International staff: 26
National staff: 35
The people of Congo-Brazzaville have been deeply affected by a civil war largely hidden from the outside world. MSF put the war on its list of top ten underreported conflicts of 1999, and teams working there are committed to drawing attention to the violence inflicted on the civilian population. The organization's work in the country constitutes one of its biggest emergency programs.
Raging off and on since 1997, the war has lead to the destruction of many public facilities, including health centers, dams, electrical sources and bridges. Almost all essential services - including health care - have collapsed, and access by NGOs to much of the south was cut off.
A terrifying road into the forest - and back again
Fighting between government forces and militia ("Cobras") and the rebel militia ("Ninjas" and "Cocoye") broke out anew in December 1998. In a desperate bid to flee the fighting in the capital, Brazzaville, many thousands of people fled into the forests south of the city. There they were frequently victims of violent acts, deprived of food
and cut off from all humanitarian aid.
At one point, more than a quarter of the country's population was estimated to be on the move, without shelter, food or medical help. The humanitarian consequences of the fighting, destruction and subsequent flows of people have been predictably devastating.
The current MSF presence in Congo-Brazzaville dates to February 1999, when the organization was confronted with the arrival of many thousands of shocked people who had lost everything and were in a desperate state of health.
The MSF mission first took charge of cholera cases in northern Brazzaville, where many displaced people had fled. April 1999, the organization began supplementing the medical services provided by Makelekele Hospital in the areas of emergency treatment, pediatric care and nutrition.
To cope with the nutritional emergency, MSF set up four therapeutic feeding centers (TFCs) in Brazzaville to care for children suffering from severe malnutrition. During the second half of 1999, MSF volunteers cared for more than 8,000 severely malnourished children.
By May 1999, many who had fled began making their way back to Brazzaville. By February 2000, more than 250,000 people had returned. During the greatest wave of the return of the population, MSF teams worked in the "Sports Center," the "Station" and Nganga Lingolo, a city suburb that was a key transit point for returning people. Returnees gathered in these areas, where they underwent medical checks. MSF assessed their nutritional health and directed the sick to a hospital or a nutrition center.
Witnesses to the horrors of war
In the hope of finally alerting the world to the underreported emergency plaguing the country, in October 1999 MSF published a document entitled "Story of a Hidden War," which uses firsthand accounts and medical information to expose the violence done to the civilian population.
MSF collected testimonies from some of the victims, who were subject to gross human rights violations and deplorable living conditions while they hid in the forest or tried to make their way home.
A nine-year-old boy named Cedric recalls: "We were going back to Brazzaville when we came across soldiers very early in the morning. I heard shots, my daddy fell to the ground, my aunt too, and I felt a bad pain in my foot." A 19-year-old girl told MSF: "A group of us came out of the forest. When we reached the military roadblock at Makana, the men were separated from the women. In the queue, they chose me and put me in a room. When I tried to escape they fired shots at my feet. Luckily they didn't hit me. Five men raped me."
Through its work at Makelekele hospital, between May and December 1999 MSF counted 1,600 women who had been raped. After long negotiations with the health authorities (in a country where abortion is illegal and the official HIV rate more than 7%), MSF was able to put into place a program to care for women who had been raped, with a focus on STD and AIDS prevention.
"Normalization" in some areas
In late 1999, the security situation had slightly improved, and MSF was able to begin medical and nutrition work in the region of Pool, which surrounds the capital. Programs also began in Kinkala, and a few months later in nearby Mindouli. In March 2000, MSF began medical and nutritional work at the hospital in the town of Sibiti, on the way from Brazzaville to Pointe Noire on the west coast.
Also in the spring, MSF launched a basic curative and preventive health care program in the northern part of Niari region, controlled by the opposition. MSF hopes to reestablish basic health care for 60,000 people in the area, which had previously been cut off from the rest of the country by three years of war and inaccessible for security reasons.