Episode: "Caught In The
In Burundi, as in neighboring Rwanda, competition
for political influence and scarce natural resources has been played
out on a chessboard of ethnic division. In 1970, roughly eight years
after Burundi’s independence from United Nations trusteeship,
ethnic Hutus began a campaign against the Tutsi-led government.
The national army retaliated massively against Hutus throughout
the country – all told, the struggle killed more than 100,000
over the course of two years.
As destructive as that war was, it pales in comparison
to the current stage of fighting – a prolonged guerrilla war
touched off in 1993 by the assassination of Melchior Ndadaye, a
Hutu and the country’s first democratically elected president.
The initiation of a peace process and power sharing
agreement between the primary Hutu and Tutsi political parties in
2001 has given Burundi a false appearance of calm in the eyes of
many outsiders. Meanwhile, the nation’s humanitarian crisis
continues unabated, and in Burundi’s cities and countryside
the war grinds on.
A Capital City Under Siege
For ten years, Hutu guerilla groups and the army of
the Tutsi-led Burundian government have waged a form of low-intensity
combat that has no discernible frontlines. In order to sustain the
ability to fight a perpetual war, both sides have targeted civilians,
looting their belongings and treating those who resist with indiscriminate
brutality. The result is a people whose lives have been structured
around constant threat of violence.
In the rural east, many highland farmers have adopted
the strategy of nightly mass-migration to lowland villages because
their families risk murder, rape and looting if they stay in the
hills overnight. At the crack of dawn, they pack up their belongings
and leave the churches and municipal halls in which they slept,
marching back into the hills in caravans of people and cattle that
stretch for miles.
In this type of war, although all major cities and
most small towns are controlled by government
forces, civilians living even in the very heart of the nation’s
capital city have not been safe from the fighting.
The Kamenge Project: Treating War-Wounded
Civilians in Bujumbura
This episode of Doctors Without Borders: Life in the
Field follows MSF Doctor Heidi D’Hert and Psychologist An
Michels as they treat physical and psychological war-wounds in the
Kamenge district of Bujumbura, Burundi’s capital. The project
was opened in 1995, two years after MSF started working in Burundi.
The hospital in Kamenge receives a constant stream
of injured men, women, and children who have been injured in fighting
between rebel and government forces. In a fairly typical month (May
of 2003), MSF’s doctors and nurses at Kamenge treated 37 gunshot
wounds, three landmine accidents, and 32 victims of other assorted
forms of war-related violence.
During this period, approximately one quarter of the
injuries treated by MSF were inflicted upon women and one out of
five patients were below the age of 16, statistics that illustrate
the effects of the violence upon civilians.
The psychiatric branch of MSF’s Kamenge project
is just as busy. In May, MSF’s counselors received approximately
160 patients per week. One out of five were diagnosed with Post-Traumatic
Stress Disorder (PTSD).
Project Update: No One is Safe
In the year since the episode was filmed, the steady
pace of civilian war-wounded in the Kamenge district has only been
interrupted once; in July 2003, Bujumbura was shelled by rebel forces,
producing more than 170 casualties, by UN estimates. The attack
lasted 10 days and displaced tens of thousands of people.
The attack on Bujumbura in July came several months
after a transition from the former Tutsi leadership to Hutu president
Domitien Ndayizeye – a landmark moment in the peace process
that was expected to ease tensions between Burundi’s armed
groups. It was the worst assault to hit Burundi’s largest
city in ten years and underlined a sad truth about the ongoing conflict:
in spite of a two-year-old peace process, no one is safe.