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International Activity Report 2007

Democratic Republic of Congo

Malnutrition, epidemics and surgical emergencies continue in DRC. Insecurity persists in many regions, particularly in North and South Kivu,
where the population is subject to violent attacks and causing continual displacement. Many areas are totally isolated and deprived of any functioning health infrastructures, illustrated by catastrophic health indicators.

Assisting victims of violence

Intense fighting between different armed groups in the Kivu region has caused thousands of people to flee their homes since August. Some sought safety in camps for displaced people in the regional capital, Goma. MSF strengthened existing projects and opened new projects to try and meet the huge needs but in many places the fighting and insecurity forced the evacuation of staff and the temporary suspension of work. In North Kivu, MSF opened a new project in Masisi, about 80 kilometers west of Goma, at the end of August. In response to ongoing violence and displacement, a team started working in the hospital and a health center in Masisi town, focusing on emergency surgery and nutritional care. The hospital’s capacity was increased from 72 to 170 beds. In October, admissions to Rutshuru hospital, where MSF has worked since 2005, increased by 50 per cent. The MSF team added tents to increase inpatient capacity, employed more staff and reinforced the pharmacy with additional supplies. In October, 330 surgical operations were performed, compared to a monthly average of 220 since January.

Repeated displacement, lack of transport and ongoing insecurity mean that mobile clinics are an essential part of MSF’s work.

Repeated displacement, lack of transport and ongoing insecurity mean that mobile clinics are an essential part of MSF’s work. When security permits, mobile teams visit numerous sites in Masisi and Rutshuru districts. In December, MSF carried out 3,299 consultations in Kitchanga, Kilolirwe, and Mweso health zones.

Responding to the needs of victims of sexual violence has long been a key component of MSF’s work. Between January and September, MSF staff treated around 3,000 victims of sexual violence in North and South Kivu. Yet it is not only in active conflict zones where this medical care is so urgently needed. In Bunia, where MSF supports the Bon Marché hospital, teams continue to see around 150 victims of sexual violence every month. In 2007 MSF carried out more than 25,000 consultations in the hospital.

Since 2003, Angolan authorities have on various occasions expelled Congolese migrants working in the Angolan province of Lunda Norte. According to UN estimates at least 44,000 people were deported to DRC in 2007. In October MSF teams set up a health center in Kamako, Western Kasai province, close to the Angolan border. Between November 2007 and January 2008, the center provided medical and psychological care to Congolese migrants, many of whom were women who had been subjected to sexual abuse by Angolan forces. MSF treated about 200 victims of sexual violence and offered primary health care to more than 900 women and children in the Kamako center and through mobile clinics. The teams also collected one 100 testimonies exposing collective rape and physical abuse perpetrated by the Angolan military.

Responding to disease outbreaks

The retreat of humanitarian agencies has left large areas of the country abandoned. Many areas are isolated and the capacity of the new government is often extremely limited. What few health structures exist either do not function fully or are not accessible to the majority of the population living below the poverty line.

In Ituri, MSF responded to a Shigella emergency in Pimbo in May and to a cholera epidemic in Laudjo in June. A new project for sleeping sickness was opened in May in the health zone of Doruma, where this neglected disease is endemic. Within three months, MSF had screened about 10,000 people and treated more than 450 patients.

In August, the influx of an additional 45,000 displaced people to crowded camps with limited sanitation just outside Goma led to a cholera epidemic. In September, MSF opened a cholera treatment center (CTC) in a central location between four of the largest camps. Teams also supported a smaller CTC in Goma hospital, and CTCs in four health clinics: two in Goma itself and two in the neighboring towns of Saké and Kiroche. By the end of November, over 1,500 people had been treated, with only six deaths reported. In the last two months of 2007, MSF responded to another outbreak of cholera in Rutshuru district, treating 1,600 people.

On 10 September, an outbreak of the deadly hemorrhagic fever Ebola was declared in Kampungu, Western Kasai province. Within days, an emergency team had arrived and was isolating and supporting infected people. Over two months, MSF teams admitted 46 people suspected of having the disease. Medical staff tried to trace anyone who had been in contact with the Ebola patients as well as searching for active cases.

Ongoing projects

As well as reinforcing and expanding medical activities in the Kivu region, long-running projects continue to provide HIV/AIDS care in Kinshasa and South Kivu, primary and secondary healthcare in Katanga and Maniema provinces and treatment for sexually transmitted infections in Kisangani. In some areas of Katanga, South Kivu and Dungu in Oriental province, the situation has stabilized to such an extent that MSF has been able to hand over activities to the Ministry of Health and other partner organizations.

MSF has worked in DRC since 1987.

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MSF Projects 2007