Dr. Jean-Claude Kiluba holds up five fingers. He wants to make sure I understand just how young he was when he was sent from his village in the Democratic Republic of the Congo (DRC) to a boarding school two hours away. “I was five!” he exclaims. “Cinq ans!”
“Were you scared?” I ask.
“No! I wanted to study.”
It’s easy to picture little Jean-Claude striding off to school wearing a new uniform and a big grin. Watching him confer with fellow physicians, counsel sex workers, and laugh with new mothers, he seems to belong everywhere and to everyone.
Jean-Claude has led PATH’s work in Haut-Katanga Province, in the southeast corner of the DRC, for the past eight years. But he’s been serving—and saving the lives of—the region’s people for 20 years, through poverty, epidemics, and war.
When the second choice becomes the best choice
“I like challenges,” says Jean-Claude.
As a child Jean-Claude wanted to be a pilot, but that meant studying abroad, something his family couldn’t afford. His solution? “I went to the university and I asked, ‘What is the faculty or department that is very hard and the rate of failure is high?’ I was told medicine . . . That is why I went to study medicine.”
Medical school in the DRC was rigorous. Only five of the 648 students in his first year went on to become doctors.
But Jean-Claude thrived. “As I began to study medicine, I concluded that it was the best study I’ve chosen,” he says. “I loved it, especially when I was saving life.”
Making sacrifices
In 2000, Jean-Claude became the director of Kenya General Hospital in Lubumbashi, DRC’s second largest city. To the north of the city raged what’s been dubbed Africa’s “First World War.” Nine countries were involved in DRC’s civil war, and more than 5.4 million people lost their lives to violence, malnutrition, or disease.
No one in the DRC was immune. “When the war occurred, my family was separated,” Jean-Claude shares. “My mother hid in the bush, and she got ill. Without care, she died alone.”
The surgery ward at Kenya General Hospital where Jean-Claude operated on more than 1,000 people. Photo: PATH/Georgina Goodwin.
Refugees from the war flooded his hospital. Jean-Claude had only two other doctors, few supplies, and almost no money. Over the course of a decade, he performed lifesaving surgeries on more than 1,000 people.
He says, “I learned that leading a general hospital like this, you must make sacrifice in life.”
Creative solutions
He shares the story of parents who brought in a child with severe anemia caused by malaria. “Without a transfusion, within an hour and a half, the baby could die. I went to the laboratory to ask for blood for my patient for the surgery. We did the blood transfusion and saved that life, but after, the parents could not pay. It is very, very difficult to abandon someone who is suffering because he doesn’t have money.”
He adds, “I could operate for free, but I couldn’t do it without the gloves, without anesthesia, without blood or sutures.”
So Jean-Claude devised creative solutions. He asked for blood donations from surgery patients who didn’t need transfusions and saved it for those who did. He added a little onto the price of prenatal consultations and put it into a fund to cover emergency cesareans.
“I concluded that health services should be free for everyone,” he says.
Why are the patients dying?
Meanwhile, Jean-Claude and his staff were facing a new challenge. Kenya General Hospital was known for being the best place to get care for tuberculosis (TB), but many TB patients were dying despite their care.
“At the time, we didn’t know that they had TB with HIV, because there was no test, no cure, no treatment for HIV, and we didn’t have training,” says Jean-Claude. “We lost many lives. Many lives.”
Jean-Claude and his fellow health workers in the DRC are slowly rebuilding the country’s health systems so no one dies without care from a treatable disease. Photo: PATH/Georgina Goodwin.
In a stroke of good fortune, a team from the prestigious Belgium Institute for Tropical Medicine visited Kenya Hospital. After witnessing Jean-Claude’s struggles and his resourcefulness, they offered him a scholarship to study at the institute. He earned his master’s in Public Health with a focus on HIV.
“Many Congolese who get the opportunity to study abroad don’t always come back,” says Trad Hatton, PATH’s country director for the DRC. “But Jean-Claude never hesitated. He brought this world-class education back to the DRC. It’s another testament to how dedicated he is to his country.”
A hospital transformed
Once Jean-Claude returned, Kenya General Hospital developed a new reputation. Says Jean-Claude, “The story was spread everywhere that in this hospital they are taking care for treatment for TB and HIV. That is why you can find so many people coming here from elsewhere.”
His reputation also reached PATH. In 2009, we hired Jean-Claude to lead the US Agency for International Development’s (USAID’s) flagship HIV project in Haut-Katanga Province. Through the project, called ProVICplus, he continued to transform Kenya General Hospital—and many others in the area—into models for clinical HIV care.
Under his leadership, the project integrated HIV testing, care, and treatment in more than 100 health facilities, in many cases introducing HIV/AIDS interventions and treatment for the first time.
One of those was Sendwe General Hospital. “We used to have people dying every few days,” says Dr. Joe Kabongo, the hospital’s director. “But with the help of Jean-Claude, we are really improving.”
Jean-Claude oversaw a program to prevent the transmission of HIV from mothers to their babies that is so successful that HIV-infected infants are now extremely rare. He also integrated maternal and newborn health services to protect moms and babies from other threats.
And just as Jean-Claude wanted, HIV care and treatment are free for patients enrolled through the program.
How to end HIV
Free treatment is not only about keeping people alive—it’s about stopping the epidemic. Sustained treatment with antiretrovirals suppresses people’s viral load so they can’t spread HIV to others.
That’s why Jean-Claude and his team recruited and trained members of key populations—sex workers, men who have sex with men, young women—to be peer educators. They act as evangelists for HIV testing and treatment.
“Jean-Claude is one of the rare people who understand the full picture of HIV.”— Trad Hatton, PATH DRC Country Director
“Jean-Claude is one of the rare people who understand the full picture of HIV,” says Trad. “He understands what needs to happen in the hospitals and in the streets where people live. The success of this project lays at the feet of his leadership, his passion to save lives, his ability to mobilize people.”
Now Jean-Claude has been appointed to head the PATH-led, USAID-funded Integrated HIV/AIDS Program for Haut-Katanga and the neighboring province of Lualaba. The project aims to bring the HIV epidemic under control in 16 health zones that cover a population of 3.5 million people by using many of the strategies that Jean-Claude and his staff have so successfully developed and deployed.
“When the day comes and we’ve ended the HIV epidemic in Haut-Katanga Province,” says Trad, “I hope that people will remember the role that Jean-Claude played. I know it’s a big one.”