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Democratic Republic of the Congo
Accessing even basic healthcare in the Democratic Republic of the Congo (DRC) is difficult. In the eastern part of the country, violent incidents occur daily, as a result of shifting alliances between armed groups, and banditry. Medical needs are great in eastern DRC and the infant mortality rate is one of the highest in the world, but general insecurity and crime in the region have at times forced Doctors Without Borders/Médecins Sans Frontières (MSF) to suspend medical activities.
Providing healthcare to victims of conflict
At the end of 2011, more than 500,000 people in North Kivu were registered as displaced, while another 630,000 in South Kivu had fled their homes.
MSF runs a number of programs, working from hospitals and health centres across the provinces, to provide healthcare to people trapped by conflict. In North Kivu, teams in Masisi, Mweso, Pinga, Birambizo, Rutshuru, Nyanzale, and in and around Goma and Butembo towns provide basic and specialist healthcare. Last year, some services at Rutshuru hospital were handed over to the Ministry of Health. In total, staff carried out more than 404,000 consultations in the province. In South Kivu, similar services are offered in Kalonge – where the program was extended to three more health centers – Lulingu, Hauts Plateaux and Shabunda, and in a second hospital in Matili. In addition, staff operate mobile clinics for people living in more remote areas – some locations can be reached only by long journeys on foot – and in camps. There is also an MSF team in South Kivu dedicated to emergency response.
At five camps on the border between South Kivu and Katanga, MSF provided basic healthcare, including vaccinations, and nutritional support. The team also ensured access to safe water. In September, staff began assisting people in two camps in the north of Kalemie town, in Katanga, providing basic healthcare and food aid.
In Katanga and North Kivu, teams of surgeons spent several weeks performing fistula repair operations in MSF programs in Manono, Shamwana and Masisi. Obstetric fistulas are injuries to the birth canal that usually occur as a result of prolonged or obstructed labor. They cause incontinence, which often leads to social exclusion. In 2011, more than 110 women underwent fistula repair surgery.
In Orientale province, MSF handed over some of its activities in Bunia to a local organisation, Sofepadi, which offers treatment for sexually transmitted diseases, family planning services and assistance to victims of sexual violence. MSF provides medical, technical and financial support to Sofepadi, and now focuses its work on emergency response and HIV treatment for children under 15. In Gety, a team provides basic and emergency health services and runs a 24-hour therapeutic feeding center.
In South Kivu in April, armed and uniformed men opened fire on an MSF car travelling to Marungu, near Hauts Plateaux, robbed the driver and stole everything. Later, gunmen attacked another MSF car on the road between Bukavu and Uvira: two staff members were wounded. In November, a number of armed men forced their way into the MSF residence in Masisi, North Kivu, and opened fire. One member of the team received a gunshot wound to the shoulder. MSF suspended mobile medical activities in the area, but continued to provide a minimum level of emergency support at Masisi general referral hospital. There were 108 attacks involving humanitarian workers in North Kivu in 2011.
Responding to epidemics
MSF has a network of emergency teams ready to respond to outbreaks of disease across the country. In 2011, in response to a measles epidemic, MSF staff vaccinated over three million children, and treated more than 13,700 for the disease.
Malaria accounts for approximately 40 percent of child deaths in DRC. MSF saw a 250 percent increase in the number of patients with malaria in its hospitals in the east of the country compared with 2009, and treated more than 158,000 people in North Kivu, South Kivu, Katanga, Équateur, Orientale and Maniema provinces.
Teams also responded to outbreaks of cholera in the provinces of North Kivu, South Kivu, Orientale, Bandundu, Équateur, and the capital Kinshasa, setting up treatment centers and treating thousands of patients.
More than one million people are estimated to be living with HIV in DRC, yet antiretroviral (ARV) treatment coverage is among the lowest in the world: some 350,000 are in need of treatment, but do not receive it. Donors are withdrawing funding from HIV programs, and MSF is seeing the number of people in urgent need of treatment grow.
An MSF team in Kinshasa runs a hospital dedicated to HIV treatment, and MSF programs at hospitals and health centers across the country also offer HIV care: in total, more than 5,000 patients are registered for HIV treatment with MSF.
Sleeping sickness program
The prevalence of sleeping sickness (human African trypanosomiasis) in the districts of Haut-Uélé and Bas-Uélé, Orientale province, is considered to be one of the highest in the world. A parasitic disease transmitted by the tsetse fly, sleeping sickness is deadly if not treated. In 2011, MSF staff screened tens of thousands of people through a mobile clinic and in programs in Dingila, Haut-Uélé, and Doruma, Bas-Uélé, and treated around 1,500 patients for the disease.
Hospital care in Maniema
MSF took over Lubutu hospital in 2006. By the end of 2011, the capacity of the hospital – which serves 100,000 people – had grown to 160 beds, and mortality in the area had dropped fivefold since 2005. In 2012, MSF plans to hand over activities to another non-governmental organization.
As well as assisting victims of sexual violence in many of its regular healthcare programs, MSF responded to around ten incidents of mass rape around Fizi, South Kivu, and Pinga, North Kivu. Altogether, more than 2,300 people received medical and psychological assistance.
At the end of 2011, MSF had 2,919 staff in the Democratic Republic of the Congo. MSF has been working in the country since 1981.