Care to Kisangani civilians hampered by shifting populations

MSF is continuing to work throughout the city of Kisangani in the Democratic Republic of Congo. Most of MSF activities had to be halted for six days when opposing military forces battled throughout Kisangani. Since June 12, MSF has been able to resume an active role in the health and welfare of the local inhabitants.

Although Kisangani remains relatively calm today, there are fears and underlying tensions that conflict may erupt again in the city. Fortunately there has been some return to basic standards as water and electricity is now available to the city for six to seven hours per day. Estimates are that 50% of the Kisangani residents have access to electricity and water.

The ICRC has identified 563 houses that have been totally destroyed or heavily damaged in both the Tshopo and Mangobo communes.

This figure is expected to rise to 2000 upon the completion of a similar evaluation of the affected zones in their entirety. ICRC is finalising its beneficiary list for the distribution of tents (2 per family), jerry-cans, household utensils and detergent to 10.000 beneficiaries.

However there are dire needs throughout the country.

On Friday June 16, the UN reported that one-third of Congo's population - 16 million people - critically needed food. More than 1.5 million people were displaced and five million were completely or partially isolated from their traditional supply routes

Medical priorities

MSF has established one surgery room and the MSF surgeon has started work.

The team has visited the four of the city's hospitals. Heavily wounded people were brought to the hospitals as soon as the recent conflicts halted. However there are still injured people arriving at the various hospitals every day. Fortunately, the numbers are decreasing.

There are approximately 150 people hospitalised at the current time.

MSF has also been assisting 33 local health centres with supplies of basic health care materials.

Primary health care and emergency preparedness

An MSF local doctor has visited 23 health structures and did not report any increase of epidemic cases. From June 12-18, there were 1,775 consultations with 21 cases of diarrhoea, 16 measles, two cholera, 928 malaria, two typhus, eight suspected cases of meningitis, 94 cases of slight malnutrition, as well as ten cases of severe malnutrition and ten deaths.

ICRC has reported 1,673 wounded, 398 civilians died and 120 militaries.

Internally Displaced Populations

The Internally Displaced Population (IDP) has been decreasing in Kisangani but it seems a large proportion of the IDP are leaving the city, preferring to find temporary shelter in locations to the west north and northwest.

There is a steady flow of people both in and out of the city and so getting an accurate count of the current and departing populations is extremely difficult.

The IDP inside Kisangani reached approximately 12,000 in the days following the end of conflict. However by the end of the weekend of June 17-18, the IDP numbers fell to 5,000.

MSF estimations report that 10-15% of the population of Kisangani has left the city for sites that include:

Kisangani-Buta: 25.000 dispersed along the road (largest
concentration: 150 persons)
Kisangani-Yakusu: 12.800 (1.200 persons in Yakusu); a significant
number of people moved further in direction Yangambi and Yanonge
Kisangani-Biaro: 1553 (biggest concentration at 25 km: 563 persons)
Kisangani-Osio: 9000 (no concentration reported)
Kisangani-Wania Rukula: 5000
total of displaced persons on 17-18 June 2000: 53.353

Within the city there are still 4533 persons displaced over 10 sites.

IDPs outside the city

IDPs outside Kisangani are far more difficult to determine. Reports are of large movements towards the North. Hundreds of people are reported to be on the move every hour. However the numbers are vague and it has proven difficult to start operational activities based on the figures provided.

Nutritional Issues

The food insecurity of the IDPs on the main axes is not believed to be reaching critical dimensions. A fairly large group of IDPs are of rural background and returning to their home communities. The massive presence of IDPs will on a longer term inevitably create additional pressure on local markets and communities that have little absorption capacity.

There are no new instances of malnutrition currently recorded at the MSF nutritional centres. There is no malnutrition yet. MSF has 12 nutritional centres in Kisangani, including five Supplementary Feeding Centres (SFC).

About 750 people attend the Therapeutic Feeding Centres and 1,000 people at the SFC. They increased their capacity for 2500 persons.