Democratic Republic of the Congo: Another year of misery

Sexual violence is especially prevalent in the region, with more than 2,500 rape survivors treated by MSF's medical teams in the 20-month period between June 2003 and January 2005.

Violence continues to flare in parts of Ituri province, in North and South Kivu provinces, and in parts of Katanga province, while the rest of the country languishes in extreme deprivation, lacking food, shelter and the most basic health care. In the capital, Kinshasa, the in-fighting government manages a "virtual" state, if anything exacerbating the wretched situation in which the Congolese find themselves.

According to estimates, some four million people have died since the outbreak of the civil war. Some have been swept away by the violence, but the great majority have died of preventable diseases such as malaria and measles, far from the apathetic eyes of the outside world.

Violence engulfs Ituri

During the past year, the northeastern province of Ituri has been the epicenter of violence in the DRC. Despite efforts at disarmament and reintegration, principally by the United Nations, numerous rebel groups continue to wage war, rendering large swathes of the region inaccessible to aid workers and destroying lives with their often indiscriminate terror.

Some of the victims are treated by an MSF team working in the Bon Marché Hospital in the provincial capital of Bunia. The hospital offers a full range of medical care including facilities for surgery where MSF regularly treats the war-wounded. Sexual violence is especially prevalent in the region, with more than 2,500 rape survivors treated by MSF's medical teams in the 20-month period between June 2003 and January 2005 (see box).

As tensions have escalated among Ituri faction groups fighting for control of resources, the ensuing attacks, rapes and mass killings have prompted tens of thousands of people to flee to Djugu territory. MSF carried out an emergency intervention in four displacement camps in Tchomia, Kakwa, Tche and Jina, helping more than 70,000 civilians gain access to medical care, water and sanitation. When cholera broke out in the area, MSF was able to recognize and control it quickly, treating more than 1,400 people with the illness.

August 2, 2005, MSF announced that it had decided to close its projects outside of Bunia as a direct consequence of the abduction and the ongoing insecurity in the area. More than 100,000 people had been benefiting from this assistance.

Two MSF staff abducted

On 2 June 2005, two MSF staff members - a logistician and a driver - were abducted by armed militiamen as they traveled to the Jina displaced persons camp 35 kilometers north of Bunia. The incident forced MSF to suspend its mobile clinics outside of Bunia and to evacuate those teams. However, the Bon Marché Hospital in Bunia continued to provide all of its services.

On 11 June, MSF was able to secure the unconditional release of its staff members. Various communities in Bunia and Ituri showed a great deal of support for MSF during the incident and mobilized massive assistance to urge the aid workers' release.

However, on 2 August 2005, MSF announced that it had decided to close its projects outside of Bunia as a direct consequence of the abduction and the ongoing insecurity in the area. More than 100,000 people had been benefiting from this assistance.

Insecurity leads to decreased aid

Insecurity is also widespread in the province of North Kivu, in the far eastern part of the country, which borders Rwanda and Uganda. The looting of an MSF base in the village of Kibati on 19 January 2005 by armed and uniformed men left MSF with no choice but to suspend and later close its therapeutic feeding program in the area, where it had treated more than 10,000 children since 2002.

The 63 malnourished children who were receiving treatment at the center when it closed on 8 April were transferred to the therapeutic feeding center in Kitchanga for continued care. This suspension came only weeks after another MSF project was suspended in the nearby Masisi and Rutshuru territories due to a similar security incident.

Around the town of Beni, MSF teams are providing shelter, water, sanitation and health care to displaced people from Ituri. They carried out 98,200 medical consultations and treated 150 victims of sexual violence in this area during 2004. In the towns of Kanya and Kanyabayonga, MSF teams admitted 1,300 severely and 5,000 moderately malnourished children into its programs during 2004.

In September 2004, the MSF team started a health program for victims of sexual violence, through which 124 patients have received treatment. Since June 2005, the team has supported Kanya's hospital, including the surgical department. Teams have also organized mobile clinics and responded to health emergencies such as cholera outbreaks that occurred in Virunga Park, Goma and Buhimba.

In South Kivu, which has enjoyed a period of relative calm since the last spate of violence in June 2004, MSF is providing health care in the villages of Shabunda, Baraka and Fizi.

Nine years ago, MSF created a Congo Emergency Team to provide fast emergency relief to meet sudden needs. Today, such teams are based in Kinshasa, Kisangani, Lubumbashi and Mbandaka. They react to urgent events such as outbreaks of measles, whooping cough, plague or cholera. They also help displaced people and those affected by natural disasters.

 

A lack of care in Katanga

MSF focuses its work on health care for displaced people in the southeastern province of Katanga where clashes between militias and the newly unified Congolese army (FARDC) continue to wreak havoc. Working in nearly a dozen towns, MSF is providing a wide range of services including primary and secondary health care, treatment for malnutrition, emergency surgery, mobile health care, long-term tuberculosis treatment and care for victims of sexual violence. In August 2005, MSF opened a new program in Mukubu when the resumption of hostilities resulted in the displacement of 15,000 people.

Other emergencies

Nine years ago, MSF created a Congo Emergency Team to provide fast emergency relief to meet sudden needs. Today, such teams are based in Kinshasa, Kisangani, Lubumbashi and Mbandaka. They react to urgent events such as outbreaks of measles, whooping cough, plague or cholera. They also help displaced people and those affected by natural disasters.

Treating those with AIDS

MSF teams have continued to increase access to comprehensive care for those living with HIV/AIDS in the DRC. In the town of Bukavu, South Kivu, MSF was providing 331 patients with antiretroviral (ARV) medicines by April 2005. The team hopes to have 900 patients enrolled in the treatment program by the end of 2005. In a second HIV/AIDS project, in Kinshasa, 870 patients had received ARVs from MSF by the end of April 2005, and the team aims to increase that number to 1,700 by the end of 2005. MSF had also monitored nearly 3,000 patients in less advanced stages of the disease in Kinshasa by spring 2005.

In early 2005, MSF started a new project aimed at treating commercial sex workers who have HIV/AIDS with ARVs. The treatment of sexually transmitted infections is also a priority for MSF teams and is integrated into basic health care projects across the country and in a targeted center in Kisangani, a city in the Orientale province of the DRC that bore the brunt of fighting during the civil war and retains a large military presence.

MSF also runs a specialized clinic to treat people with sexually transmitted infections in Kitchanga in North Kivu, and operates three such clinics in Bukavu, South Kivu.

Care for those who have none

An outbreak of the plague - an apocalyptic but easily treatable disease that last struck Europe more than a century ago - claimed more than 20 victims some 200 kilometers north of Kisangani in January 2005. Moreover, sleeping sickness (African trypanosomiasis) which was virtually wiped out by missionaries in the 1950s, has returned with a vengeance, because little is being done to control the flies that transmit the disease, and because many displaced people live in the forests where they breed. To help reduce the disease's prevalence, MSF has opened a new testing and treatment project in Isangi, one of the most affected areas.

In Equateur province, MSF supports clinics in nine health zones comprising 800,000 people. In late 2004, a team concluded a measles-vaccination campaign for more than 600,000 children under 15 years of age. The campaign took more than a year to complete because many villages could be reached only by dug-out canoe.

Despite successes like this one, thousands of people die due of treatable diseases such as malaria and measles or because of inadequate health care. Avoidable illnesses are regularly lethal when the nearest health center is far away. Like the violence in Ituri, lack of health care is the sad reality of life in the DRC, a land where people continue to die of mass neglect.

MSF has worked in the DRC since 1981.

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