November 30, 2023
Dr Paul Mushombe Nibhumba: Testimonial from Doctors of the World Medical Coordinator in Mali
Conflict, political instability, mass forced migration and climate crises are all compounding factors that greatly impact the wellbeing of the Congolese population. The provinces most impacted by the conflict are North Kivu, South Kivu and Ituri. These regions also happen to host the majority of Internally Displaced Persons (IDPs), with an estimated 1.9 million IDPs in North Kive and 1.4 million in South Kivu. Both the IDPs and the local population are facing continuous exposure to violence, disease and malnutrition. Unicef has announced that the violence in these regions have fueled one of the worst displacement crises for children and has left many vulnerable to abuse and exploitation.
In response to this rapidly growing humanitarian crisis, Doctors of the World launched in 2020 a multi-sectoral intervention to the most vulnerable conflict-affected individuals in Itombwe and Minembwe Health Zones in South Kivu. Our zones of intervention encompass primary care, sexual & reproductive healthcare, malnutrition, protection, WASH, mental health and community wellbeing. The intervention has assisted 92,554 beneficiaries, among which 42,511 were IDPs.
To develop a long-term, sustainable health program that will last even after our departure, DotW focuses on capacity-building and training of local healthcare clinics and staff. In the Itombwe and Minembwe region, we supported 10 healthcare clinics as well as trained mobile clinics to provide care to remote areas. From 2020 to 2021, DotW provided 7 training sessions that reached 278 healthcare providers on major health topics like emergency obstetric care, drug management, gender-based violence, family planning and infection prevention and control.
In the supported health centers, free access to primary health care was guaranteed to the community and helpful health information was disseminated through community health workers (CHW). By supporting these health clinics, over 65,934 consultations were carried out for infectious disease. Furthermore, with the provision of training and equipment, the clinics were able to see a clear improvement in the prevention and control of infection.
With the host community and IDPs, the trauma of conflict and displacement can have severe consequences on their mental health. That is why DotW has made mental health a key part of its humanitarian response in the DRC. With our project, we have been able to assist 3,467 people (2,052 women and 1,409 men) in a state of distress through mental health care in our supported health centers. Clinics were also organized in IDP camps, implementing consultation boxes, where patients received quality care from qualified staff personnel. While the DotW team of psychologists provided consultations, they also ensured training of healthcare staff to provide further psychosocial support to people visiting the clinics. Awareness on mental health was also improved by community health workers, who disseminated information throughout the community to raise sensitivity around the issue.
Conflict, poverty, and climate change has drastically impacted the DRCs food security and currently over seven million people in North Kivu, South Kivu and Ituri are suffering from food insecurity. At DotW, our objective was to increase access to quality life-saving treatment in supported health facilities for children aged 0-59 months, pregnant and lactating women, and to train community members, to identify and refer cases of severe malnutrition.
Fortunately, due to our intervention, from 2020 to 2021, we were able to assist 32,062 beneficiaries. DotW field coordinators evaluated each health facility to assess their needs and procure any necessary equipment and materials needed to ensure good quality of Severe Acute Malnutrition (SAM) treatment and follow-up. In total, 2,593 malnourished persons entered the treatment program and were treated by the end of the project.
To reduce the risk of SAM, DotW provided healthcare staff and community healthcare workers with training on the subject, which would be further disseminated to patients and community members. Information sessions were held on the treatment of acute malnutrition, infant and young child feeding (IYCF), and WASH nutrition. In total, 31 healthcare staff were trained and 100 CHW. Moreover, monthly support groups established by CHWs gathered over 1,130 people to discuss topics such as IYCF, and other good practices in WASH and health.
A final key point in our humanitarian response in the Democratic Republic of Congo focused on protection, particularly in the prevention of GBV. Our objective was to develop an effective emergency response and prevention strategy that involved community leaders, public services, and local authorities. Working with them and the local community, we hoped to build the local population trust to encourage the disclosure of cases and seek out timely health services.
This led to the creation of the Protective Community (PC) which established an alert circuit to identify and refer cases of SGBV, as well as develop a plan for prevention and protection of SGBV, raise communities awareness on gender, positive masculinity, the Maputo Protocol, child protection, GBV legislations and the role of communities to ensure the respect of those laws. Monthly sessions on these topics were led by the project’s psychosocial assistants and other stakeholders in the community, which has led to increased community participation and initiatives.