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Democratic Republic of Congo
MSF in Democratic Republic of Congo, 2006
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Millions of people continue to live in crisis throughout Democratic Republic of Congo (DRC) and the medical situation remains grave. Five surveys conducted by MSF in different parts of the country in 2005 showed excess mortality — more than double the commonly accepted emergency threshold — and the absence of or exclusion from medical care for large parts of the population.
"Hundreds of thousands of people are suffering multiple displacements, direct violence by a variety of armed groups, malnutrition and outbreaks of preventable diseases. This reality has become so commonplace in many areas that it goes virtually unnoticed."
Excerpt from a speech delivered by MSF staff Helen O’Neill at the United Nations Security Council Arria Formula meeting, January 24, 2006.
Fighting continued to affect regions in the eastern provinces of North Kivu, South Kivu and Katanga as well as Ituri district, causing the displacement of tens of thousands of people. Many live in the bush without adequate shelter, water, medical care or food and under the continuous threat of insecurity. Others have fled to villages and are hosted by local populations or live in camps. Against this backdrop of violence, 2006 witnessed the first and relatively peaceful presidential and parliamentary elections in the DRC in 40 years.
Fighting between local militias and the Congolese National Army (FARDC) flared up in late 2005, and in northern Katanga, thousands of people were once again forced from their homes.
"People arriving in Dubie were in a really bad state as they had walked hundreds of kilometres to get here, half-naked, with barely any food. Many mothers had given birth en route and some people did not survive. You just wouldn’t believe such a situation exists unless you actually see it."
Megan Craven, MSF nurse
For most people in central and northern Katanga, upheavals and displacements have become commonplace since the war began in 1996. Malnutrition is one result of ongoing violence, which prevents people from farming their lands for fear of being attacked by armed groups.
In November 2005, the small town of Dubie was overwhelmed when over 18,000 displaced persons arrived in a matter of weeks. Already running a makeshift hospital and a network of five health centers, MSF rapidly erected three emergency camps. In the first three weeks of January, MSF carried out 1224 medical consultations and began a mass vaccination campaign against measles.
Responding to urgent needs for the displaced, in early 2006 MSF started a program around Lake Upemba, in the center of the province. With people living Â in squalid conditions on the lake banks, in straw huts or on floating islets, MSF opened a healthcare center, launched a measles vaccination campaign and distributed supplies such as plastic sheeting, blankets and cooking utensils for displaced families. A cholera epidemic also struck the region around Upemba and Kikondja, leading MSF to open an emergency program, treating 1742 cholera patients over 20 weeks.
An MSF nurse covers evening clinic in the hospital makeshift tent in Dubie,
MSF also worked in Nyunzu, Pweto, Mitwaba, Shamwana, Ankoro and Mukubu, providing primary and secondary health services to displaced and resident populations and responding to emergencies caused by epidemics and displacement.
Bordering Rwanda and Uganda to the east of the DRC, North Kivu has been a theatre of fighting between various local and foreign militia as well as the Congolese army and UN blue helmets. Militias, as well as poor and unpaid soldiers, exert enormous pressure on civilians, who are subject to looting, extortion, rape and other violence on an almost daily basis. In Rutshuru hospital in 2005, 26 per cent of monthly surgical interventions were for war-related trauma. In 2005, 1292 survivors of rape were treated by MSF in Beni, Kayna and Rutshuru.
In early 2006, at least 40,000 people fled their homes around Rutshuru, reaching the villages of Kanyabayonga, Kayna and Kirumba. Many others remained in the bush, subject to violence and looting. MSF opened two health posts in Kanyabayonga, where most of the displaced persons were hosted, and MSF teams continue to work in Rutshuru and Kayna hospitals, providing medical and surgical care. A therapeutic feeding center is also running in Kayna.
In Bunia, capital of Ituri district, MSF continues to run the 'Bon Marché', a comprehensive hospital that includes a focus on providing care to survivors of sexual violence. More than 4500 people aged between eight months and 80 years were treated here between April 2003 and December 2005. In June 2006, MSF teams also began providing clinical treatment and monitoring when a pneumonic plague outbreak occurred several hundred kilometres north of Bunia town in the area of Rety. Two isolation centers for the treatment of patients were set up in Kwandroma and in Vedza and 376 patients were treated.
Treating HIV/AIDS and Sexually Transmitted Infections (STIs)
HIV/AIDS is a major focus for MSF in the DRC. In Bukavu, South Kivu, MSF provides comprehensive HIV/AIDS care with counselling, testing and treatment of opportunistic infections, as well as antiretroviral treatment (ART). The objective is to treat 1500 patients with ART by the end of 2006. Two Karibu clinics opened in the northeastern town of Kisangani, in June 2005 and May 2006, and provide a combined total of 3000 medical consultations monthly. Medical care is complemented by targeted health education concerning the transmission and prevention of sexually transmitted infections, HIV and issues surrounding sexual violence.
In addition to a long-running project in Kinshasa, which treats about 1900 patients with ART, a new HIV/AIDS program opened in Dungu in Oriental Province in July 2005. Following rehabilitation of the hospital, which was destroyed during fighting, MSF began providing essential medicine and training Congolese staff. One aspect of the training focuses on treatment of the deadly Human African Trypanosomiasis (sleeping sickness), which MSF treats in a separate project in Isangi, Oriental Province.
Multiple emergency interventions in 2005/2006
The eruption of violence and disease is frequent in DRC and MSF teams are required to be mobile and react at short notice, often on a large scale. To help facilitate this, quick-reaction teams known by the French acronym PUC (Pool d'Urgence Congo) have been established in three major towns. Major interventions in 2005 and 2006 included a typhoid fever outbreak in Kikwit and a major measles campaign in Mbuji Mayi, during which 380,000 children under 5 years of age were vaccinated.
MSF has worked in the Democratic Republic of Congo since 1981.