Civilians fleeing violence in the eastern Democratic Republic sometimes find a safe place, only to have to flee gain when fighting spreads, says Francois Dumont of Médecins sans Frontières, from Goma. AllAfrica's Bunmi Oloruntoba interviewed him by phone about the challenge of bringing health care to the displaced in a rapidly-changing environment.
What are you doing on the ground right now?
Our core activity is to provide health care and we try to provide free health care at the primary and secondary levels - that means through health centers and mobile clinics, we try to reach displaced people and the local population. Also, we work in the hospitals to provide surgery for the wounded [and] surgeries for maternal care, like deliveries. We also run projects in support of victims of sexual violence, malnourished children and we are responding to diseases such as cholera and measles.
Observers are very concerned about the widespread reports of sexual violence. What can your organization do to help victims?
For several years, [responding to sexual violence] has been part of our project. We have the components in place to treat victims of sexual violence [and] rape victims. There have been many women who were victims of sexual violence that were treated in the MSF facilities in several places in North Kivu.
It's a big problem. It's part of a larger problem, which is the displacement of the population. People... don't have access to food, access to water, and sexual violence is, of course, an issue.
Is the rise in sexual violence a result of the displacement of people or can it be attributed to something else?
No. I said sexual violence is part of the consequences of the war, of course. But I just want to say that it is one of the things that we respond to. Other problems that the population faces, like being forced to flee several times, to be victims directly of violence when caught in the crossfire, or people who don't have access to food, or who die from diseases that can be treated because they don't have access to health care because of the war. Sexual violence is just one of these issues.
When displaced people move, do your mobile clinics move with them?
Yes, we run the mobile clinics and supporting health posts... to reach the population. In the hospitals we provide secondary health care for people who need to be hospitalized. Through the mobile clinics the objective is to be closer to the people, because sometimes they have to walk very long distances before reaching a health facility.
How difficult is it to reach displaced people?
It has been several years that the people have been suffering from the consequences of the conflict. Many of them in various places had to flee because of fighting. It depends: some people walk 10, 20 kilometers try to find a safe place and then there is fighting again and they have to flee again... and find another safe place... They end up with nothing. That's why we are trying to run projects in many areas as possible in order to give them assistance because there is not much assistance reaching them in the fighting areas.
How does Médecins sans Frontières get to inaccessible places?
How we guarantee our access to the population is through the fact that we remain strictly a neutral organization. That means we have contact with all the parties in the conflict. We have contact with the community...
So far we have managed to stay there and remain with the people in these areas. Our security is [achieved] through this management of our contacts with all the parties and communities in the area in which we work, rather than being protected or facilitated by the United Nations peace-keeping forces.
Is the United Nations doing anything to aid your efforts? And what is going on between the UN and government troops right now?
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For what's going on between the UN and the government forces, you will have to ask either the UN or the government forces. MSF cannot tell you anything about that because we don't know. We are working independently and it is very important for us to remain independent in our security management, also for the way we deliver assistance on the ground.
Can you hazard a guess how close the rebels are to Goma or to any of the villages or towns near it?
Since I have been away, I fear I cannot give the latest information and I am sure from today you will be getting more up-to-date reports coming from the area. What I can tell you is, we have people and projects in... areas controlled by the troops of Major General Laurent Nkunda and we have projects in areas controlled by the government. As the representative of a neutral organization I can't tell you in which area any armed group are.
