Democratic Republic of Congo: MSF's decade of medical action

Fred Meylan, MSF's programme manager in DRC, outlines the achievements of MSF over the last decade.

Has the humanitarian situation in Orientale Province evolved since the first interventions?
First of all, civilians in Eastern Congo, in particular women and children, are the first victims of conflicts. Violent clashes between government forces and militiamen since the end of August 2013 in the Geti area, South Irumu, are the latest evidence: tens of thousands people have now been displaced in this region. When MSF intervened for the first time in Geti in 2006, it was for the exact same reason.

On another level, the magnitude of malaria and measles epidemics that have hit Orientale Province in the past two years underlines the difficulties of access to care for a large part of the Congolese population, and how preventive measures have failed. In some areas, in 2012, a quarter of children under five were affected by measles and more than one in ten died from malaria!

What activities have been set up by MSF in the last 10 years?
The activities carried out by teams have evolved to respond to the most urgent needs of the people. In a decade, a wide range of programs has been set up; from war surgery, mental health and primary health care to support for displaced people, care for victims of sexual violence, response to epidemics, support for emergency rooms and paediatric departments, follow-up of HIV/Aids patients and fight against sleeping sickness.

A few figures may give an idea of the immensity of the challenges faced by the teams in 10 years. More than a million consultations have been carried out in hospitals, health centres and temporary structures set up by MSF in the province. Teams have hospitalized more than 120,000 people and carried out 38,000 surgical interventions. About 12,000 victims of sexual violence have received medical, psychological, socio-economic and legal care. Since MSF became involved in the fight against sleeping sickness, 200,000 cases have been detected and 5,500 people have been treated.

What are the main challenges in implementing these interventions?
In a country like the DRC, making sure people have access to care is a challenge in itself. Responding to the urgent needs of people in conflict situations, for example, has obvious risks. The teams have often worked in extremely difficult situations. Even right now, they are doing remarkable work at the heart of the clashes in Geti. If MSF can still implement medical activities in this area, it's because the two parties to the conflict respect its action as they themselves, or their loved ones, have benefited from the free and quality health care. MSF helps people in danger, irrespective of their religion, ethnic identity, gender or political agenda. For communities, MSF's presence guarantees protection.

In the DRC, logistics are also a major challenge. Without supplies, conducting medical activities would be impossible. In the more remote areas, considered by many as inaccessible, teams set up supply systems to deliver medicines and equipment required for health structures to operate. Medicines, for example, are bought in Europe. It is not unusual for some tablets to be carried by six or seven different modes of transport before arriving at their destination: truck, train, plane, car, boat, motorcycle, bicycle - sometimes in a very short timeframe if the order is urgent.

What activities are currently in progress?
MSF continues to provide emergency response in Orientale Province and is also running projects in Dingila. In Geti, we have strengthened our medical activities to respond to the needs of people recently displaced. Our priorities for 2013 are to reduce in hospital mortality by supporting emergency and intensive care rooms in hospitals in Geti and Dingila, and to fight sleeping sickness in the Ganga-Dingila health zone. In Bunia, an emergency response team is ready to provide immediate help to people in the Uélés and Ituri. MSF continues to respond to the medical needs of people in the province to the best of its ability.