File photo of a general view of Bulengo camp for internally displaced people in the east of the Democratic Republic of the Congo on March 2, 2023. A group in the east of the country has taken up arms again, disrupting the already fragile humanitarian situation in the area. Since early April 2022, almost 900,000 people living in the territory of Nyiragongo, Rutshuru and Masisi have been forced to flee their homes to seek refuge in villages north and west of the city of Goma and other communities in the territory of Lubero. As of March 2023, more than 40,000 people were taking shelter in the camp of Bulengo. WHO and partners are helping to improve sanitation and are providing emergency health services for camp residents, but the needs in the area are enormous and more support is needed. Photo Credit: WHO / Guerchom Ndebo
The humanitarian needs are soaring in the Democratic Republic of the Congo (DRC) with women and children particularly vulnerable. Women and girls are paying the high price of armed conflict and displacement. 30,000 cases of gender-based violence were reported in DRC in 2023. These numbers are among the highest in the world.
Close to 10 million people are on the move in the country where poverty and hunger affect a quarter of the population or 25.4 million people. The challenges faced by the people in the country have reached alarming levels, exacerbated by a combination of violence (wars and intercommunal fighting), climate shocks and epidemics.
DRC is the second largest displacement crisis globally after Sudan, with more people forced to flee the violence since the start of the year. In many parts of the country, particularly in eastern DRC, civilians are caught in renewed fighting, and hospitals are overwhelmed with injured people. Attacks on health persist, impeding access to essential health services for those in need. Over 55 health facilities, documented on the World Health Organization surveillance system for attacks on healthcare platforms, have been damaged or robbed since 2022.
The overall health situation is worsening in the country. Close to 20 million people require health assistance in 2024, yet the crisis, as the health response, remains severely underfunded. The country is facing its worst cholera outbreak since 2017, with 50,000 suspected cases and 470 deaths recorded in 2023. Already 9 465 suspected cases including 174 deaths (CFR 1.8%) have been reported this year. The risk is particularly high in internally displaced people (IDP) sites where living conditions are dire, with water supply, hygiene and sanitation services inadequate – conditions that favour the spread of cholera.
DRC is also battling the largest epidemic of measles recorded since 2019, with close to 28,000 cases with 750 deaths so far in 2024. There were 311,500 cases/5799 deaths (CFR 1.3%) in 2023. The combination of measles and malnutrition has a severe health impact on children under 5 years of age and the lack of access to vaccines and vaccination services further exacerbates the situation.
Anthrax and plague have been also affecting the communities in Eastern DRC in the last months.DRC is facing reported cases of anthrax in the province of Nord Kivu, affecting 6 health zones. 76 suspected cases (1 confirmed) have been reported including 11 deaths from December 2023 to February 2024. The country is also battling plague in 2 health zones (Rethy and Logo) in the province of Ituri. Already 205 cases have been reported including 7 deaths (CFR 3.4%) since the beginning of this year.
In addition, the still-emerging outbreak of mpox has been on the rise across the country over the last year. Close to 4,000 suspected cases and 271 deaths have been recorded so far in 2024, which represents a higher case fatality than what was seen during the global outbreak. Over two-thirds of the cases are reported in children. Young children are particularly at risk of death. There is the geographic expansion to previously unaffected provinces such that almost all provinces, including Kinshasa, are now reporting cases; this also represents a threat of expansion to neighbouring countries and beyond.
Since 2023, there has been a newly documented sexual transmission of mpox due to the more virulent clade I of the virus, with outbreaks among sex workers and among men who have sex with men.
WHO is supporting the health authorities to respond to mpox hotspots in the country and to implement the national mpox response plan, including through integration and collaboration with the national HIV/AIDS control and immunization programmes.
The spread of cholera and other infectious diseases poses significant threats to the population’s health. Combined with malnutrition, the diseases are increasing the risk of mortality, especially in children, and putting even more pressure on the health system.
However, in addition to conflict-related challenges, severe flooding has recently ravaged communities, exacerbating the risk of diarrhoeal and water-borne diseases and compounding the strain on the already fragile health system.
Despite all these compounding challenges, WHO continues to support the government and its health partners in responding to this complex crisis. WHO scaled up its health response in the eastern part of DRC last year through:
- Delivering supplies to prevent and respond to disease outbreaks and supporting patient management, including through the setup of treatment centres.
- Vaccinating almost 5 million people against cholera in November 2023, in the most affected provinces, including North Kivu.
- Strengthening routine immunization activities in eastern provinces
- Supporting partners to provide health services to survivors of sexual and gender-based violence and scale up mental health and psychological support in North and South Kivu provinces.
WHO calls on all parties to ensure access to lifesaving health services for civilians and to protect health facilities. The world should not turn a blind eye to a situation that could have severe knock-on effects on security and health in the region.
*An update by Dr Boureima Hama Sambo, WHO Representative to the Democratic Republic of the Congo and Dr Rosamund Lewis, WHO Technical Lead for Mpox to the UN Geneva press corps at the biweekly Palais press briefing held earlier today.
– global bihari bureau
