Thousands more abandoned their villages and the temporary camps in which some were sheltering when fighting intensified in late October around Goma, the capital city of North Kivu Province directly across the border from Rwanda. The violence culminated in an armed stand-off outside the city on Oct. 29, and CNDP's call for a ceasefire. By November 7, that ceasefire was no longer holding.
The crisis has left the longer-term peace process—and a January ceasefire between the government and 22 armed groups—in shambles. The CNDP has claimed that the January peace agreement, which had been violated numerous times, favored the Congolese government and its forces.
The latest fighting follows more than a decade of conflict in the eastern provinces and stems back to the 1994 Rwandan genocide. But many other factors contribute to the ongoing violence as well: weak state authority, the illegal exploitation of Congo's vast natural resources, and the free flow of arms across porous borders.
The result is disaster for the Congolese caught in the crossfire and suffering from the deprivation constant conflict brings. Humanitarian needs are escalating: The fighting forced some aid groups to suspend their operations, preventing life-saving help from reaching those who needed it. Since 1998, an estimated 5.4 million people have lost their lives to the conflict and the hunger and disease it unleashes.
In early November, Oxfam was already helping about 85,000 people, including 65,000 camped in four temporary settlements around Goma. The organization planned to help an additional 100,000 people in areas to the north and west of the city. Assistance has included the provision of clean water and sanitation services—essential in preventing the spread of waterborne diseases-- to those in the four camps. Oxfam has also been trucking water to 20,000 people in Kanyabayonga north of Goma.
Oxfam is calling for:
My neighborhood was one of the worst affected by the fighting, which went on all last night. About two kilometers from my house, the gunmen went into a compound and killed seven innocent civilians. Our neighbors were attacked by gunmen who came into their compound and robbed them, taking mobile phones and money. We were okay, but I found some bullets in my compound.
I was in the Oxfam office when the panic started yesterday. People saw the national army troops leaving Goma with their tanks and vehicles, and at the same time they saw the UN troops shifting civilians to a safer compound. No one informed the population about what was happening, and they thought the rebels were going to take control of Goma. People panicked.
Many people took advantage of the panic yesterday to make trouble. They looted shops and robbed families. It was a mixture of people fighting, criminals, and undisciplined soldiers, using small arms like AK-47s. But in other areas there was a deployment of national army units who were disciplined and protected the people. I haven't seen UN soldiers anywhere myself.
Today, it's calm and very quiet. Usually the traffic here starts at six in the morning, but I looked out at 10AM and all I saw was one motorbike. The shops are all shut. Life hasn't started up yet.
A lot of people are displaced and are living in the suburbs of Goma in very harsh conditions, and the fighting is making those conditions even worse because there's no access for humanitarian workers.
In particular, one group of displaced people has now been forced to move for the third time in a couple of months. They are living in schools and hospitals, or with host families in and around Goma. They desperately need water, food, and shelter. There's no health care or medicines. People are living in the open air, and if they do get a little food it's not enough to feed the whole family.
This current crisis has made it harder for Oxfam to respond. We are watching the situation and I'm going out this afternoon to check out our work in the camps.
]]>In the DRC, increasing violence has forced people to flee from their homes, and led to the deaths of almost 1,500 people a day. Though no other conflict causes that kind of death rate, Oxfam's workers hear similar stories of murder, rape, and displacement from men and women from Colombia to Sudan every day. Sixty years after the main Geneva Conventions enshrined civilians' rights to protection, they are violated in every current conflict.
Some states and non-state actors choose to kill civilians, or pursue strategies in which civilians are too likely to die. Some governments choose to protect their citizens: to keep them safe. Some do not protect all of them, or not well enough. There are, however, successful examples of protecting civilians that show what governments and others can do when they choose to.
They have an interest in protecting civilians, because mass atrocities fuel the conflicts that, in an interdependent world, create security threats that cannot be contained. And an increasing number of governments have a "moral interest" too, because their electorates expect them to help prevent, not just condemn, the atrocities they see beamed around the world through modern information technology.
To do so, they need to make four key changes.
