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MSF in Burundi, 2008
Field Staff: 101
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In April, two years after a peace deal was signed to end more than a decade of conflict in Burundi, rebels of the National Liberation Forces (FNL) launched an offensive against the capital, Bujumbura, prompting fears of a return to war. In June, the government and the rebels signed a ceasefire.
However, the long years of war have weakened the country’s health system. Therefore MSF teams constantly monitor potential health emergencies, such as epidemics or nutritional crises.
In June, Doctors Without Borders/Médecins Sans Frontières (MSF) opened a new center for obstetric emergencies in Kabezi, in the vast province of Bujumbura Rural, which has around 565,000 inhabitants. Every month, this specialized center provides medical care, including cesareans, to an average of 100 women presenting with complications during pregnancy or delivery who cannot be treated in health centers.
"Complications arise in 15 to 20 percent of deliveries," explains Dr. Pablo Nuozzi, the MSF project coordinator. "The mother has to be within reach of an operating theater and a blood transfusion in order to benefit from emergency healthcare and, as a last resort, a cesarean. The medical care offered by MSF is crucial because obstetric emergencies place the mother’s and baby’s lives in danger and can cause serious after-effects such as sterility or a fistula between the vagina and bladder."
Through its mobile ambulance service, MSF refers emergency cases 24 hours per day from a dozen health centers to its 35-bed center in Kabezi.
MSF intends to use this project to draw attention to the scale of mother and baby mortality in Burundi and emphasize the importance of accessible and free medical care in this domain. A presidential decree adopted in 2006 guarantees free health care for pregnant women and children under five in Burundi. Yet this free access remains hypothetical for the population of Bujumbura Rural, due to the poor state of roads and the lack of specialized staff, material, and medicine.
Treating sexual violence
Although the years of open conflict have ended, sexual violence has remained a concern in Burundi. In 2008 the MSF’s Seruka center—seruka means "coming out of the dark" in Kirundi, the national language—provided medical and psychological treatment to victims of sexual violence in Bujumbura Mairie. Since the opening of the center in 2003, more than 7,000 victims have been cared for. The Seruka team has seen an increasing number of young patients visiting the center. In 2008, 60 percent of the victims had not yet turned 19 years old; half of these were under 12 years old. Statistics clearly show that a large proportion of aggressors are civilians known to the victims. The Seruka center remains an exception in Burundi; it is difficult for the victims of sexual violence to find appropriate care, in spite of the fact that rape represents a medical emergency.
In 2008 the Seruka Initiative for Rape Victims was created by local medical staff and is due to take over all activities of the Seruka center from MSF in 2009.
MSF has worked in Burundi since 1992.