The Katanga region in the Democratic Republic of Congo (DRC) was hit by a huge measles epidemic in 2015, and tens of thousands of people were affected.
Such health emergencies occur with alarming regularity in DRC, a result of poor infrastructure and inadequate health services, which are unable to prevent or respond to outbreaks of disease. In Katanga, for example, there have been measles epidemics every few years, owing to the failure of routine vaccination programmes and the shortage of healthcare in remote parts of the region. MSF launched activities in April in Malemba Nkulu health zone, eventually deploying multiple teams and intervening in over half of the affected health zones. Teams carried out vaccinations and supported measles treatment for patients at over 100 health centres. By early December, they had vaccinated over 962,000 children against measles and supported the treatment of nearly 30,000 who had caught the disease.
At the beginning of the year, MSF mobile clinics responded to malnutrition and malaria among internally displaced people in camps in Nyunzu and Kabalo in Katanga, and vaccinated children under the age of five living in the camps and the surrounding areas against measles. MSF also continued its efforts to bring cholera under control in Kalemie and in Kituku, Undugu and Kitaki health zones, monitoring and treating diarrhoeal diseases, providing oral vaccinations, improving the water supply infrastructure and distributing filters. In addition, over 30,100 people were treated for malaria during May and June in Kikondja, and measles vaccinations were provided between July and November in Kikondja, Bukama and Kiambi. A South Kivu emergency response team also vaccinated 81,590 children against measles in Haut Lomami between September and November.
As the security situation in the Shamwana area stabilised, displaced people began returning home. MSF expanded its support from six to seven health centres and increased the number of specialised community health sites where patients with malaria, malnutrition and diarrhoeal diseases are identified and treated. Teams continued to provide comprehensive healthcare at Shamwana hospital, carrying out 76,293 outpatient consultations and 1,680 individual mental health sessions.
Despite some improvements, the eastern provinces remained largely insecure, as the Congolese army and several different armed groups fought for control over resource-rich territory. There were attacks on civilians, which caused further waves of displacement, and many incidents of banditry and kidnapping. MSF remains one of few international organisations providing medical care in these areas.
In Mweso health zone, at the border between Walikale, Masisi and Rutshuru, where almost 105,000 internally displaced people live, MSF continued its comprehensive medical programmes at the respective hospitals, and assisted at local health centres. Teams distributed emergency and relief items to newly displaced people in Mweso and carried out over 185,000 outpatient consultations – about a quarter of which were for malaria. More than 13,200 individual mental health sessions were completed, over 4,000 children received treatment for malnutrition and 6,500 births were assisted. At the Walikale project, close to half of the 133,000 outpatient consultations were related to malaria. Women with high-risk pregnancies were followed up and accommodated at a women’s centre in Masisi hospital. Mobile clinics visited displacement camps and remote villages in the area. Teams treated 343 victims of sexual violence, provided 168,801 outpatient consultations and ran general health education and information activities for over 18,000 people.
The MSF-supported general hospital in Rutshuru remains the only referral hospital in the area and teams there provided over 33,300 emergency consultations – many for malaria – and admitted over 3,700 patients for surgery in 2015.
MSF continued to offer screening and treatment for HIV, including for patients co-infected with tuberculosis (TB), at its HIV project based in Goma, which supports five other health facilities. MSF also treated 1,000 people in Goma for cholera.
MSF opened a project in Lulingu in August, supporting the general hospital and six peripheral health centres, with a particular focus on care for children and pregnant women. Malaria, gastrointestinal and respiratory tract infections were the main illnesses staff treated in 2015. Services include paediatrics, emergency services and an operating theatre. In a similar project in Kalehe, Hauts-Plateaux, MSF supports Numbi reference health centre and three other centres in the area. Some 124,000 outpatient consultations and over 37,000 reproductive health consultations were carried out and around 35,700 children received routine vaccinations. Through support to Shabunda general hospital, Matili hospital and seven health centres, MSF continues to bring medical assistance to displaced people and local communities in isolated areas experiencing protracted conflict.
An increase in malaria in recent years has overwhelmed the MSF-supported Baraka hospital, where capacity has been exceeded by 300 per cent. A 125-bed facility was built for patients who are no longer in critical condition but still need medical care. Several community-based sites helped thousands of children access treatment for malaria, pneumonia and diarrhoea. Staff carried out 287,000 outpatient consultations and admitted nearly 17,000 patients for care. Teams at Kimbi hospital, associated health centres in Lulimba, Misisi and Lubondja, and community sites provided 149,500 outpatient consultations and treated 125,600 patients for malaria, 373 patients for TB and 311 patients for HIV. A South Kivu emergency response team launched seven different interventions to tackle epidemics and address the needs of displaced people.
In March, MSF opened a new project in Bikenge city, a remote city in the mining area, focusing on the needs of vulnerable groups: pregnant women, children under the age of 15, victims of sexual violence and surgical emergencies. The team carried out around 24,700 consultations, treated 116 victims of sexual violence, and assisted 1,090 births.
Ituri, Haut-Uélé and Bas-Uélé
MSF opened a project to assist returnees and displaced people in Boga health zone. The team supports Boga general regional hospital and Rubingo health centre, offering reproductive, emergency and intensive healthcare. The team’s health education and information activities reached over 25,000 people this year. There are frequent clashes between armed groups and the UN and Congolese forces in the Gety region, and civilians are displaced repeatedly. MSF continues to support the regional general hospital and three health centres, focusing on emergency services and care for pregnant women and children. Staff treated 381 victims of sexual violence in 2015.
The Bunia Emergency Pool works throughout Ituri, Haut-Uélé and Bas-Uélé, and this year responded to 12 emergencies including outbreaks of cholera, meningitis and measles.
An emergency intervention responding to an influx of refugees from the crisis in Central African Republic evolved into a new project in 2015. Teams worked in Bili and Bossobolo health zones, and mobile clinics delivered basic healthcare to Boduna, Gbagiri, Gbangara, Nguilizi and Gbabuku. More than 62,500 outpatient consultations were provided.
MSF’s Kinshasa-based project has been ensuring comprehensive medical and psychosocial care for people with HIV/AIDS since 2002. Staff working at an MSF hospital and seven partner facilities supported the health ministry in managing a cohort of over 5,300 patients in 2015. They carried out 43,000 outpatient consultations and 32,600 educational sessions.
The Pool d’Urgence Congo, an MSF emergency team, received 171 alerts and intervened in seven emergencies for malnutrition, measles, cholera and refugee crises that benefited over 300,000 people across the country.
Régine – Mother of five, Manono health zone, Katanga.
"The day the doctors came to my village to vaccinate children against measles, I buried one of my children who had died of measles. Another of my boys also suffered from the disease and he could no longer breathe, so we took him to the Manono hospital. The doctors put him on a machine to help him breathe and he received medication. I told the doctors I had three other children all alone at home who were also suffering from measles. I had no choice but to leave them alone because their father was not there ... so we left on motorbikes for my village, to bring them to the hospital for treatment."