displaced persons' camps on Goma's outskirts, began to spread into the city itself after these camps were emptied during the fall of Goma.

Negotiating with Rebels for Humanitarian Access

The challenges extended beyond public health, encompassing security and access. One afternoon, armed men – whose affiliation was unclear – barged into the WHO compound. Although staff managed to de-escalate the situation, the incident highlighted the critical need for an understanding with the de facto authorities.

Demonstrating immense courage, Dr. Balde sought out the M23 rebels, who had taken control of the North Kivu governor’s offices. Presenting his WHO "Incident Manager" card, he emphasized that diseases like Ebola and cholera affect everyone, and the agency's sole purpose was to contain them. This paved the way for a fragile but functional channel of communication.

The Enduring Cost of Altruism

Dr. Balde's time in Goma came at a significant personal cost. Days blurred into a relentless cycle of fevered meetings, and evenings were spent in solitary hotel rooms, often with heavily armed men dining nearby. During Ramadan, under a city-wide curfew, he broke his fast nightly with the same simple meal, amidst the city's trembling uncertainty.

Upon his return to Dakar two months later, his blood tests revealed the toll on his physical health. He described it as a "real personal sacrifice," acknowledging the often-overlooked mental health strain on humanitarians.

A veteran of numerous disaster zones, including post-earthquake Haiti and the Ebola outbreak in Guinea, and an associate professor at the University of Montreal, Dr. Balde has confronted many emergencies, including COVID-19, since joining WHO in 2017. Yet, he admitted that Goma left a uniquely profound mark. "I did everything I could to go back, but I paid a price," he stated. His family also bears this price, understanding that their father disappears into places where the world is "breaking apart". Despite the hardships, one sentence encapsulates his unwavering resolve: "I had to be there".

The situation in eastern DRC continues to be marked by insecurity and humanitarian challenges, with the crisis increasing the risk of diseases like mpox. The UN Security Council recently heard that diplomatic efforts have not yet improved the dire security conditions on the ground.