November 27, 2007
As fighting continues between various armed groups in North Kivu province, Democratic Republic of Congo (DRC), MSF teams are increasing their assistance to people who have been displaced and the host populations that are supporting them. The conflict has increased what were already huge medical needs in this eastern region of DRC. MSF teams are seeing large numbers of malnourished children in some districts. Thousands of people have been displaced and are either living in camps with very little food or with host families, stretching what were already quite limited resources. Many people who have not been displaced are afraid to go to their fields to farm. As a result, many people are almost completely dependant on the ability of aid organizations to reach them and distribute food.
With different groups controlling different parts of North Kivu, it is often difficult for MSF teams to travel around. At times, teams have had to be evacuated for security reasons and medical activities have had to be suspended. Mobile clinics operate when possible, and MSF staff supply health centers in different districts with materials and drugs. However, these centers are often looted and the materials either stolen or destroyed.
Medical teams continue to assist people who have been wounded in the fighting. The situation is tense and civilians often bear the brunt of the violence. On November 10, a town in Masisi District, where MSF supports a health center and a hospital, was attacked. Seven people were killed and six wounded, all of them civilians. On November 13, fighting caused people living in Mugunga camp, just outside Goma, to flee. When they returned, many found that their temporary homes had been systematically looted. Amongst other things, the plastic sheeting, which is their sole protection from the rain and wind, was gone.
MSF Activities in North Kivu
MSF is currently working in the Rutshuru, Masisi, Lubero, Walikale, and Goma districts of North Kivu, with a total of 425 Congolese staff and 45 international staff. In October, MSF opened a new project in Nyakabanda camp, Uganda, providing assistance to the estimated 13,000 refugees who had fled there from eastern DRC.
Rutshuru Town Area
MSF has been working in the 200-bed Rutshuru reference hospital since August 2005 providing secondary health care, including surgical, medical, pediatric care and specialized care to victims of sexual violence. In the third week of October, admissions to the hospital increased by 50 percent. The MSF team responded by adding tents to increase inpatient capacity, employing more staff, and reinforcing the pharmacy with additional supplies. Some 330 surgical operations were performed in October, compared to a monthly average of 220 since January 2007.
Since early September, MSF has rehabilitated and helped re-open three health centers in the Binza health zone, which had been closed since February. In Buramba, Katwiguru, and Kiseguru, 5,800 consultations have been provided to date.
With thousands of displaced persons constantly on the move, MSF has dispatched medical teams to establish mobile clinics in schools, abandoned health centers, and tents to provide basic health care, and to refer severe cases to Rutshuru hospital. MSF's mobile medical teams have conducted more than 2,000 consultations in Kabaya, Kinyandoni, Rugare, Katale, and Karembi. As measles cases have been reported in some parts of North Kivu, MSF started a campaign to vaccinate children against measles in mid-November. Due to ongoing violence in Rutshuru district, the campaign is currently on hold.
In response to outbreaks of violence and increasing displacement, MSF opened a new project in Masisi, about 50 miles west of Goma, at the end of August. The emergency response initially focused on surgery for people wounded in the fighting. MSF also worked on improving conditions in the hospital. The showers and latrines were repaired, electricity was installed and a new pharmacy and nutritional center were opened. The capacity of the hospital was increased from 72 beds to 120.
A team of five international staff work in the hospital and health center in Masisi town, focusing on emergency surgery and nutritional care. The surgical team have completed 278 operations since September—163 of these were for war-related injuries. On November 10, an attack on the neighboring town of Lushebere left seven people dead and six wounded. MSF transferred the injured patients to Masisi hospital where they were operated on and are now recovering in the inpatient department.
In the health center, MSF supports Ministry of Health staff who have done over 7,000 consultations since the beginning of October, mainly for malaria, urinary and respiratory infections, and worms.
In October, an assessment of children under five in Masisi revealed that 10 percent of those screened were suffering from malnutrition. MSF has responded by opening an ambulatory nutritional program targeting 1,200 children. A lack of transport and insecurity on the roads makes it difficult for some people to come to Masisi hospital, so a MSF mobile team is also visiting towns around Masisi—Bugari, Mushaki, and Lushebere—to provide food and medical care to malnourished children.
Mweso and Kitchanga Area
MSF staff have been forced to suspend activities several times since teams started working in Mweso health zone in February 2007. On October 17, a small team was able to return to the area and provide support to St. Benoit hospital in Kitchanga. A full team of five international staff and eight Congolese staff are now back in the hospital, working together with the Ministry of Health staff to provide basic health care and medical care for children with malnutrition. Over 100 consultations are done per day. MSF also supports a Congolese organization, SOPROP, which provides medical care and counseling for victims of sexual violence.
Until October, MSF supported four Ministry of Health clinics in Bukama, Kashuga, Kalembe, and Jardin Thécole de Ngeri (JTN). However, these clinics have been looted on several occasions, so MSF has decided to limit supplies. When security permits, mobile teams visit the clinics twice a week to provide medical care and supply drugs and other materials. MSF teams have not been able to get to JTN for the past two months and have been told that the entire population has fled. MSF has also recently started supporting a clinic inside Kilolirwe IDP camp, providing health care to the displaced and the host population. As Mwezo health zone is not stable, MSF will adapt its support to the rapidly changing situation.
An estimated 45,000 people are thought to be living in camps outside Goma, with several thousand more finding accommodations with host families. MSF is working with the Ministry of Health to treat and contain cholera. Cholera is endemic in DRC and MSF teams will normally see a number of cases in North Kivu every year. However, this year, the influx of an additional 45,000 who are living in a crowded camp situation with limited sanitation means that there have been far more cases of cholera than normal.
MSF opened a cholera treatment center (CTC) in a central location between four of the largest camps on September 24. Teams also support a smaller CTC in Goma hospital, as well as CTCs in four health clinics—two in Goma itself and two in the neighbouring town of Saké. So far over 1,100 people have been treated, with only four deaths reported.
Cross-border mobile clinics from Kisoro, Uganda, traveling to three locations in eastern DRC— Jomba, Chengerero and Bunagana—were suspended so that the team could respond to a sharp influx of refugees crossing into Uganda following a resumption of clashes on October 19 and 20. Staff continue to assist approximately 13,000 people who have fled to Nyakabanda camp in Uganda, roughly nine miles from the border with DRC. Six international staff and around 50 Congolese staff constructed shelters and latrines and provide clean water and sanitation facilities. MSF is the only organization providing medical care in the camp. Staff at MSF’s health clinic conduct between 100 and 150 consultations a day, primarily for diarrhea and respiratory infections. Seriously ill patients and women in labor are transferred to Kisoro hospital, a 20 minute drive away. Outreach workers follow up with patients, including children who are suffering from malnutrition and need supplementary food. MSF teams recently helped the local health and sanitation authorities to vaccinate 5,030 children between six months and fifteen years old against measles and polio.
MSF has been working in the Democratic Republic of Congo since 1981.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)