Photo: Over the next four weeks, MSF project coordinator Will Turner and his team will mount an expedition to screen 40,000 people for sleeping sickness in remote villages of the Democratic Republic of Congo.

DRC: Through northern Congo with a fridge

Travelling along muddy rainforest tracks by motorbike and crossing swollen rivers by dugout canoe while carrying a refrigerator, a microscope and a generator is no easy task. But this is what MSF project coordinator Will Turner and his team will be doing for the next four weeks. 

Without treatment, sleeping sickess - transmitted by the tsetse fly - is always fatal.

Photo: The raining season may close off vehicle access to roads, but MSF staff will find the means to reach their patients in need. DRC 2013 © MSF

Photo: An MSF clinic in Kitchanga, North Kivu. DRC 2009 © Michael Goldfarb

DRC: North Kivu Fighting Damages Health Structures and Displaces Thousands

Amid fighting in the town of Kitchanga in the east of the Democratic Republic of Congo (DRC), which has caused widespread casualties and damage to health facilities, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is mobilizing medical resources to the affected area, the organization said today. More than 55 civilians have reportedly been killed in the fighting, and 135 people wounded. Shelling also struck St. Benoit Hospital in Kitchanga today, killing two people and wounding eight. Many homes and other buildings have been burned, including the MSF compound. Thousands of civilians have fled. “We call upon all parties to the conflict to respect the neutrality of health structures,” said Hugues Robert, MSF’s head of mission for North Kivu province. “MSF is very concerned about the plight of civilians during intense periods of fighting like this. All parties to the conflict should not harm the population.” Several MSF Congolese staff members were displaced from their homes by the fighting, and widespread panic and fear is gripping the population as tensions between communities in the region escalate. Reaching Kitchanga is extremely difficult. An MSF surgeon, anesthetist, nurse, and emergency logistician arrived by helicopter yesterday to provide additional support to an MSF medical team based in the town. Dressing kits, surgery kits, medicine, plastic sheeting, and tents were also delivered. Several wounded people were also transferred to the North Kivu town of Mweso and to the provincial capital, Goma, for further treatment.

Photo: If not treated on time, measles-affected children often develop severe medical complications, such as respiratory infections and malnutrition. DRC 2013 © Tristan Pfund/MSF

Measles Continues to Stalk the DRC

This past December, Doctors Without Borders/Médecins Sans Frontières (MSF) issued an alert about a measles epidemic in northern Democratic Republic of Congo (DRC)’s Equateur and Orientale provinces, trying to draw attention to the situation and the lack of resources available to health personnel responding to the emergency. Two months later, however, the measles epidemic is still afflicting tens of thousands of children in the area. The disease is extremely contagious and can spread quickly in countries like DRC that have large gaps in their health care systems. The effects can de devastating. Measles leads to serious medical complications in patients. Mortality can reach up to 15 percent, or even as high as 25 percent in extreme instances. Since March 2012, MSF has treated more than 18,500 patients and vaccinated more than 440,000 children, but it is clear that many more need assistance. “We see lots of small, recently dug graves along the roads,” says Nathalie Gielen, manager of an MSF team returning from Djolu health zone in Equateur. “We counted 35 dead in one village. A father told us that he had lost seven children in three weeks. Traveling from village to village, we hear just one word: measles. People are frightened and hopeless. They’re asking for help.”

Photo: MSF doctor Susanna Ericsson examines a young patient. DRC 2013 © MSF

Letter from Shamwana, Democratic Republic of Congo

MSF doctor,Susanna Ericsson works in the Democratic Republic of Congo, where ongoing fighting between government forces and Mai-Mai militias in Katanga province has forced thousands of people to flee into the surrounding bush fearing for their lives. Here, Dr. Ericsson describes the experience of one such patient.

Our patient arrived early in the morning the day after we removed all non-essential staff from the project. She was the first person to be taken care of by our emergency “skeleton” team.

She was 23 years old, and came from a small village called Kilenge that has no health care facilities at all. The village is 25 kilometers [about 15 miles] from Kafumbe, where there is a small health post. There has not been anybody working at the health post for a long time because of the fighting and because there is a lack of health personnel and medicines in this region.

The patient had started getting abdominal pains at home, and got worried as she was already late in her pregnancy. She went over to her mother’s house and a traditional birthing attendant and a traditional healer were called for. For three days this woman drank concoctions of different herbs and the traditional healer gave her some physical exercises to do to get the baby out.

On the fourth day, the baby still hadn’t been born and her family was very worried as she had developed fever, smelled very bad, and the pain was worse than ever. At 3:00 am that morning the family set out for Shamwana where MSF runs a hospital offering free medical care to all.

It took the family 48 hours to reach MSF’s hospital on foot. The patient was transported on a bicycle, and 10 men and 4 women came along as protection, since the roads are not safe, and they were worried about an ambush.

Upon arrival at the hospital in Shamwana the patient immediately went into emergency surgery. A serious infection had already spread though her body and her baby had died. There is no doubt that without the surgery provided by MSF, the woman would not have survived. 

Photo: Patients in South Kivu wait to receive measles vaccinations in a 2010 MSF mass immunization campaign. DRC 2010 © Haavar Karlsen.

65,000 Children Vaccinated Against Measles in DRC’s South Kivu

In the past month, MSF teams in the Bunyakiri region of Democratic Republic of Congo’s South Kivu Province have vaccinated more than 65,000 children aged 6 months to 15 years against measles. The campaign had to be briefly suspended in the north of the region due to the volatile security situation in an area where several armed groups are present and fighting is frequent.

