DR Congo: Communities as both beneficiaries and agents of change

Première Urgence Internationale’s teams have been working in the Democratic Republic of Congo for 20 years, providing assistance to 350,000 people throughout the country. In the province of North Kivu, the various interventions allow us to fight against the increasing difficulties of access to quality health services.

^{Communities in the Kibua health zone have seen their health status greatly improve; | © Première Urgence Internationale}

The territory of Walikale, in North Kivu, in the east of the Democratic Republic of the Congo, has been the scene of armed conflict for several years, resulting in a major deterioration in the health status of the local population. Whether they are victims of violence or indirectly affected by the lack of access to quality health care, the region’s inhabitants are particularly vulnerable to disease and malnutrition. In addition, neonatal mortality is particularly high (138‱ newborns). In the Kibua health zone (Walikale territory), only 43% of the population has access to clean water and 40% of households report that their children regularly have diarrhea. Acute malnutrition thresholds are particularly alarming; the chronic malnutrition rate is 56.4%, 16.4 points above the nationally defined severity rate of 40%.

The teams of Première Urgence Internationale have focused on improving the living conditions of the most vulnerable, particularly through access to quality health care, the fight against acute malnutrition, and the strengthening of community resilience.

The risks of self-medication

In the village of Lubonga, for example, the health center was in “catastrophic” condition, according to the chairman of the local health committee. “There were times when some patients preferred not to be hospitalized, because of the state of the health center, and opted for self-medication at home,” he laments. Première Urgence Internationale has rehabilitated the health center, building a children’s hospital room, a small pharmacy, a laboratory and a maternity ward.

A new maternity ward has also been opened in Kibua, allowing mothers in the community to give birth in good conditions. “I named my child Martin, the name of the project manager of Première Urgence Internationale,” says the first woman to give birth in the new center. “Today, we receive free health care and are assisted by midwives during deliveries. In addition, we receive loincloths, soap, diapers and knitted fabrics for our babies, which helps us a lot.”

Morbidity and malnutrition rates soar

Home deliveries can cause maternal and infant deaths; however, these choices are most often made because adequate health services are inaccessible. In the long run, this lack of access has very disturbing effects on morbidity and malnutrition rates. As the chair of the Kishanga health committee describes it, “The community had not been sensitized to the prevention of malnutrition or epidemics, causing many deaths.”

In addition to strengthening health care in the centers, it has been crucial to get the right messages across to all levels of the community, sometimes including traditional medicine practitioners, to whom much of the population turns when there is no clinic. Today,” continues the president of the health committee, “we have noticed an early use of health services and the strengthening of collaboration between modern and traditional medicine, notably through capacity building of traditional practitioners on epidemiological surveillance and referral.

In total, more than 70,000 people have benefited from this intervention by Première Urgence Internationale, supported by the Bureau for Humanitarian  Assistance (BHA). In the 11 health areas targeted by the project, 34,446 people were able to benefit from health activities. The important networking at the community level has also allowed 29,672 people to benefit from nutrition activities, including awareness-raising and screening, in order to increase resilience and induce positive behavioral changes in the long term.

^{Here at the health center of Lubonga; the clinic rehabilitated by Première Urgence Internationale allows the staff to resume care  | © Première Urgence Internationale}