"I'm not famous," said the slogan on his T-shirt.
And that's probably why you haven't heard very much about Milongo's problem'or the problem of countless Congolese women caught in a war that has used their bodies as a battlefield. Rape has ruined their lives. And now, it's creeping into their villages, too, corroding what's left of community life after so many years of conflict.
But since it's happening in a place that's far away, in villages whose names we can hardly pronounce, we don't pay attention. We should—because it's a horror that stalks us, too. About 132,000 women a year in the United States report they are victims of rape, or attempted rape, says the National Organization for Women. That's one of the reasons Congress passed the Violence Against Women Act in 1994—to combat sexual assault.
Now, there's a new protection bill set for debate in Washington. This one would take the first steps toward guarding the safety of women everywhere—even in countries where governments are not up to the task. Proposed by US Senators Joseph R. Biden and Richard Lugar, the International Violence Against Women Act would require the development of a five-year strategy—supported by a $175 million annual investment—to support programs targeting violence against women. Among them would be public awareness campaigns and a strengthening of criminal and civil justice systems.
Additionally, through increased training for aid workers and expanded reporting requirements, the bill would tackle the violence women and girls suffer during humanitarian crises and conflict—times when women are particularly vulnerable. Nowhere is this more evident than in the Democratic Republic of Congo. John Holmes, the United Nations under secretary for humanitarian affairs, told a reporter last October that the sexual violence in Congo is the worst in the world.
But what makes these attacks even more insidious is the consequence of speaking out about them: There is danger in challenging Congo's culture of impunity. Justine Masika lives with it daily—behind the barbed wire wall erected around her house to keep her safe. She is the head of a Goma-based group that has helped more than 7,000 women who have suffered from sexual violence. Last year, soldiers punished her for her truth-telling and advocacy. They invaded her house and attacked her daughters.
But Masika is not alone. Others, like Lamia Milongo, are fighting back, too. When the soldier abducted his 12-year-old daughter to claim her as his "wife," Milongo put his own safety aside and went in pursuit. He rescued her and returned her home unharmed. But the daughter of his neighbor was not so lucky. Her rescue came too late. Now, at 15, she is pregnant, shamed, and facing a life of hardship and poverty since in Congolese culture women who have been raped are often cast off by their communities.
Sexual violence is a plague the world should be rid of. Mothers like Masika need our help. So do fathers like Milongo. We took an important step here in the US in 1994. Now it's time to take the next one—into our global community—with passage of the International Violence Against Women Act.
]]>The two agreements, together with recommendations from the Conference on Peace, Security and Development in North and South Kivu organized by the government in January 2008, form the basis of the Congolese government?s peace program for eastern Congo, known as the Amani Program, led by the national coordinator Abbé Apollinaire Malu Malu. The agreements provided an important foundation for peace. The signatories agreed to a ceasefire and committed to protect civilians and respect international humanitarian and human rights law.
In July 2008, a group of local and international non-governmental organizations established the Congo Advocacy Coalition to track progress on these commitments and focus attention on areas where improvements are urgently needed. Specifically the coalition decided to track six key commitments related to protection of civilians. These include:
Attacks against civilians and their property occurred at an alarming rate in the six months following the signing of the various peace agreements. Assessments conducted by different organizations in eastern Congo indicated that the civilian population continues to experience widespread attacks, sexual violence, looting, and forced labor.
More than 200 civilians were killed in indiscriminate firing by armed groups or as a result of summary executions in North Kivu, particularly in Masisi and western Rutshuru territories.
Sexual violence against women and girls has continued at its previous horrifying rate since the peace agreement was signed. Women and girls were raped by combatants of all armed groups and soldiers of the Congolese army, as well as by civilians. Over 2,200 cases were registered in June 2008 in the province of North Kivu. One community in Rutshuru reported over 150 cases of rape in April alone.
Fighting and targeted attacks on civilians led to the displacement of nearly 100,000 civilians in North Kivu since January 2008 with another 50,000 displaced in South Kivu. The UN estimates a total of 1.1 million people are currently displaced in both provinces, including those who fled previous fighting. Nearly half of the newly displaced people in North Kivu fled from the Bukombo administrative area in Rutshuru. New displacements have also been registered in Masisi and southern Lubero territory, all areas that have been subject to fighting.
