How MSF is fighting COVID-19 in DRC
Across all our projects, teams are working on awareness raising, health promotion, and the implementation of preventive measures. With the second wave hitting Kinshasa in December, we started supporting the Kinshasa University clinics (CUK) in January 2021 to treat people with moderate and severe cases of COVID-19.
In addition, the MSF-supported Hospital of Kinshasa, dedicated to HIV/AIDS patients, has been equipped with isolation tents for people with suspected and confirmed cases and a reference system put in place. The same approach was implemented in Kasai province, in Kananga, where MSF supports the General Hospital with triage and donations to the hospital and health centers according to their needs.
In Democratic Republic of Congo (DRC), Doctors Without Borders/Médecins Sans Frontières has worked to tackle massive outbreaks of measles and Ebola, while continuing to address many other ongoing health needs.
In 2019, MSF teams worked in 21 of DRC’s 26 provinces, providing a wide range of services including general and specialist health care, nutrition, vaccinations, surgery, pediatric care, support for victims of sexual violence, as well as treatment and prevention activities for HIV/AIDS, tuberculosis (TB), measles, cholera, and Ebola.
The world’s largest measles epidemic
MSF’s response to the measles epidemic included support for local surveillance activities, mass vaccination campaigns and treatment for complicated cases in 16 provinces: North and South Kivu, Bas-Uélé, Kasai, Kasai Central, Kwilu, Mai-Ndombe, South Ubangi, Tshopo, Tshuapa, Ituri, Kongo Central and the four ex-Katanga provinces. Measles is a vaccine-preventable disease but the failure to cover all health zones with routine vaccination and the delay in organizing supplementary campaigns are among the reasons this outbreak is so big. In DRC, factors contributing to low coverage include the lack of vaccines, vaccinators and access to health care facilities, as well as logistical difficulties such as transport. Our teams vaccinated over 679,500 children and treated some 48,000 in our facilities. The outbreak occurred at the same time as the Ebola epidemic, which complicated the response.
Assisting displaced people
To address the needs of displaced people, MSF teams provided medical care and distributed water, mosquito nets, and relief items at around 30 sites. Until February, we continued supporting health facilities in Mai-Ndombe, following two days of intercommunity violence in December 2018, during which there were many casualties. We treated injuries and burns, ran mobile clinics, and distributed relief items to around 2,850 displaced households. In North Kivu, we assisted displaced people in four camps through mobile clinics and water, hygiene, and sanitation activities. In Kasai Central, we ran mobile clinics and health promotion activities to assist Congolese people pushed out of neighboring Angola. Learn how you can best help in DRC and other countries.
Comprehensive care in the Kivu provinces
In the Kivu provinces, which have been plagued by conflict for many years, MSF has maintained some long-term projects that ensure continuity of care, while also responding to epidemics, mass displacement and other emergencies.
In North Kivu, our teams operate in Goma, Mweso, Walikale, Masisi, Rutshuru, Bambu and Kibirizi health zones to support the delivery of general and specialist health care in hospitals, health centers and posts, and through mobile clinics and community-based outreach activities. Our services include emergency and intensive care, surgery, referrals, neonatal, pediatric and maternal health care, mental health support, HIV and TB programs, vaccinations, nutrition and treatment for sexual and gender-based violence.
In South Kivu, we support hospitals and health centers in Baraka and, Mulungu, Kalehe and Kimbi-Lulenge health zones, offering treatment for malnutrition, HIV, TB and other infectious diseases, mental health support, and maternal and reproductive health care. In Baraka and Kimbi we work closely with communities to respond to the three main illnesses affecting the population; malaria, diarrhea, and respiratory tract infections. In 2019, we started constructing a new hospital in Baraka and upgraded Kusisa and Tushunguti hospitals by installing a solar energy system.
Treating victims of sexual violence
We have teams working in clinics in both Kivu provinces, as well as Kasai Central, Maniema, and Ituri, offering reproductive health care, including safe abortion care, and medical and psychological treatment for victims of sexual and gender-based violence. With multiple forms of violence often perpetrated at the community level, MSF is training people to be first responders, or trusted focal points, for victims in their own communities. In Kimbi-Lulenge and Kamambare health zones (South Kivu), and in Salamabila (Maniema), Masisi (North Kivu), and Kananga (KasaiCentral), MSF works with 88 such focal points. Most are female, as the majority of victims are women and girls. MSF tries to tackle the prejudice that leads to stigma and even family rejection, and tries to organize referrals to other organizations who can offer socioeconomic assistance. Please donate to support our work in DRC and other countries around the world now.
