Angie is a doctor who has been working with MSF / Doctors without Borders in the Democratic Republic of Congo. Today she blogs about an outbreak of violence, and the kindness of strangers...
Claudio and I are finally coming to the end of our mission in Kitchanga. The end of a mission is always a strange point in time where we have become familiar with the context and work but have completely run out of energy to continue our work.
The past few weeks in the mountains have been hectic. Due to increased fighting in the region, more and more IDPs [internally displaced people] have been coming into the areas we work in. In Bibwe, there is an estimated 15,000 IDPs who have settled in the villages in the forest around Bibwe. In Kivuye, there are 2083 new IDPs who have been integrated into the refugee camp.
A vaccination campaign is a huge logistical exercise
Due to increased overcrowding and a risk of a measles epidemic, we started organizing a measles vaccination campaign in collaboration with the Ministry of Health. The target group of a campaign consists of children aged six months to 15 years. In order to provide sufficient herd immunity, a coverage of 100% is required ie: all children need to be vaccinated. In reality, a result of 75% coverage is acceptable. A vaccination campaign is a huge logistical exercise. It starts with getting the approval from the Ministry of Health. This is followed by a population count, calculation of supplies required, ordering supplies, sensitizing the community as well as informing all actors in the area. One of the primary activities is choosing a suitable site and setting up the vaccination circuit. The site needs to be of a suitable size with a waiting area, one entrance and one exit on opposite sides, space enough for the registration team, team for oral medications (vit A and albendazole), vaccination team, preparators of the vaccines as well as a storage and disposal facility.
Kivuye was chosen as the first site for the vaccination campaign for several reasons. In terms of medical need, two cases of measles were identified. For logistical reasons, Kivuye was chosen as there is a functional fridge in Kivuye Health Centre and the new IDPs have been integrated into the official camp. In contrast, the IDPs near Bibwe are scattered in the fairly inaccessible villages in the forest. We planned a Monday to Saturday visit (8-13 Oct).
Everybody was buzzing with excitement
Spirits were high and everybody was buzzing with excitement as we threw ourselves into the campaign. In the first two days of our campaign, we had vaccinated 3096 children. Unfortunately, midway during the campaign, we were contacted by our base in Kitchanga. Security in the mountains had deteriorated and we had to halt the campaign and return to Kitchanga. As it was too late in the day to drive back to Kitchanga, our team had to stay the night at Kivuye. We were unable to drive to Mpati to retrieve our belongings in our Maison de Passage. Fortunately for us, it was market day in Kivuye so we were able to buy a goat, potatoes and cabbage for our evening meal. When the local people heard that we were staying in Kivuye, they started coming to the health centre with their pots, pans and kitchen utensils. We even received a bag full of spring onions. I was very touched by their kindness. These people had so little for themselves yet they were giving us what little they had. That evening, as I held the security briefing with the team, we could hear the heavy pounding of artillery in the distance. Temperatures dropped in the night. We did not have blankets and only had the clothes on our back. We curled into little balls as we tried to conserve what little heat we had.
When the local people heard that we were staying in Kivuye, they started coming to the health centre with their pots, pans and kitchen utensils.
The following morning, we handed over our vaccination circuits to our staff in Kivuye and drove back to Kitchanga. Everyone was dirty and exhausted when we arrived at the base. As always, we have a debrief after each security incident. During the debrief, we were able to talk through the worries and fears of everyone involved. It was actually quite a relief to me that most of the staff were more concerned about the belongings they left behind then the stress of the evacuation.
Everyone was dirty and exhausted when we arrived at the base.
Our staff in Kivuye sent us the final results of the vaccination. Due to insecurity, after we left Kivuye, the staff were only able to vaccinate a further 750 children over the next couple of days. Overall, 3846 children out of a target 5010 children were vaccinated. This reflects a coverage of 77%. Not bad in light of the difficult conditions we were working in!
Claudio and I have flight tickets out of Congo next Wednesday. We are crossing our fingers and if all goes well, this time next week, we will find ourselves among family and friend we have not seen for a long time.