DRC: Giving voice to untold human suffering

Years of conflict in Democratic Republic of Congo (DRC) have led to one of the most devastating human crises of our era, with millions of deaths and displacements of people linked directly or indirectly to the conflicts. Yet the continued suffering of countless Congolese goes largely overlooked.

For this reason, MSF, active in the country (formerly called Zaire) since 1981, has issued several reports and collections of personal accounts of Congolese civilians in an attempt to bring to light the dire health emergency caused by years of war. The following pages give excerpts from the MSF book Quiet, We're Dying in which a number of Congolese describe what their lives have been like in their own words. Another collection, The War was Following Me: Ten Years of Conflict, Violence and Chaos in the Eastern DRC, is available online at www.msf.org.

Despite a series of peace talks aimed at ending the war, conditions have continued to deteriorate for much of the civilian population. Millions have been forced from their homes by fighting: around 2.3 million inside the country and nearly 350,000 in neighboring countries. Since 1998, the deaths of over 3.5 million Congolese can be attributed to the conflict.

The country's infrastructure has effectively collapsed and very few people have access to decent heath care, due not only to the lack of medicines and health staff, and transportation problems, but also to the widespread poverty.
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MSF maintains medical aid programs in both government and rebel-held territory in the face of wave after wave of bitter fighting. MSF teams work daily with victims of violence, people suffering from malnutrition and diseases such as measles, diarrhea, cholera and meningitis, and also deal with occasional outbreaks of polio, Marburg disease and bubonic plague.

Life is especially precarious for those forced from their homes by the fighting. Conditions are most severe in eastern Congo, where rebel forces and other armed groups remain highly active. Unfortunately, continued offensives by armed groups make it extremely hard to reach affected civilians, who have often fled deep in the bush where there is high insecurity and access is extremely difficult.

MSF teams use all possible means to reach them, traveling through the jungle by motorbike and canoe when necessary. The condition of the people is shocking: lack of food and health care, and extreme violence, including rape, continue to cause misery and loss of life on an unprecedented scale. MSF cares for displaced people in Kitenge (Katanga province) and Kitshanga (Nord-Kivu province); work in Sicotra IDP camp outside Kinshasa was turned over to an Italian NGO in March 2002.

MSF's support for health posts and hospitals in two dozen health zones also benefits the displaced, as well as local residents. In some areas, MSF provides the only medical service available. In Nord-Kivu, MSF is also running two therapeutic feeding centers and seven supplementary feeding centers.

Epidemics thrive in this environment of insecurity and collapsed health systems, and much of MSF's work in the DRC revolves around emergency preparedness and response with teams and stocks prepositioned in key locations throughout the country. In November and December 2001, MSF, in collaboration with the Ministry of Health and another NGO, responded to a meningitis outbreak around the eastern city of Bukavu with treatment and vaccinations. MSF teams worked on both sides of the front line in Katanga province when yet another cholera epidemic broke out in October 2001. By late August 2002, MSF had treated over 14,000 cases.

HIV/AIDS is a problem in Congo to which little attention has generally been paid. MSF runs a pilot program in Bukavu, providing voluntary testing and counseling, and treatment of sexually transmitted diseases (STDs) and opportunistic infections. Since 1995, similar programs have been in place in 22 health centers in the capital Kinshasa, 20 in Katanga province and 15 in Equateur province. Over the next year, MSF hopes to expand the Bukavu and Kinshasa programs to include antiretroviral treatment.

International media attention turned to DRC on January 17, 2002 when Mount Nyiragongo volcano erupted, destroying almost a fifth of the heavily populated town of Goma. MSF, already present there, participated in the response by providing clean water to people fleeing into nearby Rwanda. As they returned, MSF undertook a measles vaccination campaign for 87,000 children to prevent an outbreak in this already weakened population. MSF continues to monitor the region for signs of cholera, measles and meningitis.

International staff: 84
National staff: 814