August 27, 2013
Uganda 2013 © Andres Romero/MSF
Doctors Without Borders/Médecins Sans Frontières (MSF) is providing urgently needed medical care and water and sanitation services in western Uganda, where tens of thousands of refugees fleeing insecurity in North Kivu province, Democratic Republic of Congo (DRC), arrived in mid-July.
Around 22,000 refugees are now living in the Bubukwanga transit camp, a space that was designed for only 12,500 people, 18 kilometers [around 11 miles] from the DRC border.
MSF is providing maternity care, vaccinations, and nutrition treatment, and is also working to improve a potentially dangerous water and sanitation situation. Medical care is provided both to refugees and locals, reaching a total catchment population of 50,000 people.
Next week, MSF will begin offering medical care in the Kyangwali permanent camp where refugees are being transferred. The UN refugee agency, UNHCR, has thus far transferred around 4,000 refugees from the transit camp to this permanent site and plans to continue transferring 2,000 each week. The permanent camp is 150 kilometers [around 90 miles] away, but the journey, which can take up to six hours, poses a risk for the refugees unto itself. An accident involving one of the buses transferring refugees killed an infant and injured 24 other people. The injured were transported in an MSF ambulance to a nearby hospital where MSF and other medical staff provided critical care.
Additionally, the number of new arrivals at the transit camp is increasing as the security situation deteriorates in DRC; around 3,000 arrived last week alone.
MSF remains concerned about the water and sanitation condition in the transit camp.
“Although the situation has improved in recent weeks, there are inadequate latrines, only one latrine for 82 people, that are full to overflowing, posing a serious risk of cholera, dysentery, and shigellosis infections,” says MSF head of mission Ruben Pottier. “Cholera is a big concern. It is an endemic area for cholera and the seasonal peak is always at the start of the rainy season.”
The rainy season has just begun, further increasing the cholera risk and reducing road access for the trucks that empty the latrines. MSF has been building latrines, trucking in clean water, and pre-positioning the medical supplies that would be needed to respond to a cholera outbreak.
MSF is providing around 300 outpatient consultations each day in the transit camp, mostly for respiratory tract infections, malaria, and diarrhea. Teams have also provided assistance to survivors of sexual violence in the camp.
MSF is also supporting an inpatient department that has grown from 20 to 47 beds and includes a pediatric ward, an adult ward, and a maternity ward.
“We’ve particularly scaled up capacity in sexual and reproductive health,” says Pottier. “In an emergency we should not forget that life goes on, women still give birth, and there is an urgent need for medical care for complicated deliveries. Our maternity unit can deal with complicated deliveries—we only need to refer for Caesarean sections—and since July 22 we’ve delivered 92 babies.”
In the Kyangwali permanent camp, MSF is establishing a health unit in the refugee reception area. Starting next week, teams will offer basic health care, referrals for patients requiring ongoing medical treatment, and vaccination and malnutrition screening for children. Children who started malnutrition treatment in the transit camp will be monitored to ensure their treatment continues.
MSF will continue to scale up activities in both camps as more refugees arrive.
MSF has worked in Uganda since 1986. In addition to responding to emergencies, MSF runs an HIV and TB treatment program in Arua.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)