Why are we there?
- Armed conflict
- Endemic/epidemic disease
- Healthcare exclusion
- DRC: “I have trouble believing that such a level of horror is possible”
- Legacy of the Rwandan genocide
- DRC: MSF releases report on shocking humanitarian situation
This is an extract from our latest Activity Report, looking back on our work in the previous year.
Most people in the Democratic Republic of Congo (DRC) are suffering a desperate lack of healthcare: many health facilities are barely operational. Escalating violence in the east has increased the already high level of medical need.
In 2012, a newly formed armed group, M23, attacked Rutshuru in North Kivu province before occupying the provincial capital of Goma for several days. Hundreds were injured and thousands were forced to flee, again: they abandoned Kanyaruchinya displaced persons camp, heading to neighbouring camps or further south.
Médecins Sans Frontières/Doctors Without Borders (MSF) continued to run services at Rutshuru hospital throughout the violence, although with a reduced team. From July to December, staff provided basic healthcare, nutritional care, maternity services and assistance to victims of sexual violence at Kanyaruchinya health centre, and set up a cholera treatment centre.
In November MSF started work in Mugunga III camp, offering basic healthcare, nutritional support, measles vaccinations and treatment for victims of sexual violence. Surgical staff operated on 60 war-wounded in Virunga hospital, Goma.
Comprehensive healthcare in North and South Kivu
MSF fully resumed activities in Masisi hospital in North Kivu in 2012: services had been reduced after a member of staff was injured in a security incident in 2011. The team supports all services at the 160-bed hospital, and provides basic healthcare at two health centres and mobile clinics. Comprehensive services are also provided in Mweso, Kitchanga and Pinga.
In South Kivu, MSF supports basic and specialist services in hospitals and health centres in Kalonge, Minova, Shabunda, Kimbi Lulenge and Baraka.
In Lubutu, Maniema province, MSF’s hospital programme has reduced mortality significantly. In March MSF handed over to the Ministry of Health after the team demonstrated that high-quality, easily accessible health services can be offered at almost the same cost as that defined by the Ministry of Health.
Insecurity limits medical activities
In April, two staff members were abducted in Nyanzale, near Rutshuru. They were returned unharmed after several hours but medical activities – including both basic and specialist services, and assistance to victims of sexual violence – in Nyanzale were closed, and the number of staff at Rutshuru was reduced.
Pinga, also in North Kivu, was repeatedly the scene of armed conflict, and when residents, including MSF staff, had to flee, MSF services were interrupted. Heavy fighting between the army and a Mai-Mai group, which expanded its influence in the region over the year, meant that an emergency response to high rates of malaria in Walikale was suspended for several weeks.
In South Kivu, staff who had been working in six health facilities and running mobile clinics in Hauts Plateaux, Uvira were evacuated in February due to armed conflict, though MSF continued to supply the facilities with medicines. When the MSF compound in Baraka was robbed and staff intimidated, services continued, though with fewer personnel.
Assisting the displaced in Katanga
Until August, a team in Kalémie in Katanga province provided basic healthcare, maternity services, nutritional support and water in two camps for people who had fled conflict in South Kivu.
Fighting flared up in Katanga itself between the army and Mai-Mai militias. MSF provided basic and specialist health services to the displaced in Mitwaba between April and August, and in Dubie from March. Longer-term programmes providing comprehensive health services in Shamwana saw a decrease in inpatients as fighting hindered access to the hospital. Displacement prevented follow-up for many patients.
Assisting victims of conflict in Orientale province
In Geti, Ituri district, MSF provides basic and specialist services, paying particular attention to maternal and child health, although insecurity hampers activities. More than 820 patients, two-thirds of whom were under five years of age, were admitted to the emergency department, which is supported by MSF.
In Bunia, MSF provides financial, human and logistical resources to two Congolese organisations (SOFEPADI and EPVI) offering women’s health services, family planning and HIV treatment.
MSF also supports the emergency department of Dingila hospital in Bas-Uélé. In 2012, 1,070 patients were admitted, more than half of whom were suffering from malaria.
In Niangara in Haut-Uélé, a team continued to support the general hospital as well as three health centres, where activities were expanded to offer mental health services and routine vaccinations. The programme in Dungu was handed over to health authorities in December, following an improvement in the security situation and a reduction in the number of trauma patients.
Three-quarters of all reported cases of sleeping sickness (human African trypanosomiasis) are in DRC, yet testing for the disease has declined significantly. In Ganga-Dingila and Ango, Bas-Uélé, MSF worked with Ministry of Health staff in the hospital and in mobile teams, screening some 60,000 people for sleeping sickness and treating 1,070.
A further 100 patients in Bandundu and Kasai-Occidental provinces received treatment through a mobile programme, which closed in December. MSF’s programme in Doruma in Haut-Uélé was handed over to the Ministry of Health as the number of cases had fallen below the emergency threshold.
Only 15 per cent of people living with HIV in DRC have access to the antiretroviral (ARV) treatment they need, one of the lowest coverage rates in the world.
In Kinshasa, staff at MSF’s Centre Hospitalier de Kabinda have treated a large number of patients arriving in later stages of the disease with serious complications. Some 4,700 patients are receiving ARV treatment in Kinshasa, and many people attend MSF’s other HIV programmes across the country.
Malaria is the leading cause of illness and death in DRC. In 2012, an outbreak struck several regions of Orientale, Équateur and Maniema provinces. Unusually high numbers of cases of serious malaria required hospitalisation.
MSF teams set up treatment and intensive care units, supplied drugs to health facilities and organised the transfer of seriously ill patients to hospital. Between June and September, MSF treated tens of thousands of patients, the majority children under five-years-of-age. A team also brought short-term support following malaria outbreaks at locations in North Kivu and Katanga.
At the beginning of the year, there was a measles epidemic in the areas of Dungu and Faraje, Orientale province. MSF vaccinated 37,400 children and treated 61 patients. When another massive epidemic broke out in October, MSF carried out a major vaccination campaign. Teams also responded to measles in Katanga, South Kivu, Bandundu and Équateur provinces.
MSF responded to outbreaks of cholera in DRC throughout the year, treating a total of 1,160 patients in Ituri district, Orientale; 1,550 in and around Goma, North Kivu, where the team also organised patient transfers to MSF-supported hospitals and donated medicines to other health facilities; and 300 in Lubumbashi, Katanga.
Staff also managed a cholera treatment centre in Kalémie hospital and assisted in responding to outbreaks in Bandundu and South Kivu provinces.
Ebola outbreak in Haut-Uélé
Ebola, a haemorrhagic fever transmitted through bodily fluids, broke out in Isiro in Haut-Uélé in August. There is no known cure for Ebola and the mortality rate fluctuates from 30 to 90 per cent. MSF assisted the response, treating 18 patients and providing psychosocial support.
At the end of 2012, MSF had 2,782 staff in the Democratic Republic of Congo. MSF has been working in the country since 1981.