Dr. Frederick Zuspan, Chairman of the Department of Obstetrics/Gynecology at the Ohio State University College of Medicine, participated in an informal medical exchange to Zaire. He was located at the Tchi Kagi Hospital, a regional bush hospital near the capital of Kananga. While the hospital is considered one of Zaire's most modern, it would compare with an understaffed and poorly-equipped US hospital of 80 or 90 years ago. Despite the chronic understaffing and primitive medical equipment, results of medical intervention are good. The incidence of postoperative infection is surprisingly low, and Dr. Zuspan emphasized the excellence of the missionary doctors, as well as the general hardiness of the population. He noted a high incidence of tetanus, especially among babies. In the cities, pregnant women are given 2 doses of tetanus toxoid as prophylaxis, and the midwives are encouraged to cut the umbilical cord long and to refrain from the custom of packing the cord with manure or dirt. The latter practice greatly increases the risk of neonatal tetanus. Cervical cancer is common, as are gonorrhea and pelvic inflammatory disease. The high incidence of infertility seen is thought to be associated with gonorrhea and PID. Cancers of the breast, colon, and endometrium are rare. Toxemia of pregnancy is also rare, a surprising finding, since the maternal diet is often protein deficient. It is speculated that the custom of long naps in midday may increase uterine blood flow, preventing toxemia.