LUBERO, Democratic Republic of Congo – War erodes the foundations of the health system in the eastern Democratic Republic of Congo. Months of violence between government forces and M23, an armed group of neighboring Rwanda support, stimulated looting and closings of medical clinics around the territory of Lubero. The facilities that remain open are struggling with supply shortages, staff departures and assembly difficulties carrying patients.
Luseko Kakule, president of an association of pharmacy owners in Kirumba and director of a health post, said that six patients recently died on the way to care. The blockages on key roads have complicated medical transfers and the replenishment of pharmacies in the region, where stocks of malaria drugs decrease. “We have to borrow roundabout routes and incur prohibitive costs that inevitably have an impact on patients who are already devoid,” he said.
The installations accustomed to the transfer of patients with malaria or severe complications during pregnancy in cities with acute care was forced to improvise. “War is paralyzed with our activities,” explains Muhindo Muyisa, chief nurse at Kasando Health Center. “Access to quality vaccines and drugs is difficult due to road closings. Even refer patients to more appropriate installations is a challenge. ”
Since the end of 2021, M23 has advanced in a strip extending north and south along the eastern border of the DRC, establishing parallel governments in captured territory. He now controls the capitals of the provinces of northern Kivu and southern Kivu, and many smaller localities, including Kirumba, where militia soldiers patrol in vans with fatigue, rifles and green rubber boots.
“The increase in the costs of declaring products imposed by the current administration makes our task even more difficult,” explains Debora Kahindo Syamonyya, who manages a pharmacy in Kirumba.
“War is paralyzed with our activities.”Chief nurse at Kasando Health Center
Current antibiotics have almost doubled prices in recent months, while other drugs, such as insulin, have completely disappeared from the market. “Since the climbing of violence, I can no longer find essential drugs for my mother, who suffers from diabetes,” explains Kavugho Lipanda, resident of Kirumba, 40. With regular access to insulin, she explains, her mother is generally without symptoms. Now, she suffers from insomnia and an overproduction of urine known as the diuresis, which leads to dehydration and headache, and can cause kidney damage. “His empire situation,” explains Lipanda.
M23’s advance to capture the city of Goma earlier this year led to a looting of warehouses with assistance supplies. Some humanitarian groups have evacuated staff. The fighting also forced the closure of Goma airport with the main road at the head of the North, turning off a major restocking road to the rest of the northern Kivu province.
“For lack of drugs, we can often write only prescriptions that patients can never fill,” explains Kambale Muhindo, secretary of the Kayna health area, which covers a large area north of Goma and west of Lake Edward. “Some health officers, discouraged by the lack of resources and financial support, have left their posts.”
Some pharmacists fear having to close soon. “I had invested US $ 900 in my pharmacy. Today, I am in danger of closing my doors because of the losses, ”explains Katungu Liso, owner of the Mbahiphar pharmacy in Kirumba. Forced to flee at the top of violence, she says that depressed sales and the rise in prices have prevented her from reconstituting her inventory.
Moïse Katembo Kapanza, head of the Kirumba Tupone Health Clinic, said violence has also disrupted agriculture, a backbone of the rural economy. “War ruined the livelihoods of our patients, which makes them insolvent in the face of the disease,” he said.
Many were afraid to visit local clinics or come to work, explains Kibosile Muratusi Innocent, chief nurse in Kamandi Health Center. “Fear has emptied our establishment of patients, deliveries and staff. We are witnessing births on the bush, an increase in postoperative infections and tragic losses due to the lack of basic medical aid. ”
In March, the World Health Organization deplored the virtual exhaust of medical supplies in eastern DRC. During a recent visit to Goma, Thierno Baldé, head of the WHO Regional Emergency Center, said that in northern Kivu, “1.5 million people are directly affected by the disruption of essential health services”. Several mediation efforts are underway, including a recent meeting in Lomé, Togo, on May 17, under the auspices of the African Union. Meanwhile, M23 progresses more in the Congolese territory.
Kakule, of the Pharmacy Association, wants to see the international community intensify both a help and diplomatic pressure: “The urgency of humanitarian action and a peaceful resolution of the conflict are acute. The world should not transform the deaf ear to this call from the East DRC. ”