Democratic Republic of Congo (DRC)

Where is the Democratic Republic of Congo?

Photographer : Wikimedia Commons

The Democratic Republic of Congo is located in central Africa and is the third-largest country on the African continent. It’s bordered by the Republic of Congo, the Central African Republic, the Sudan, Uganda, Rwanda, Burundi, Tanzania, Zambia and Angola. DRC has a population of about 55 million people.

What’s going on in the Democratic Republic of Congo?

The Democratic Republic of Congo (DRC) is in the midst of an urgent and acute humanitarian crisis. As a result of the country’s ongoing conflict, the population have suffered, and continue to suffer, from displacement, murder, rape and other violence. Malnutrition and disease are widespread and much of the population lacks food, shelter and basic health care. Yet to date, their struggle to survive has been a largely silent one, under-reported and neglected by the international community.

It is estimated that 3.8 million people have died since civil war broke out in the DRC in 1998. The majority of deaths have been due to largely preventable disease (such as malaria, measles, malnutrition) rather than violence. However, war has reduced access to health services for large numbers of the population. Violence continues to flare in Ituri province, North and South Kivu provinces, and in parts of Katanga province. Despite efforts at national reconciliation and the presence of a United Nations Peacekeeping Force, numerous armed groups still prey on populations and regional governments fuel the conflict. As a result, large parts of the country, particularly in the north-east, are rendered inaccessible to aid workers.

Some revealing indicators and statistics:

• Population: 57.5 million

• Life expectancy: 44 years

• Infant mortality: 129 deaths/1000 births

• People living with HIV/Aids: 1.1 million

• Number of physicians: 7 doctors/100,000 people

• United Nations Human Development Index: rank 167 of 177 countries (2003)

• Urbanisation: 31% urban, 69% rural

• DRC monthly mortality rate is 40% higher than the average for sub-Saharan Africa—2.1 deaths per 1,000 people, or the equivalent of 1,200 fatalities per day, compared with a continental average of 1.5 deaths per 1,000.

• Mortality rates are highest in DRC’s eastern provinces, where violence and lawlessness are widespread. There, death rates are 93% higher than the sub-Saharan Africa average.

• Malaria is endemic and is responsible for 45% of childhood death. Children under five years old, of whom only an estimated 0.7% sleep under an insecticide-treated net, suffer from 6 to 10 malaria-related fever episodes each year.

• Gender-based violence, although mostly undocumented, is the greatest threat to women's reproductive and sexual health and emotional well-being.

• HIV prevalence is estimated at 4–5%, indicating that the epidemic is spreading from high-risk groups to the general population. It is estimated that about 1.1 million people are living with the disease, of which almost 60% are women, and that 100,000 deaths annually are caused by AIDS.

• One in five children dies before reaching the age of five. Mothers die in childbirth in 13 out of every 1,000 deliveries.

• Out of sight, out of mind: DRC is always in the top 5 of Medicines Sans Frontier’s (MSF) list of most underreported crises.

• Humanitarian aid: MSF is the leading humanitarian organisation providing urgent medical aid to the DRC population. MSF has been operating in DRC for 25 years to date, operating on an independent and politically neutral mandate. There are currently 2,133 national staff and 223 international staff administering MSF’s medical aid.

What are the challenges for providing medical treatment in DRC for humanitarian organisations like MSF?

• The volatile security conditions are a major challenge for humanitarian aid providers like MSF as well as the Congolese population. The volatile security situation means that various villages and zones throughout the country are controlled by opposing rebels and militias. Therefore, travelling through different villages, which is necessary to reach medical facilities, is dangerous and risky. This means a large portion of the population remains inaccessible to aid workers.

• Distance and lack of roads means travelling to health facilities is a long and dangerous journey. It may take several days to reach the nearest facility, by which time it is often too late to treat patients from otherwise curable conditions and diseases. Lack of roads and ambulances also makes reaching patients difficult and sometimes impossible.

• A further problem encountered by many families is the burden of responsibility for those left behind when, for example, a mother takes her sick child to receive medical attention. She has to arrange for someone to look after the rest of her children. If the father is the one to do this, it means he cannot go to work which affects his ability to provide food for his family.

• The difficulties associated with access to essential medicines, which also affects many other developing countries, is a significant issue in the DRC. This is mainly because the diseases, which are responsible for the deaths of so many people, are often curable but treatments are not cheaply accessible.

• The lack of health infrastructure, such as hospitals, means that humanitarian organisations like MSF need to treat patients in make-shift and semi-permanent structures such as tent hospitals. Despite the obvious challenges, MSF is able to provide lifesaving medical treatment and surgeries for thousands of people. In the Bon Marche Hospital (in Bunia), a makeshift emergency structure, set by MSF in 2003, has over 300 beds and handles over 2500 consultations a month.

The humanitarian cost of the crisis on women and children

Children in the DRC

• Children in the DRC are dying from the same diseases that needlessly kill children all over Africa—malaria, diarrhoea, measles, malnutrition—but on a more devastating scale.

• Of the estimated 3.8 million people who have died in the DRC since 1998, almost half of them have been children under the age of 5.

• UNICEF reports that about 30,000 children have been forced into militias, while untold thousands of girls have been raped.

• Thousands of orphans swamp the streets of Kinshasa, the capital.

• A child dies in the DRC almost every two minutes, mostly from preventable causes.

Women in the DRC

Rape and other forms of sexual violence have affected hundreds of women, girls and men of all ages. Sexual violence has become another dimension of the war perpetrated by all warring parties against the civilian population. Sexual violence has medical, psychological and socio-economic consequences for the victims. The medical consequences of sexual violence include increased transmission of HIV/AIDS and serious complications in reproductive health. Fear, nightmares, and psychological body pain are some of the psychological problems experienced by victims. For women, rape often means rejection by their husband and even the community. Victims of sexual violence feeling isolated and ashamed are often forced to find their own way and as a result suffer from socio-economic hardship.

How do I know this?

Breaking news.ie_Congo, world's deadliest humanitarian crisis_, 2006, http://breakingnews.iol.ie/news/story.asp?j=168269...

MSF 2005, Access to healthcare, mortality and violence in Democratic Republic of the Congo

MSF, War and Neglect in the Democratic Republic of the Congo (DRC)

MSF-US 2002, ‘DR Congo: quiet, we’re Dying’, International Activity Report 2002, http://www.doctorswithoutborders.org/publications/... ;

MSF 2005, ‘Democratic Republic of the Congo: Another year of misery’, MSF Activity Report 2004/2005, http://www.msf.org/msfinternational/invoke.cfm?obj...

MSF 2006, DRC Information Sheet 2006

UNICEF, At a glance: Democratic Republic of Congo, http://www.unicef.org/infobycountry/drcongo.html

World Health Organisation, DRC, http://www.who.int/countries/cod/en/

World Health Organisation 2006, Country profile: DRC, January, http://www.who.int/hac/crises/cod/background/DRCon...

For the latest information on the situation in the Democratic Republic of Congo, visit MSF’s Congo mini-site at: http://www.msf.org.au/minisites/drc_exhibition/ind...

This page was written in conjunction with MSF Australia