Throughout 2009, the civilians suffered continuous violence from different armed groups in eastern Congo. Hundreds of people were killed, thousands of women, children, and, sometimes, men were raped and hundreds of thousands of people fled their homes. Guerilla warfare has replaced armed clashes in North Kivu where combatants spread terror by looting and burning houses in reprisals against the perceived support of communities to different factions.
In 2008, the fighting occurred mainly between the Congolese army (FARDC) and the National Congress for the People’s Defense (CNDP) rebel group. This past year saw the conflict change when the Congolese and Rwandan armies started an offensive in both North and South Kivu to wipe out Rwandan rebels of the Democratic Forces for the Liberation of Rwanda (FDLR). The Congolese military received logistical support from the UN peacekeeping mission in DRC, known as MONUC.
In October, MSF teams were vaccinating thousands of children against measles at seven sites in FDLR-controlled territory in the Masisi region—and in support of the Congolese Ministry of Health—when the Congolese army opened fire, sending civilians and aid workers alike running for cover. This attack occurred despite security guarantees from all sides to operate in the region. Thousands of people were forced to flee to unknown locations, and MSF was forced to evacuate its teams to the regional capital, Goma.
MSF immediately denounced the military offensive. “We feel we were used as bait,” said Luis Encinas, head of MSF programs in Central Africa. “The attack was an unacceptable abuse of humanitarian action to fulfill military objectives.” The MSF vaccination campaign could continue in other areas and reached a total of 165,000 children.
Despite the mounting insecurity throughout eastern Congo, MSF continued to provide medical assistance to hundreds of thousands of people in one of its largest interventions of 2009, running mobile clinics, vaccination campaigns, cholera treatment programs, relief items distributions, hospital programs and sexual violence treatment clinics. MSF is the only international humanitarian organization performing surgery in North Kivu, performing an average of 14 emergency surgeries a day in Rutshuru Hospital. From November 2008 to October 2009, MSF carried 528,850 medical consultations, cared for 10,160 malnourished children, and treated 4,900 patients suffering from cholera, and provided medical care to 5,330 rape survivors in Eastern Congo.
At the same time, the people of Haut-Uélé and Bas-Uélé, in northern DRC, were caught in a dramatic cycle of violence linked to attacks perpetrated by the Ugandan rebel group the Lord's Resistance Army (LRA), and the Ugandan and Congolese offensive against the LRA. Civilians also find themselves facing increasing banditry. Hundreds of thousands of people have been displaced over the last year. Ongoing attacks continue to send thousands fleeing to seek shelter and greater security in towns. The population of Doruma city has tripled. The towns of Gangala and Banda are each hosting more than 20,000 displaced without assistance. These locations have become enclaves with outlying fields and villages left deserted.
As one of a handful of humanitarian organizations on the ground, providing surgical, nutritional, psychological and basic medical care to thousands of displaced people, MSF called on humanitarian organizations to respond with a greater presence in the rural areas most affected by this extreme violence. Increased violence forced MSF to suspend its lifesaving sleeping sickness program.
Ituri, a region that had been calmer in last few years, was the scene of increased violence and tension between the Front for Patriotic Resistance of Ituri (FRPI) and the FARDC, leading to the displacement of 50,000 people. MSF is the only NGO present in the area to provide assistance. In other regions, the country’s health system remains seriously ill, leaving many Congolese exposed to diseases. Over the last year MSF teams have continued to provide free healthcare and responded to Ebola, cholera and measles epidemics. Across the country, MSF teams have vaccinated more than 500,000 children against measles in 2009.