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Issue #1698      August 19, 2015

A reason for hope in war-torn DR Congo

The ongoing conflict in the Democratic Republic of Congo (DRC) has been the deadliest since the Second World War. More than five million people have died – mainly of starvation and disease – and marauding militia groups have raped and abused hundreds of thousands of women and children.

Healthcare at Panzi Hospital. .
Panzi Hospital.

Deep in the east of the country, where the war began in the aftermath of the Rwandan genocide, one surgeon in a small and under-funded hospital is giving women and children a reason for hope.

In 1999, Dr Denis Mukwege founded Panzi Hospital, in Bukavu, the capital of South Kivu province, to provide medical care and support to rape victims. He has received several international awards and been nominated for the Nobel Peace Prize for helping to treat over 30,000 survivors of sexual violence. Dr Mukwege explained:

“The perpetrators of these crimes destroy life at its entry point. The women can no longer have children. Often they get infected with AIDS and will spread the disease. Their men are humiliated. So the perpetrators destroy the entire social fabric of their enemies, their communities, their future generations, without even killing the woman.”

In October 2012, Dr Mukwege, a fierce critic of the Congolese government and armed rebels, was almost killed by four unidentified assailants. The assailants held members of his family hostage and waited for him to return to his home in Bukavu. He managed to escape by diving to the ground as the first shots were fired. Sadly, his security guard, who was a close friend, was killed. Dr Mukwege is now forced to live permanently within the grounds of Panzi Hospital under 24-hour protection by UN peacekeepers.

In transit

Panzi hospital sits on the side of a dirt track teeming with people and motorbikes on the outskirts of Bukavu. In stark contrast to the sprawling town that surrounds it, the hospital is well organised and scrupulously maintained. It provides general medical care to the population of South Kivu, but specialises in treating patients with specific conflict-related health problems.

Maison Dorcas, a transit house at the back of the hospital, is dedicated to providing long-term support to survivors of sexual violence, including training in literacy and numeracy, small business management and other livelihood skills, along with continual psychological care, such as group therapy and individual counselling sessions. It also works with local women’s groups and co-operatives to offer family mediation and micro credit.

The plague of rape in eastern DRC is starting to receive some of the international attention that it deserves, but the traumas experienced by mothers and babies are less well known.

Dr Mukwege told me: “In South Kivu province, babies are at high risk of contracting neonatal infections. This leads to premature deaths and discourages mothers from using family planning, which causes the number of pregnancies to increase along with the rate of maternal mortality.”

BirthLink, a British charity working to improve neonatal care in developing countries, has formed a partnership with US NGO Global Strategies to introduce and implement high-impact, cost-effective interventions at Panzi Hospital to decrease the mortality of newborns. This includes donating equipment to provide respiratory support, nutrition and lactation, alongside training and educating Congolese doctors and nurses to regulate temperature and prevent infection. These simple measures can halve a premature baby’s chance of dying.

Kathy Mellor, BirthLink’s founder, explained that ‘these are really not complex or expensive solutions. These are basic principles of care that can significantly reduce the number of babies that die each year from preventable and treatable conditions.’

Some babies at Panzi are born as a result of rape and are at high risk of developing HIV. Transmission from mother to baby can be prevented but requires a course of antiretroviral drugs immediately after birth. The majority of these mothers live in dire socio-economic conditions and can rarely pay their bill once treatment is complete.

Faida arrived at Panzi Hospital in April 2014. “Whilst I was pregnant I became very sick. I went into labour prematurely, so I came to Panzi to have an abortion. After the operation, I asked, ‘Where is my aborted baby?’ And then they told me that I had had a preterm baby and that it was in the neonatal unit. They said that the baby was alive and getting quite well, but she could be in the neonatal unit for a long time. I couldn’t believe it, my baby survived after only 26 weeks’ gestation!”

Both Faida and her baby Joyce were discharged from hospital four months later. Faida returned to Panzi this July to show the doctors at Panzi and the BirthLink team her healthy, happy and giggling baby. If it weren’t for the compassion, care and expertise available at Panzi, Joyce wouldn’t be alive today.

Reintegration

I met a 13-year-old girl who was abducted by three soldiers and raped in the forest. She didn’t realise that she was pregnant until she gave birth two months prematurely. She was terrified and found it difficult to love her baby; it having been born in hate and violence. She couldn’t produce milk and her baby was beginning to starve. But after receiving treatment at Panzi Hospital, both mother and baby survived. They now live together in the Maison Dorcas compound, learning the necessary skills for reintegration into the community.

Although there are other hospitals in South Kivu, Panzi offers the most up-to-date medical care and has many facilities, such as the neonatal department and Maison Dorcas recovery centre, unavailable elsewhere in the region. Christine Amisi, Co-ordinator of Panzi Hospital’s Fistula Project, explained: “Many small and sick babies from other hospitals in the region are now transferred to the neonatal unit at Panzi for treatment. We are currently receiving more cases than we can deal with.”

A core challenge for the future will be to introduce and maintain the same high quality of care available at Panzi across DRC more generally.

The DRC has earned the unfortunate sobriquet of “rape capital of the world”. Dr Mukwege has dedicated his life to trying to change this dark reality. He recognises that a healthy society is one in which women and adolescent girls, newborns and children survive and thrive. And this is an intelligent investment: the United Nations estimates that improved care around the time of birth and for small and sick newborns could save almost three million lives (mothers and babies) each year at an additional cost of just US$1.15 per person in 75 countries.

In troubled regions like eastern Congo, this has the potential not only to radically improve the lives of mothers and babies, but also to maximise human capital and contribute toward the wider development agenda. And with a courageous leader like Dr Mukwege on their side, the women of eastern DRC can at least hope for an opportunity to heal and eventually be reintegrated into their communities and families.

New Internationalist

Next article – Medical nightmares

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