Democratic Republic of Congo: "I saw how desperate the people are"

April 4, 2008

This article is part of the Spring 2008 issue of the MSF Alert newsletter.

SITUATION REPORT

Since 1998, civilians in the Democratic Republic of Congo’s (DRC) North Kivu province, along the Rwandan border, have been caught in the middle of a battle for control between local and foreign militias, and the Congolese army. A United Nations peacekeeping force has also, at times, stepped into the fighting on the side of government forces. The government of President Joseph Kabila has been engaged in a new wave of heavy combat with rebel leader Laurent Nkunda’s forces since August 2007. A number of different groups such as the Mai Mai militia and the Rwandan Hutu rebels of the Democratic Forces for the Liberation of Rwanda (FDLR) are also involved in the fighting. Doctors Without Borders/Médecins Sans Frontières (MSF) teams have been on the forefront of trying to assist people trapped by the conflict.

“I remember one woman who was caught in the crossfire at the beginning of October,” said Anne Khoudiacoff, an MSF nurse working in theMasisi district hospital. “She was carrying her child on her back; 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 had been shot in the leg and were taken to the surgical ward.”

Fighting of the kind this woman narrowly escaped has driven hundreds of thousands of people from their homes over the past year. Many have sought safety in the forest near their villages, only to have to flee again. They have little access to food or basic health care and live under near-constant threat of attack and rape from the various armed groups.

“We are now seeing more people living in camps than we’ve seen in North Kivu in the last 10 or 15 years,” said Jane Coyne, MSF head of mission in North Kivu. MSF is running emergency medical programs on both sides of the front line in the districts of Goma, the provincial capital; Rutshuru; Nyanzale; Masisi; Kitchanga; Mweso; and Kilolirwe. “It is shocking to see these displaced people carrying what little they have, just moving constantly, and it happens every other week,” said Dr. Maria Guevara, MSF medical coordinator for North Kivu.

Even though MSF is running one of its largest medical programs in North Kivu, tens of thousands of people remain out of reach. “The conflict in North Kivu involves multiple armed groups,” said Coyne. “So every time you cross into one of the frontiers controlled by an armed group, it’s more complicated to access the population. There are places in North Kivu where no international organization has been in a long time and we don’t really know what the state of the population is.” No respite from war

A ceasefire agreement reached on January 21 has done little to ease the violence. Armed groups broke the agreement within hours. “Despite the glimmer of hope kindled by the Goma conference on peace, I saw how desperate the people are,” said Philippe Havet, MSF emergency coordinator for Masisi district. “All their property is lost. People are tired of the situation. Violence, disease, and running have been their daily life for years. In the last six months, I have witnessed great distress, a lack of food and health care.”

The grinding pace of the conflict has taken its toll on people. Malnutrition and disease remain the greatest killers. In late-January, MSF had more than 900 children under treatment for severe acute malnutrition in Masisi district. “The little kids may look cute and plump, but they actually have kwashiorkor, a dangerous form of malnutrition in which a protein deficiency causes edemas (or swellings) that makes them look plump,” said Dr. Guevara.

In these conditions, a simple cold can become life-threatening. “People are not dying from complicated things; they’re dying from completely preventable problems,” said Coyne. “They are living in terrible conditions, children are getting respiratory infections, the infections aren’t treated, they come into the hospital with pneumonia and it’s too late. The long-term impact of violence in Congo is that people can’t get access to basic health care and that’s what we’re fighting for every day.”

Epidemic diseases have taken their toll as well. In late 2007, MSF faced a cholera epidemic of unusual proportions for the region. More than 2,000 cases were recorded in less than two months in Rutshuru district. The explanation lies in the precarious living conditions of the displaced population. The villages where they are concentrated are growing and becoming virtual cities, but lack the necessary water and sanitation infrastructure. In response to the outbreak, MSF set up a cholera treatment center in the Rutshuru hospital and treatment units on the city outskirts. Increasing levels of rape

One particularly disturbing aspect of DRC’s conflict is the alarmingly high rate of sexual violence. In North Kivu, MSF treated more than 2,500 victims of sexual violence in 2007. In January 2008 alone, 550 rape cases were admitted to MSF facilities in the province.

MSF offers to pay for transportation in order to encourage women who have been raped to seek immediate treatment. Victims must be treated within 72 hours after the attack if prophylactic treatment for HIV/AIDS is to be effective. A network of women distributes information and the message is broadcast on the radio, emphasizing the need to obtain medical treatment within 72 hours.

 

Related:

• Images of Congo's War

Tags: Democratic Republic of the Congo, Conflict in Eastern DRC