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Voices From the Field: Masisi, Democratic Republic of Congo
October 1, 2007
The Doctors Without Borders/Médecins Sans Frontières (MSF) team in Masisi in the Democratic Republic of Congo's North Kivu province is comprised of 100 Congolese and 5 international staff, works in the 120-bed hospital and a health center. They offer surgical care to war-wounded, as well as general health care and nutritional support to displaced people and the local population. Anne Khoudiacoff, 29, is a Belgian nurse who arrived in DRC in early October. Here she describes her work.
What does the MSF team do for people wounded in the fighting?
When there is fighting, like there was recently near Masisi, we try to treat the many wounded people who arrive at the hospital in a very short time. Since the end of August, our surgeon and anesthetist have performed surgery on 145 patients with bullet wounds. I remember one woman who was caught in the crossfire at the beginning of October. She was carrying her child on her back, but miraculously neither she nor the child was badly hurt. The bullet passed between her spine and her baby's head. It caused a deep burn on her back but the medical team was able to treat her. I've also seen several civilians who have been shot in the leg and were taken to the surgical ward.
In addition to the war victims, the health needs are also huge among the displaced and the local population.
Since the end of August, when the MSF team started working in Masisi, the hospital's various departments have worked at full capacity. There are many cesarean sections — up to 20 per week — and other obstetrical problems. The health center that MSF supports carries out an average of 1,000 consultations a week, mainly for malaria, respiratory and urinary infections, diarrhea, and malnutrition problems. There are a number of reasons that we see so many patients. First, the care MSF offers is free of charge. Second, a number of the region's health posts have been closed, either because the staff has fled or because these structures have not been supplied with drugs. Patients come from far away and often walk for several days in the hills, where they risk meeting various armed groups, to get to the MSF clinic. Many people arrive at the hospital in critical condition.
What are the living conditions like for the displaced people in the Masisi region?
There are an estimated 24,000 displaced people in Masisi and in the neighboring localities of Lushebere and Buguri. Most of the time, they are hosted by families who give them some wood and reeds and the men then work to build some kind of temporary makeshift shelter for their families. For this reason, we often see women alone with their children at the hospital. I have seen a number of houses where 10 or 12 persons had to sleep in spaces of about 16-square meters (52-square feet). Host families share kitchen utensils, jerry cans or food, but we can see that both the displaced and the local population are increasingly struggling. It's the rainy season now and torrential rains are a daily occurrence. At an altitude of 1,600 meters (5,200 feet), the nights are cold. In our consultations, we see a number of people with pneumonia, flu, but also diarrhea, cases of dehydration and of malnutrition. All this suggests that these people live in extremely precarious conditions.
Is malnutrition a problem in Masisi?
At the moment there are 40 children suffering from severe malnutrition in the nutritional center of the hospital, which is run by a partner organization. Last week, MSF conducted a rapid nutritional assessment among 1,000 children under five years of age in Masisi and Buguri, based on the measurement of their arm circumference. This assessment indicates that about 10 percent of these children are suffering from malnutrition. Some of them would have died because they're not getting enough food. Therefore, we have decided to launch an ambulatory nutritional program targeting 1,200 particularly vulnerable children. This program consists of three distributions per week, both in Masisi and Buguri, of therapeutic food for malnourished children and of additional rations for their families.
The fighting has shut down the existing health system and nutritional support in the whole region. This often has terrible consequences for the people. Last week, three children died at the hospital. They had arrived in such critical conditions that we couldn't do anything for them. I remember one child who was brought by his mother, suffering from severe malnutrition with medical complications. The mother couldn't feed her son or her other nine children at home. The child wasn't doing well at all, so she decided to take him to the church, but the church had been burnt down. Then she came to the hospital, but unfortunately it was already too late. I am worried about the people who survive in the more remote locations.