DR Congo: Emergency Preparedness & Response

Kabambare has long been one of the areas of the DRC, facing extremely high levels of malnutrition and poverty as a result of conflicts between armed groups. Some 33,000 people are in need of immediate humanitarian assistance. Ongoing conflicts in adjacent areas are constantly forcing the population to move, making it difficult for them to work in the fields and, as a result, endangering their food security. Remoteness, impassable terrain, and unstable security situations do not allow local people access to markets and healthcare. Deliveries of medicines and medical supplies are lengthy and costly, which is why hospitals and other medical facilities report an acute shortage. Medical facilities in remote villages, often affected by conflict, do not have sufficient resources to ensure a hygienic environment, which significantly increases the risk of disease transmission. People in Need works with local communities to improve their living conditions, especially in the areas of nutrition, health, and hygiene. The People in Need team, in cooperation with the partner organization Doctors of the World, focuses its attention on the most vulnerable groups, which are mainly children under 5 years of age and pregnant and breastfeeding women. Helping victims of sexual violence is no less important. We train the health care staff and ensure that there are enough vital medicines, highly nutritional products for the treatment of malnutrition, and other basic equipment. In addition to ensuring access to quality health care and malnutrition treatment for more than 25,000 people, an important part of the project is an information campaign carried out by local health volunteers directly in the communities. They raise awareness about the prevention and effects of malnutrition and other common diseases as well as good hygiene habits and a proper diet. The campaign is designed to respond to the needs of women and children, who are most affected by malnutrition and other diseases, but also places great emphasis on involving men so that they too know what is important in prevention and treatment. Thanks to the active involvement of volunteers, this knowledge is spreading among all residents and even in very remote villages, where they help prevent further cases of acute malnutrition.

This project was established in response to the humanitarian crisis that escalated in the Democratic Republic of the Congo during 2018, particularly in the eastern part of the country. According to the United Nations, up to 13 million people in the DRC are currently in need of humanitarian assistance.  People in Need is working in the Kabambare region, where the malnutrition rate is alarmingly high – every fifth person is undernourished. The project delivers aid to children and mothers of small children in particular.
The Kabambare region is difficult to access because of the lack of safe roads and paths. This makes it challenging to supply medicines and medical materials to hospitals and other health-care facilities, which constantly report severe shortages of both. Health-care facilities in remote villages, which are most affected by the conflict, suffer the greatest resource deficiencies, which in turn increases the risk of disease transmission.
In response, People in Need provides life-saving medicines, high-nutritional supplements to treat malnutrition, health-care materials, and other medical equipment. We also train staff at local health-care facilities on how to prevent malnutrition and ensure good nutrition, and on the importance of breastfeeding for the healthy development of children. We also focus on positive changes in basic personal hygiene habits.
To date, we have provided basic health care for at least 3,000 undernourished children and 200 undernourished women. We also ensure an adequate supply of medicines and nutrition packages to health-care facilities, and help train health-care workers.
People in Need also trains mothers – in the presence of their husbands – on how to identify, prevent and treat malnutrition and diseases in their children. Thanks to the active involvement of men in this process, PIN has observed gradual societal changes. For instance, men have begun to realize what is and isn’t safe for their wives during pregnancy. They have also learned about what should be avoided during pregnancy and what a quality diet should include. Local health-care volunteers receive similar trainings to help hospitals and health-care centers identify cases of malnutrition and other diseases in remote villages. These volunteers share their acquired knowledge among all people in far-flung villages. Thus, PIN-trained volunteers are helping prevent other cases of acute malnutrition, one of the most serious problems in the Congo.
 

There is a lot of violence and population movements in Kalole, in the South Kivu province. According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), during the latest violence, more than 4 300 students lost access to education following school closures, and 30 000 people lost access to health care following closures of health facilities while many people have moved.
The overall goal of the intervention is to contribute to the improvement of living conditions of the people affected by the crises by enforcing food security in the area.
The intervention contributes to the improvement of immediate and medium-term food security through cash support, better access to improved seeds, tools and trainings for farmers and their families. PIN targets the most vulnerable households, including those without access to land. For these households, the intervention supports groups and facilitates access to community fields for sowing and harvesting. Setting seed banks will allow the inhabitants to plant crops also in the next season, and to increase the availability of improved seeds in the area.

.The deteriorating security situation, poor accessibility, extreme levels of acute and chronic malnutrition, over 150,000 displaced people in 2017 - all of which are characterized by the province of Maniema, where People in Need is currently working. Within this project, we help the most vulnerable groups in the Kabambare area, children under 5, mothers and pregnant women for whom poor hygiene, inadequate nutrition and poorly prepared diet are among the most important factors that negatively affect their health and development. We support local healthcare facilities to distribute special rich nutritional pastes and milk, which by their composition help to treat acute malnutrition in young children. We also provide training for women, health professionals and community members about the causes of malnutrition, its measurement, prevention and treatment. At the same time, we strive to increase awareness of proper hygiene that prevents the transmission of bacteria causing diarrheal disease.

In the inaccessible areas of the Congo bush in the Shabunda region, we focus on the treatment of acutely malnourished children, the transport of nutrition supplements to the health nutrition centres and the training of medical staff. That is accompanied by raising awareness in communities covering information about prevention as well as timely detection of malnourishment and the options for suitable treatment. For instance, last year in Shabunda we helped 19,287 people. We are continuing to help in 2017, when we intend to provide help to 36,330 people.

Work in Shabunda is complicated by the difficult terrain where all aid, including medicines, is airlifted in via humanitarian flights and subsequently transported by motorbike or even on foot to distant villages and healthcare centres. To complicate matters, a number of rebel groups operate in these areas, which are rich in natural resources, threatening the safety of local people and complicating the work in the terrain.

In 2015 and 2016 we also helped  mothers and children amongst the refugees from Burundi who, in reaction to the worsening political situation at home, crossed the borders into eastern Congo which is already suffering from food scarcity.  Under this programme we were able to help a total of 2,629 children suffering from acute malnourishment, children both from Burundi and from the host communities.

People in Need operates in several remote and unstable areas of South Kivu. It strives to strengthen the health infrastructure in the province and make basic health care accessible to internally displaced persons as well as the local host population.

Particularly, we focus on supporting the centers by training of their personnel, rehabilitation of the physical facilities, providing basic medicines, equipment and materials. In addition we provide performance related payments to the personnel of the supported health centers in order to ensure the free primary care to the internally displaced persons and other vulnerable groups. Within our programs we promote good hygiene and nutritional practices which are crucial for sustainable improvement of the health status of the population.

Given the poor conditions of the centers, People in Need also focuses on reconstruction of maternities and health center buildings, and installs new facilities such as latrines and rainwater catchment systems. The health personnel is also trained in the basic medical facilities hygiene, which comprises the burning of infectious material and the use of appropriate cleaning agents.

The community health volunteers are one of the main channels for the awareness raising. They are usually trained by PIN in different messages which they transmit to their neighbors during subsequent village meetings.

Some examples of the messages:

• The handwashing before every meal and after using the toilet is essential to prevent diarrhea and other diseases;
• The breast milk is the best food for the infants up to six months;
• The birth in the health facilities is safer, because the trained health personnel is able to intervene in case of obstetrical or new-born emergencies.

Furthermore PIN provides psychosocial and medical assistance to the rape victims and abused women, with an increased focus on prevention of rape by the sensitization of the communities and its leaders. (According to the UN estimates, up to 200 thousand women have been raped in the South and North Kivu provinces in the last 15 years.)

Along with the activities mentioned above, PIN collaborates extensively with the Provincial Health Department on the capacity building of the health care personnel and community volunteers.