Burundi: Treating civilians affected by war

Shocking levels of sexual violence MSF's teams in the DRC have witnessed an alarming level of sexual violence in the northeastern province of Ituri. Thousands of women and children, and some men, have been raped as wanton violence escalates. More than 2,500 patients were treated for rape or sexual violence in MSF's hospital in Bunia, the provincial capital, between June 2003 and January 2005. The data show that all ages were affected, from four months to 80 years old.

"What shocks me is that 77 percent of rape victims who presented themselves to MSF in the last six months were raped by two or more assailants," says Rowan Gillies, M.D., president of MSF's International Council, who worked as a surgeon for MSF in Bunia. "I find these figures horrific and disgraceful. And they are only the tip of the iceberg."

He continued, "Rape and gross violations against civilians continue unabated and today we find ourselves unable to reach the victims because of the extreme levels of violence in the area. Each week 40 girls and women who have been raped seek MSF's help in Bunia. Many, many more never reach us."

In the northern province of Karuzi, MSF staff work to ensure quality primary health care in 10 health centers and secondary health care at Buhiga Hospital. MSF provides medicines, training and supervision of medical activities as well as drug and financial management.

The team also implements nutritional activities in the region as needed, providing supplementary feeding to malnourished patients. In the eastern Ruyigi province, MSF offers basic health care. The MSF team supports seven outpatient health centers and two hospitals - the latter located in Ruyigi town and in rural Kinyinya. Activities include direct patient care, waste management, health education and training of local staff.

Since 2000, MSF has operated a basic health care program in Ijenda district in the western, rural Bujumbura province. The MSF team supports 10 public health structures in the province, providing training and supplying medicines. In addition, MSF has started supporting a hospital and two health centers in the Musema region of the northern Kayanza province.

Until the end of May 2005, MSF also provided health care services at Makamba Hospital in the southern province of Makamba. The hospital team supported all major services, including surgery, and provided drugs, medical material and technical expertise.

Helping survivors of sexual violence

Since 2003, MSF has assisted victims of sexual violence in a health center located in Bujumbura, the capital. This center serves both the population of Bujumbura and those living in the region's hills. At the facility, a team provides medical and psychological care to women and children. Other services are offered as well, including family planning and care for sexually transmitted infections.

The MSF team also focuses on raising awareness about rape in the community and educating residents on sexual violence and its consequences. As of mid-2005, approximately 120 victims were being cared for each month. MSF teams provide support to survivors of sexual violence in other parts of Burundi as well, including Ruyigi, Kinyinya and Karuzi.

Assisting people with cholera

In January 2005, MSF reopened a cholera-treatment center in the Kamenge neighborhood of Bujumbura. By February 2005, the number of cholera patients had begun to decrease and MSF closed those activities. However, the center is still treating war-wounded civilians from rural Bujumbura, the country's last province still at war. More than one hundred have been hospitalized there and more than 300 people have received outpatient care. MSF also helps Burundians suffering from other diseases and supports the implementation of appropriate treatment protocols, such as the use of artemisinin-based combination therapy (ACT) for malaria patients.

Helping Rwandan refugees

In early June 2005, MSF began offering urgently needed medical assistance to Rwandan refugees living in intolerable conditions in the Songore transit camp in Burundi's northern province of Ngozi, 20 kilometers from the Rwandan border. The camp, which was built for 800 people, soon held more than 7,000 Rwandans, mostly Hutus, who feared possible prosecution by local genocide courts. The refugees had insufficient water, food and shelter. MSF staff quickly began treating people through a mobile clinic and later a health center.

Rwanda and Burundi dismissed the entire group as "illegal immigrants" despite their requests for asylum in Burundi. Later in June, the government of Burundi began to repatriate by force the inhabitants of Songore camp as well as 2,000 people gathered at other camps. This action emptied the camp within a few days. Denied access to the camp at the start of the operation, MSF and other aid organizations protested strongly against the situation and worked to raise awareness about it.

MSF has worked in Burundi since 1992.