Every day many children were dying in Lulingu and Tchonka, in Democratic Republic of Congo (DRC), for unknown reasons. The area is extremely remote, roughly 300 kilometres from the provincial capital Bukavu and reachable by travelling between eight and 10 days along impassable roads. It is also accessible by plane, which is how supplies arrived for the Médecins Sans Frontières (MSF) team called by the local authorities to intervene to fight a peculiar epidemic killing the children in the villages.
After diagnosing the disease as a virulent outbreak of malaria, and after a three-month intervention treating 7,657 patients at the hospitals and health centres in Lulingu, Katchungu and Tchonka, and drastically reducing mortality rates, Helena Valencia, MSF field coordinator, assesses the emergency intervention.
"People attributed [the outbreak] to some sort of witchcraft because the mortality rate in children was very high; approximately eight children died every day in Lulingu hospital," says Valencia. Following our arrival, and after a correct diagnosis, people were able to see that with the right treatment, in three days the disease reverted and they could stop burying their dead."
Malaria endemic in area, children hard hit
In the Lulingu area, where MSF had already conducted a similar intervention last year, malaria is endemic. The large number of lakes in the region is a breeding ground for the mosquitoes carrying the disease. In a mining area, where manioc is one of the few crops on which people survive, combined with dry fish from the lake, malaria ravages, especially hitting young children who have fewer defences. If there are complications, with malnutrition, measles or anaemia, the fatality rate shoots up, especially among the youngest.
"It is a poor area, villages that have seen better times in the past, where now there is no investment, no work, just illegal mining and a very volatile region controlled by warlords, armed groups," says Valencia. "There are no options to progress. It is a no-man's land and in conflict between the Raïa Mutomboki (self-defence armed groups) and the FARDC (DRC's regular army)."
Like in the rest of the country, going to hospital is not always an option when people get sick, because they have to pay for the medical services. "So they'd rather go to the chambre de prière [prayer room] and entrust sick people to religious leaders. Only when patients are in very serious condition do they decide to take them to hospital," says Valencia.
As is the case in all of its work, MSF's treatment was free of charge "Many patients arrived and we were able to save many lives," she says.
4 tonnes of supplies, 24 staff brought in
The intervention meant transporting by plane all the necessary supplies: generators, medicines, diagnosis tools and motorcycles to make staff and supply movements easier in the area. Four tonnes of material and 24 people were brought in for the emergency.
MSF also conducted a prevention campaign, distributing 15,000 mosquito nets provided by UNICEF - community health workers went into villages to explain to people the need to use the nets correctly, and the importance of detecting the disease as soon as possible for the cure to be faster and more effective. During the intervention in Lulingu, MSF donated supplies to the Katchungu hospital. The hospital was rehabilitated and a pharmacy opened, and laboratory staff were trained in early diagnosis of the disease.
"The closing of the emergency intervention was smooth," says Valencia. "People stopped us in the street to thank us because their children were no longer dying. They knew that MSF had been there before and we had come back, and so they trust that we will return again if something similar happens."