On this month's cover, nurse Elie Kasindi Kabululu cares for a patient at Centre Medical Evangelique (CME) in Nyankunde, Beni, Democratic Republic of Congo. Originally, this CME location served a population of 150,000 and also housed a nursing school; but in 2002, during war in the region, the facility was attacked. About 1,000 people were killed-including patients and staff-and the center was looted and destroyed.
CME rebuilt facilities at three locations (Nyankunde, Beni, and Bunia) and continues to provide medical services and train nursing students. However, it operates under difficult conditions due to inadequate staffing, outdated equipment, and insufficient funding. "There are a limited number of specialists," says Kabululu, and the single ambulance is 10 years old and "timeworn." The hospital is still not self-sufficient "due to the poverty of our patients," he says, adding that, as a result, "We are not able to treat all the patients who come to us for medical assistance." He also notes that the area remains unstable: even nurses and physicians are sometimes kidnapped and held for ransom.
Providing medical assistance in the world's war-torn and neediest areas is commonplace for health care providers like Kabululu, just as it is for humanitarian organizations such as Medecins Sans Frontieres (MSF), which works in 70 countries worldwide-nearly half of these in Africa. Shortly after the recent outbreak of Ebola in West Africa, MSF sent close to 300 international workers to help combat this public health emergency. To read one nurse's experience traveling to Liberia for MSF to work in a treatment center, see "Inside an Ebola Treatment Unit: A Nurse's Report."-Diane Szulecki, associate editor