Photo © Francesco Zizola |
Another year of misery
The past year has been a so-called transition period in the Democratic
Republic of the Congo (DRC); a time when the country was meant to
move from war to peace. However, for the majority of the people living
in this vast troubled land, the transition is nothing more than a mirage.
Violence continues to flare in parts of
Ituri province, in North and South Kivu provinces,
and in parts of Katanga province,
while the rest of the country languishes in
extreme deprivation, lacking food, shelter
and the most basic health care. In the capital,
Kinshasa, the in-fighting government
manages a "virtual" state, if anything exacerbating
the wretched situation in which
the Congolese find themselves. According
to estimates, some four million people
have died since the outbreak of the civil
war. Some have been swept away by the
violence, but the great majority have died
of preventable diseases such as malaria
and measles, far from the apathetic eyes of
the outside world.
Violence engulfs Ituri
MSF's teams in the DRC have witnessed an
alarming level of sexual violence in the
northeastern province of Ituri. Thousands
of women and children, and some men,
have been raped as wanton violence escalates.
More than 2,500 patients were treated
for rape or sexual violence in MSF's
hospital in Bunia, the provincial capital,
between June 2003 and January 2005. The
data show that all ages were affected, from
four months to 80 years old.
"What shocks me is that 77 percent of rape
victims who presented themselves to MSF in the last six months were raped by two or
more assailants," says Rowan Gillies,
M.D., president of MSF's International
Council, who worked as a surgeon for MSF
in Bunia. "I find these figures horrific and
disgraceful. And they are only the tip of
the iceberg." He continued, "Rape and
gross violations against civilians continue
unabated and today we find ourselves unable
to reach the victims because of the
extreme levels of violence in the area. Each
week 40 girls and women who have been
raped seek MSF's help in Bunia. Many,
many more never reach us." | |
During the past year, the northeastern
province of Ituri has been the epicenter of
violence in the DRC. Despite efforts at disarmament
and reintegration, principally by
the United Nations, numerous rebel groups
continue to wage war, rendering large
swathes of the region inaccessible to aid
workers and destroying lives with their
often indiscriminate terror. Some of the
victims are treated by an MSF team working
in the Bon Marché Hospital in the provincial
capital of Bunia. The hospital offers
a full range of medical care including facilities
for surgery where MSF regularly treats
the war-wounded. Sexual violence is especially
prevalent in the region, with more
than 2,500 rape survivors treated by MSF's
medical teams in the 20-month period
between June 2003 and January 2005 (see
sidebar).
As tensions have escalated among Ituri
faction groups fighting for control of
resources, the ensuing attacks, rapes and
mass killings have prompted tens of thousands
of people to flee to Djugu territory.
MSF carried out an emergency intervention
in four displacement camps in Tchomia,
Kakwa, Tche and Jina, helping more than 70,000 civilians gain access to medical care,
water and sanitation. When cholera broke
out in the area, MSF was able to recognize
and control it quickly, treating more than
1,400 people with the illness.
Two MSF staff abducted
On 2 June 2005, two MSF staff members — a
logistician and a driver — were abducted by
armed militiamen as they traveled to the
Jina displaced persons camp 35 kilometers
north of Bunia. The incident forced MSF to
suspend its mobile clinics outside of Bunia
and to evacuate those teams. However, the
Bon Marché Hospital in Bunia continued to
provide all of its services. On 11 June, MSF
was able to secure the unconditional
release of its staff members. Various communities
in Bunia and Ituri showed a great
deal of support for MSF during the incident
and mobilized massive assistance to urge
the aid workers' release. However, on 2
August 2005, MSF announced that it had
decided to close its projects outside of
Bunia as a direct consequence of the
abduction and the ongoing insecurity in
the area. More than 100,000 people had
been benefiting from this assistance.
Insecurity leads to decreased aid
Insecurity is also widespread in the province
of North Kivu, in the far eastern part of
the country, which borders Rwanda and
Uganda. The looting of an MSF base in the
village of Kibati on 19 January 2005 by
armed and uniformed men left MSF with
no choice but to suspend and later close its
therapeutic feeding program in the area,
where it had treated more than 10,000 children
since 2002. The 63 malnourished children
who were receiving treatment at the
center when it closed on 8 April were transferred
to the therapeutic feeding center in
Kitchanga for continued care. This suspension
came only weeks after another MSF
project was suspended in the nearby
Masisi and Rutshuru territories due to a
similar security incident.