Responding to epidemics
Throughout 2019, our teams supported the national response to large cholera outbreaks across both Kivu provinces. Our teams treated patients in cholera treatment centers (CTCs) and ensured that they and their care takers were made aware of good hygiene and sanitation practices to reduce the risk of spreading. We also carried out epidemiological surveys and donated medicines. During an outbreak between May and September, we opened a temporary CTC in Kyeshero (Goma), Lubumbashi (Katanga) and four more in Masisi, where we treated almost 700 patients in one month, most of them displaced people living in precarious conditions in camps.
Malaria also continues to be a major health issue in DRC. At Baraka hospital in South Kivu, we increase treatment capacity every year with 100 beds to respond to the seasonal peak. In 2019, we introduced larvicide spraying in mosquito breeding hotspots as a preventive strategy. In Bili health zone, North Ubangi, where malaria is hyper-endemic, our teams ran a project across 62 health facilities focused on treating young children.
In the capital, Kinshasa, and Goma, we support 11 health care facilities to expand access to HIV treatment and screening, strengthen follow-up and ensure a steady supply of ARVs. In Kinshasa, we provided medical and psychosocial care for 3,167 HIV-positive patients at Kabinda hospital and seven other facilities. At Misisi health center in South Kivu, MSF community health educators are part of an HIV support group called the Social Committee for Health Promotion, which raises awareness and fights stigma in the community. In 2019, the group followed 1,821 patients registered in HIV programs in Misisi, Lulimba and Nyange health centers.
Throughout 2019, we continued our advocacy efforts to address the lack of bed capacity for advanced HIV/AIDS patients, tackled ARV stockout problems, and enhanced specialist care for pediatric patients.
In July 2019, the World Health Organization declared the Ebola epidemic a public health emergency of international concern. By December 31, there had been approximately 3,300 confirmed cases and 2,200 deaths, making it the second-largest outbreak ever recorded, after the one in West Africa in 2014–2016. Over 1,000 patients survived the disease.
During the year, MSF teams continued to provide assistance to people in North Kivu and Ituri, including medical care for confirmed and suspected Ebola cases and vaccinations for people who had been in close contact with those diagnosed with the disease. In addition, we worked to reinforce access to general health care in the region, develop community engagement, and integrate Ebola care into local health care facilities. The aim was to adapt our activities to address the full medical and humanitarian needs of the population, which go well beyond Ebola.
In February 2019, the Ebola treatment centers we supported in Butembo and Katwa came under violent attack, forcing our teams to leave the area. Over the following months, we scaled up our support to hospitals and health centers at a time when the contamination of facilities and the reassignment of local health staff to Ebola activities was reducing their capacity to provide health care.
Our missing colleagues
On July 11, 2013, four MSF staff were abducted in Kamango, in the east of DRC, where they were carrying out a health assessment. One of them, Chantal, managed to escape in August 2014, but we are still without news of Philippe, Richard, and Romy. We remain committed to obtaining their liberation.
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Between July and August 2019, confirmed Ebola cases were reported in Goma city and South Kivu province, as well as in neighboring Uganda. In each location, we supported the health authorities to manage the response. These occurrences, which could have signaled a major expansion of the outbreak to new areas of the country and across the border, turned out to be short-lived, and North Kivu and Ituri continued to be the hotspots for the rest of the year.
Progress was made in 2019 with respect to the new medical tools being used to tackle the virus; preliminary analyses indicated that the rVSV-ZEBOV vaccine, in use since the start of the outbreak, is effective in preventing infection, while two of the four developmental treatments subject to the randomized controlled trial gave positive indications and remained the only two treatments in use. A clinical study of a second potential Ebola vaccine was launched in September.
In a context marked by violence against Ebola responders—over 300 attacks were recorded in 2019, resulting in an increased presence of security and military forces around Ebola treatment facilities—our ongoing challenges are gaining the trust of the population and getting local communities to participate in the response effort. These are crucial for an effective response strategy.