…in the time of cholera

November 20th, 2007 by susans

Today I went to see some of the cholera camps that MSF has set up around Goma. Cholera in endemic here and MSF teams normally see a few cases every year but, with an additional 45,000 or so people living in camps on the outskirts of the city, things have been much worse this year. MSF set up one cholera treatment centre between 4 of the big camps in the city and is supporting another 5 health centres in different locations around Goma and the neighbouring town of Sake. Over 1,100 people have been treated so far. Fortunately, the number of cases seems to be going down now.

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Photo : Susan Sandars, MSF | Cholera patient.

It’s so strange driving along the main road towards Sake. The camps on both sides of the road are a stark reminder of what is happening here and a real contrast to the hustle and bustle of Goma. It’s a shock to see that some of the small shelters that people live in aren’t covered with plastic sheeting, but then the driver reminds me why. Last week one of the camps here, Mugunga, was attacked. Thousands of people fled, apparently the roads were lined with people walking towards the city centre, carrying whatever they could with them. When they returned a day or so later, the sheeting that was covering their tents and providing some small protection from the wind and the rain had been stolen. The shelters look strangely naked without it. Those that still have sheeting now take it down every morning and keep it with them so that they can run at a moment’s notice. A piece of sheeting, which costs about seven dollars, is their most precious possession.

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Photo : Susan Sandars, MSF | Mugunga Camp.

Although the cholera outbreak is waning, there are still around fifteen patients in the centre I go to. Many of them are children. All of them are displaced. One woman I speak to tells me her story. Originally from Mweso (Masisi District) she came here two months ago when there was fighting in her village. She came here on foot, but the journey was slow as she had her two children and her neighbour’s ten year old son with her. His parents disappeared and so now she’s looking after him, or rather he’s looking after her. Life is hard in the camp. During the day she goes to the fields to get bananas to sell and make some money, leaving her children in the care of the ten year old. One big branch of bananas will sell for 150 Congolese francs. A plate of maize and beans costs 600 francs. She always gets diarrheoa after eating the maize and beans. Yesterday she felt very ill, with diarrheoa, vomiting and a fever. She fainted. When she woke up she was in the cholera treatment centre.

Culture-shock

November 16th, 2007 by susans

The journey back to Goma takes longer than it should. It has rained every day since I arrived in Masisi and the roads have got even worse than they were on the drive up here. We spend several hours waiting for trucks to be pulled out of the mud and even pull a few out ourselves. A number of World Food Programme trucks loaded with grain have been stuck overnight and are being guarded by UN peacekeepers to prevent them from being looted. Later in the journey, when we pass another food truck, I can see why… four men with guns in military fatigues are standing by the truck, each one of them holding a sack of grain.

Arriving in Goma is a bit of a culture shock. Life in the city continues as normal and it’s hard to believe there’s a war going on.

Understanding what?!

November 15th, 2007 by susans

Today I go with one of the nurses, Raphael, and his team to Bugari where MSF provides food for malnourished children twice a week. Although Bugari is only about 15km away from Masisi, it’s too far for people to come to get food. For the last three weeks Raphael and his team have been coming here and giving food to malnourished children under 5 and their families. When we arrive the mamas are already lining up with their kids, waiting to be seen by the MSF team.

When the centre gets a bit quieter, Raphael and I take a walk down the hill to a neighbouring village. When Raphael came here last week the village was deserted, all its inhabitants had fled and were living in the bush. Some of them came back during the day to cook and for the children to go to school, but at night they all felt safer sleeping in the bush. Three days ago they all returned. I struggle to understand our colleague Jerome’s explanations as to why this village fled whereas the one ten minute’s walk away did not, and why they have now come back. As he points out which hills are controlled by which groups and explains recent troop movements and developments in the conflict, I realize that perhaps I will never understand. After all, how could I?