Around the town of Beni, MSF teams are
providing shelter, water, sanitation and
health care to displaced people from Ituri.
They carried out 98,200 medical consultations
and treated 150 victims of sexual violence
in this area during 2004. In the towns
of Kanya and Kanyabayonga, MSF teams
admitted 1,300 severely and 5,000 moderately
malnourished children into its programs
during 2004. In September 2004, the
MSF team started a health program for victims
of sexual violence, through which 124
patients have received treatment. Since
June 2005, the team has supported Kanya's
hospital, including the surgical department.
Teams have also organized mobile
clinics and responded to health emergencies
such as cholera outbreaks that
occurred in Virunga Park, Goma and
Buhimba.
In South Kivu, which has enjoyed a period
of relative calm since the last spate of violence
in June 2004, MSF is providing health
care in the villages of Shabunda, Baraka
and Fizi.
A lack of care in Katanga
MSF focuses its work on health care for displaced
people in the southeastern province
of Katanga where clashes between
militias and the newly unified Congolese
army (FARDC) continue to wreak havoc.
Working in nearly a dozen towns, MSF is
providing a wide range of services including
primary and secondary health care,
treatment for malnutrition, emergency surgery,
mobile health care, long-term tuberculosis treatment and care for victims of
sexual violence. In August 2005, MSF
opened a new program in Mukubu when
the resumption of hostilities resulted in the
displacement of 15,000 people.
Other emergencies
Nine years ago, MSF created a Congo
Emergency Team to provide fast emergency
relief to meet sudden needs. Today, such
teams are based in Kinshasa, Kisangani,
Lubumbashi and Mbandaka. They react to
urgent events such as outbreaks of measles,
whooping cough, plague or cholera.
They also help displaced people and those
affected by natural disasters.
Treating those with AIDS
MSF teams have continued to increase
access to comprehensive care for those living
with HIV/AIDS in the DRC. In the town
of Bukavu, South Kivu, MSF was providing
331 patients with antiretroviral (ARV) medicines
by April 2005. The team hopes to
have 900 patients enrolled in the treatment
program by the end of 2005. In a second
HIV/AIDS project, in Kinshasa, 870 patients
had received ARVs from MSF by the end of
April 2005, and the team aims to increase
that number to 1,700 by the end of 2005.
MSF had also monitored nearly 3,000
patients in less advanced stages of the disease
in Kinshasa by spring 2005.
In early 2005, MSF started a new project
aimed at treating commercial sex workers
who have HIV/AIDS with ARVs. The treatment
of sexually transmitted infections is also a priority for MSF teams and is integrated
into basic health care projects
across the country and in a targeted center
in Kisangani, a city in the Orientale province
of the DRC that bore the brunt of
fighting during the civil war and retains a
large military presence. MSF also runs a
specialized clinic to treat people with sexually
transmitted infections in Kitchanga in
North Kivu, and operates three such clinics
in Bukavu, South Kivu.
Care for those who have none
An outbreak of the plague — an apocalyptic
but easily treatable disease that last struck
Europe more than a century ago — claimed
more than 20 victims some 200 kilometers
north of Kisangani in January 2005.
Moreover, sleeping sickness (African
trypanosomiasis) which was virtually
wiped out by missionaries in the 1950s, has
returned with a vengeance, because little is
being done to control the flies that transmit
the disease, and because many displaced
people live in the forests where
they breed. To help reduce the disease's
prevalence, MSF has opened a new testing
and treatment project in Isangi, one of the
most affected areas.
In Equateur province, MSF supports clinics
in nine health zones comprising 800,000
people. In late 2004, a team concluded a
measles-vaccination campaign for more
than 600,000 children under 15 years of
age. The campaign took more than a year
to complete because many villages could
be reached only by dug-out canoe. Despite
successes like this one, thousands of people
die due of treatable diseases such as
malaria and measles or because of inadequate
health care. Avoidable illnesses are
regularly lethal when the nearest health
center is far away. Like the violence in Ituri,
lack of health care is the sad reality of life
in the DRC, a land where people continue
to die of mass neglect.
MSF has worked in the Democratic Republic of Congo since 1981.
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