Photo: Patients in the inpatient department of an MSF hospital in Katanga Province. DRC 2012 © Sandra Smiley/MSF

DRC: Thousands of Displaced Civilians at Risk in Katanga Province

As tensions increase between government forces and Mai-Mai militias in Katanga province, southeastern Democratic Republic of Congo, all parties must avoid harming thousands of civilians who have fled into the surrounding bush.

The exact extent of the displacement is hard to quantify, but most of the villages along a 115-kilometer [about 71 miles] road from Shamwana to Dubie are empty, as are villages along a 70-kilometer [about 43 miles] stretch between Shamwana and Mpiana.

“Civilians risk being caught up in the fighting and mistaken for combatants,” said Christine Slagt, MSF project coordinator in Shamwana. “Some militia groups are preventing people from leaving the area.” 

This week, MSF removed nonessential staff from its referral hospital in Shamwana, about 300 kilometers [about 186 miles] from the provincial capital Lubumbashi, leaving a skilled core team with surgical capacity to respond to an expected increase in war-wounded patients.

MSF has been running the hospital since May 2006, providing people living in the Kiambi, Mitwaba, and Kilwa health zones with free health care. Medical teams treat malaria, tuberculosis, HIV/AIDS, and malnutrition, and provide reproductive health services, mental health care, and emergency surgery.

Photo: People queue for food distribution in Mugunga III camp. DRC 2012 © Aurelie Baumel/MSF

DRC: High Levels of Sexual Violence in Goma Camps

People displaced by armed conflict around Goma are now suffering high levels of sexual violence in and around the camps where they have taken shelter.

Between December 3, 2012, and January 5, 2013, the MSF team working in Mugunga III camp, a few kilometers west of Goma, registered and treated 95 patients who were victims of sexual violence, with a notable increase in late December. MSF denounces the lack of action on the part of those responsible for protecting civilians and the poor security conditions in the Goma camps. 

“The camps and surrounding villages face a glaring lack of security,” said Thierry Goffeau, MSF head of mission in Goma. “The responsible authorities and the leaders of the various armed groups all claim—without exception—that they are defending the civilian populations. They must thus assume their responsibility and ensure that the most vulnerable are not subject to violence or reprisals.”

Photo: From just outside the main entrance of Masisi hospital the view stretches over the mountainous and sometimes conflict-wracked landscape of North Kivu. DRC 2011 © Yasuyoshi Chiba/Duckrabbit

Violence In DRC Wracks Masisi Too

While people living in Goma and sheltering in nearby camps continue to live in fear of new clashes between an armed group called the M23 and loyalist forces, Doctors Without Borders/Médecins Sans Frontières (MSF) is witnessing increased violence in Masisi, some 80 kilometers (48 miles) to the northwest. In this isolated area of North Kivu, the medical emergency organization is providing support to the region’s primary hospital.

The violence, the fiercest since 2007, has forced tens of thousands of people to flee and has sharply restricted access to medical care around Masisi. MSF program manager Amaury Grégoire provides an update:

What is the current situation in the Masisi region?

We are very concerned by the sharp upturn in violence. The number of wounded that our surgical team has treated more than tripled in three months. Nearly one out of every five operations today involves people with gun or knife wounds. We have not seen this level of violence in since we arrived in Masisi in 2007.

What explains this upsurge in violence?

There are many armed groups in the region and the slightest disputes are resolved by violence. People are threatened and attacked every day at home, in the fields and on the road. These attacks are often motivated by money, but we are seeing increasing numbers of purely gratuitous attacks and ethnically-motivated assaults. They are perpetrated by armed groups but also by civilians who belong to other communities.

Who are the primary victims?

The wounded patients admitted to the hospital include armed men, of course, because the region was the scene of considerable fighting over the last few weeks. But we are also seeing a growing number of civilians, including women and children. In some cases, the violence has reached horrifying levels. On November 4, the village of Shoa, which is located a few kilometers from the town of Masisi, was attacked. Seven people who died from machete wounds were brought to us at the hospital. The victims included two pregnant women and a baby. Later, on November 29, following a series of attacks in the village of Kihuma the MSF teams treated 32 wounded patients, 8 of whom were suffering from violent trauma. This unprecedented violence left seven people dead that day.
Is MSF also seeing an increase in rapes?

In Masisi, our teams usually treat between 40 and 70 rape victims every month. In November, our teams treated 20 victims of sexual violence. We fear that this reduction is not a good sign. Unfortunately, violence towards women has not dropped all of a sudden. Insecurity and rising ethnic tensions create obstacles for people who need to come to the hospital or a health center. People are afraid and remain at home, often risking their life.

What is the direct impact of this new situation on people’s lives?

There are nearly 40,000 displaced persons around the two villages of Rubaya and Kibabi alone. These families are living in extremely precarious conditions and an outbreak of cholera made their situation even more desperate. In addition, people are afraid to go to health centers. With the exception of emergency visits, where we see a sharp increase in the number of victims of violence, admissions to the Masisi hospital have dropped considerably. We know the need is there but people are afraid to leave home. For example, there are many at-risk pregnancies in the region. In this area we have found that between five and 15 women out of 100 require an emergency Cesarean section. In the last few weeks, many fewer of those women have come in. In November, half of the beds were empty, while normally, most of our beds are occupied. It’s very worrisome. These women have no other alternatives and will be forced to give birth alone, without help. We know that some of them will not survive.