Democratic Republic of Congo: MSF calls for a rapid and tangible increase in humanitarian aid in response to North Kivu crisis

June 21, 2023 Some 600,000 displaced people are living in desperate conditions, with inadequate access to food and exposed to violence in camps around Goma, in the North Kivu region. Médecins Sans Frontières/Doctors Without Borders (MSF)’s medical teams have witnessed alarming rates of malnutrition and mortality in some of the camps. UN agencies recently announced they would be stepping up their efforts to meet the needs of people in the east of the country. These intentions urgently need to be translated into additional assistance and protection in line with displaced people’s needs.  

Displaced people are waiting to collect water in Rusayo camp. Around 100,000 people live in this camp, hailing from different war-torn areas of North Kivu. Lack of clean water in the displacement sites remains a major obstacle for many individuals, which causes serious health risks. ©Michel Lunanga

For several months now, Médecins Sans Frontières (MSF) has noted the slow pace of deployment and the inadequate level of aid provided to people who have fled their homes following the fighting due to the resurgence of the M23 armed group. Despite a certain increase in humanitarian aid in the past weeks, the approximately 600,000 people currently living in several sites surrounding Goma continue to lack assistance, particularly concerning food and shelter, which remain insufficient in quantity and quality.  

 On Friday 16th of June, the UN announced it will be raising the severity of the crisis to the highest level on the scale of UN organizations. This is a positive sign, but this awareness urgently needs to be translated into a significant, rapid and tangible increase in the aid provided to people in the camps.  

View of Rusayo displacement site, a dozen kilometers outside Goma, the provincial capital of North Kivu, where it is estimated that around 85.000 people found refuge. ©Michel Lunanga
Nearly 60 people have found shelter in a container located within the Rusayo camp. Without access to their field, most displaced people are deprived from their main livelihood and food is a daily struggle. They either rely on humanitarian assistance or the few products they manage to buy to eat, and many can only afford one meal per day. ©Michel Lunanga

A retrospective mortality survey carried out by MSF in April in Rusayo, Shabindu and Don Bosco camps, covering the period from January to April, revealed alarming mortality rates among children under five. In Rusayo, where the population is estimated at between 85,000 and 100,000, more than three children died on average every day (1.6 deaths per 10,000 children per day) from various causes during this period.  

In Elohim, which had a population of around 4,000 at the time of a rapid nutritional survey carried out at the end of May, MSF has collected data that revealed malnutrition rates well above emergency thresholds, with rates of severe acute malnutrition reaching 4.9 per cent among children under five. In May, one in four children in the Elohim camp were treated by MSF for malnutrition. In this same camp, many displaced people report having received no food assistance since their arrival, in some cases as long ago as January. At other camps, such as Rusayo and Shabindu, some food has been distributed, but not to all residents. This alarming situation is compounded by several risk factors such as cases of measles and cholera in the camp. 

Claude Imara, a 23-year-old woman, fled her home in Rugari, Rutshuru territory, and found refuge at Rusayo camp, near Goma, 70 kilometers from her village of origin. She soon noticed that her little girl had started developing concerning symptoms: her hair began changing color and her feet became swollen. Claude came to the MSF’s clinic where her daughter was screened for severe acute malnutrition. She received nutritional therapeutic food to treat her daughter at home and monitor if her health status is improving. ©Michel Lunanga
Viviane Nyirarukundo, aged 29, fled her village in Masisi territory. Previously, her two children were in good health but after their arrival in the camp their health started to deteriorate and one of them started to show symptoms of malnutrition. The mother brought him to the MSF’s clinic, and the child recovered but as the difficulty to find food persists, her child plunged once again into a state of malnutrition. Viviane lives alone with her two children, as her husband abandoned her upon learning that she had been raped. She must now fend for herself to find food for her and her two children. ©Michel Lunanga

The shortage of food is also impacting the health of adults, especially women, who often have to leave the camps during the day to look for food or firewood, exposing themselves to the risk of violence, particularly sexual violence. In early May, MSF raised the alarm over the high number of women treated by its teams for sexual violence: in two weeks, 674 women from Bulengo, Lushagala, Kanyaruchinya, Elohim, Munigi and Rusayo camps reported having experienced sexual violence. Currently, still an average of 40 women a day report being a victim of sexual violence in these same sites. Although humanitarian organizations appear to be aware of the gravity of the situation, aid and protection measures are currently benefiting only a small proportion of sexual violence survivors. The safety of civilians inside and outside the camps must be urgently ensured. 

Viviane Nyirarukundo, aged 29, fled her village in Masisi territory. Viviane lives alone with her two children, as her husband abandoned her upon learning that she had been raped. She must now fend for herself to find food for her and her two children. ©Michel Lunanga
This catastrophic situation is even more incomprehensible given its proximity to the major city of Goma, where aid could easily be distributed. Relief activities are being developed here and there, but without any coordination or overview of the situation in the camps. The scale of mobilization of the aid system is far from sufficient and far too slow. There is also a blatant lack of visibility and information on the aid provided and on the number of people in need of support – information which is nonetheless necessary for the proper coordination of aid organizations.
Dr. Guyguy Manangama
Head of Emergency Programmes for MSF

Many of the displaced people arrived in the camps after experiencing serious episodes of violence. MSF’s retrospective mortality survey in Rusayo, Shabindu and Don Bosco camps showed that violence was the main cause of death among men (up to 40 per cent in some camps), with two deaths per 10,000 people per day,  between January and the end of April, which was mostly experienced in their place of origin or on their journey to the Goma area. This is twice the emergency threshold of 1 death per 10,000 people per day.

Upon the arrival of patients in the MSF’s clinic inside Rusayo camp, they are directed to the triage where their identity is recorded, and a medical file is created before they can proceed to the consultation. ©Michel Lunanga
Samuel Mugabo is providing nutritional therapeutic food and medications to Foibe Bonane, a displaced mother whose child is battling malnutrition and measles. ©Michel Lunanga
The scale and duration of displacement is historic, even for Eastern DRC.This gives us an idea of the response that is needed. Yet hundreds of thousands of people continue to be largely neglected by the aid community, despite the growing awareness of the humanitarian system.
Dr. Guyguy Manangama
Head of Emergency Programmes for MSF

During the first months of the crisis in 2022, the humanitarian response, including that of MSF, was too slow to get underway, the organization acknowledges. Since then, MSF has continued to implement interventions to support the population. Today, it has mobilized a further €1 million to provide ready-to-use therapeutic food to the most vulnerable families, especially those with children under the age of five suffering from acute malnutrition. 

The humanitarian situation is also desperate in other areas of North-Kivu, such as the Lubero, Masisi and Rutshuru territories, where MSF is sometimes the only organization on site, and where the level of aid available to people in need is also seriously inadequate.   

MSF teams use the mid-upper arm circumference (MUAC) tape to determine the children’s nutritional status. In Rusayo camp, there is a dedicated program for malnourished children. ©Michel Lunanga

MSF teams have been working in 12 camps for displaced people around the city of Goma, providing free medical care, supplying drinking water and building latrines and showers according to the most urgent needs. MSF teams have also responded to the cholera and measles epidemics that have affected some camps by treating patients and organizing vaccination campaigns. MSF teams are also providing medical care in other citiesof the North Kivu province, as well as in Minova and Numbi in the South Kivu province, where tens of thousands of displaced people have also taken refuge. In North Kivu, MSF continues to provide free essential medical care in the health zones of Rutshuru, Kibirizi, Bambo, Binza, Mweso, Masisi and Walikale. 

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