September 12, 2007
Violent clashes between government soldiers and rebel fighters broke out in North Kivu province, in eastern Democratic Republic of Congo, on August 27. Fighting in Masisi and Rutshuru, in the south of the province, created even more displaced people—40,000, according to the United Nations—and affected Doctors Without Borders/Médecins Sans Frontières (MSF) activities in six areas. People in this region are isolated and information about their health needs remains largely unknown.
When the fighting began, a two-person MSF team was in Masisi to evaluate health-care needs, and they immediately began working in the town hospital. At the outset, the situation was extremely difficult; nearly the entire medical staff of the hospital had fled and the team had to make do with remaining equipment and supplies. The staff eventually returned, however, and an MSF surgeon and anesthetist arrived, greatly improving conditions. In addition, MSF delivered one-and-a-half tons of medical supplies to the hospital from the provincial capital, Goma.
"The first days after the fighting, we took in 50 wounded patients, both civilians and soldiers," says Ann, an MSF nurse. "Most were evacuated to Goma, about 35 miles away, including a mother and baby, who almost died. She was carrying the baby when a bullet hit her spine and the infant's leg."
Many Masisi inhabitants who fled the fighting have returned and are now coming to seek treatment. On average, medical staff treats 150 patients daily in the hospital and at a town health center. Significant numbers of patients have respiratory infections, due to cold nights and the start of the rainy season, and severe malaria. To address the situation, MSF has expanded the team and continues to send medical supplies from Goma.
At the height of the violence, MSF activities in Rutshuru town hospital, where MSF has worked since 2005, continued with a reduced team. Located along the road linking Goma to the northern part of the province, gunfire exchanges have occurred in the area immediately surrounding Rutshuru. So, on September 1, MSF reduced the size of the team working in the hospital to five people.
The caseload declined over several days, as people found it very difficult to travel all the way to the hospital; only three wounded patients were treated during that time. MSF gradually rebuilt the team to run surgical and emergency activities and care for victims of sexual violence. Four internally displaced person (IDP) camps already existed near Rutshuru, and with the arrival of additional IDPs, a new camp was set up.
For security reasons, MSF teams were evacuated to Goma from Nyanzale, in the west of the province, and Kitchanga, in the north. Unfortunately, the evacuation disrupted plans for a measles-vaccination campaign targeting the IDP camps and residents of Nyanzale, covering nearly 70,000 children between 6 months and 15 years of age. Just as MSF was preparing to set up the cold chain and begin the vaccinations, violence broke out, causing people to empty out of IDP camps and villages.
Further north, in Kayna, MSF's treatment program for victims of sexual violence continues to operate. In late August, 154 rape victims came for treatment over the space of eight days. By comparison, the average caseload in Rutshuru is 70 cases per month. Given the upsurge, MSF decided to strengthen the team in Kayna.
Finally, on the other side of the border with Uganda, a three-person MSF team is providing assistance to more than 2,500 new people who fled North Kivu and took refuge in Kisoro. The team is supplying them with medicine, water, and shelter, and is building latrines at the site where they have settled.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)