Not for the faint-hearted

November 14th, 2007 by susans

A day spent at Masisi hospital is not for the faint-hearted. You will see pretty much everything you could imagine. A baby born two months premature that is no bigger than your hand. An 8 year old who is so malnourished she looks like an old, wise woman, but can still smile and reply “mzuri” when asked “habari”. An 8 year old boy whose leg had to be amputed after he fell in a fire. He went to the health centre to get treatment but they didn’t have any drugs or bandages, so his family took him to a spiritual healer who was paid to pray for him. But the prayers didn’t heal the injuries and by the time he got to the hospital – seven days after the accident – the burns were so infected that his toes were falling off and his leg was infested with maggots.

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Photo : Susan Sandars, MSF.

A woman whose uterus ruptured after an obstructed labour. A 12 year old girl who was shot in the back during an attack on her village. A 50 year old man who was injured in the same attack. He was shot in the chest when he couldn’t give his attackers the $100 they demanded. A woman being wheeled into surgery for a caesarean after being in labour for 24 hours and only being 7cm dilated.

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Photo : Susan Sandars, MSF.

It strikes me that some of these things have been caused by the war that is going on here, but many have not. Unfortunately the poverty and suffering that goes on in DRC existed long before this latest round of violence and will most likely continue long after it ends.

Hungry in the land of abundance

November 13th, 2007 by susans

The violence here has added to the malnutrition. It’s hard to believe that anyone could be hungry in North Kivu. It’s incredibly green and lush and the almost constant rain means that the land is very fertile. But people are hungry. Those that have not fled the violence are often too scared to go to their fields to farm. And those that are displaced and are living in camps or host families are simply not receiving enough food. The roads from Goma to Masisi are terrible and trucks with supplies regularly get stuck in the mud and can be looted.

Children are most at risk. Another NGO runs a feeding centre for kids that are severely malnourished at the hospital so MSF has opened another centre that focuses on kids that are moderately malnourished. Mothers wait patiently for their children to be weighed and measured, seemingly oblivious to the screams of terror that their offspring let out when put into a harness and hung from a set of scales attached to the ceiling.

In the afternoon Philippe, the project coordinator, takes us to the displaced people’s camp in Masisi town. The camp grew when young students and their teachers fled to Masisi, so that they wouldn’t be forced to fight in the war here. Since then more people have arrived and built tiny shelters from sticks and plastic sheeting provided by MSF. It’s hard to imagine how anyone could live in such cramped, basic conditions let alone that people would choose to do so.

Signs are everywhere

November 12th, 2007 by MSF Field Blog

At the end of August, MSF started supporting a hospital in Masisi district and today I’m supposed to be traveling up there to visit it. I get to the office at 07:15 to wait for the call to say that the roads are okay. Up until now it’s been uncertain as to whether I can go or not. The fighting, primarily between the army and a rebel group led by Laurent Nkunda, has got worse in recent weeks. People are living in fear and it’s not hard to understand why. Villages can be attacked without warning and people killed for no reason.

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Photo : Susan Sandars, MSF | Masisi Hospital.

But today the roads are clear and we set off. As we drive out of Goma we see the camps where thousands of people, who’ve fled to the capital in search of some kind of safety, are living. The further we get from the city the more armed men we see. Different villages and towns are controlled by different armed groups and the MSF driver keeps me informed throughout the journey as to whose territory we are crossing into.

The signs of war are everywhere. We pass through several villages that are completely deserted, everyone has fled. The tukuls that they lived in, which are basic at the best of times, are empty, the doors open. I’m not sure whether they’ve been kicked open or left that way by their inhabitants to show that there’s nothing left to loot.

BIO : Susan Sandars

November 11th, 2007 by susans

Susan SandarsSusan Sandars works as MSF’s Regional Information Officer (RIO) in Nairobi, Kenya. Her work involves regular trips to field projects in east and central Africa to respond to media requests and produce information and communications materials about MSF’s work in the region.