Many displaced people expressed a desire to return to their villages if security permitted, but very few have been able to do so. Those who have returned often spend the night in the forests surrounding their villages as a protective measure. Some returned only temporarily, fleeing again days or weeks later.
There has been little return of refugees from Rwanda, Uganda or Burundi into North and South Kivu. The Congolese government and the Office of the UN High Commissioner for Refugees (UNHCR) have not yet signed tripartite agreements with Rwanda, Uganda, or Burundi to facilitate the return of Congolese refugees from these countries. In July a working group was created to put in place the tripartite agreement with Rwanda and plan returns when the security situation permits.
Recruitment of combatants, both voluntary and forced, amongst a range of armed groups in North and South Kivu, continued despite the ceasefire and intensified during the past three months. Some of these groups were largely dormant before the peace talks. Former demobilized soldiers and combatants have been targeted for re-recruitment, raising concerns about the effectiveness and sustainability of previous demobilization programs.
While there are no reports of large-scale recruitment of children since the signing of the Goma agreement, sporadic recruitment by some armed groups has continued. Moreover, there has been limited progress on the demobilization of the estimated 2,500-3,000 children who remain in the ranks of armed groups and in some units of the Congolese army. Child protection agencies began screening troops for children in mid-April, but their activities stalled due to coordination issues between UN agencies, and only restarted in early July. Following two joint missions, a total of 47 children were separated from armed groups. Outside of these missions, at least a further 507 children have been demobilized since January. In June, the government launched a national program of ?zero tolerance? for the recruitment and use of children by armed groups and committed to taking further action on demobilizing all associated children.
Despite ongoing recruitment, 1,200 combatants in North Kivu responded to the call to lay down their weapons. From January to May 2008, according to officials in Goma, 282 CNDP combatants, 800 Mai Mai and PARECO combatants, and 156 Congolese combatants from the FDLR surrendered. Some were sent to army retraining (known as brassage) centers, but others, such as 334 Mai Mai Mongol combatants in the town of Bambu, were left for months without any assistance. Programs to assist demobilized combatants are not fully operational, contributing to serious delays in demobilizing combatants. A number who surrendered were sent to the military intelligence prison in Goma rather than being directed to demobilization programs. Many were detained for months without charge and were subjected to cruel and degrading treatment; a number were tortured.
Efforts have continued to encourage the remaining 6,000 FDLR combatants in eastern Congo to disarm and return to Rwanda. Since January, 301 FDLR combatants were demobilized. After talks with the Congolese government in Kisangani in late June, the FDLR splinter-faction, Rally for Unity and Democracy (RUD), agreed to demobilize 400 troops and repatriate to Rwanda, with the option of temporary relocation for some combatants within Congo.
Civilians are not allowed to move freely and often encounter improvised road blocks erected by armed groups or the Congolese army where they are subject to various forms of extortion. Civilians are forced to pay money or a percentage of their produce, sometimes called ?taxes?, either at such road blocks, when they go to the market, or as they return to their fields. Army soldiers and armed groups also confiscate electoral cards (which also serve as identity cards in Congo), and demand money in exchange for the return of the card.
At least 36 attacks on humanitarian workers were recorded in North Kivu since the signing of the Goma agreement, the majority being ambushes at gunpoint on main and remote roads. A total of 15 humanitarian workers were injured in these attacks. Two humanitarian staff were caught in the crossfire and wounded by bullets when an armed group attacked the Kinyandonyi displacement camp in Rutshuru territory. Humanitarian activity is temporarily suspended in certain areas following a number of attacks.
Despite the ongoing clashes some previously inaccessible areas are now receiving emergency assistance. However, other areas remain inaccessible, particularly around front lines and buffer zones. The picture is not a static one and generally the degree of accessibility changes according to the level of military or criminal activity which flares up along ever shifting axes.
Since mid-June access from Goma to Masisi town is severely hampered following several armed robberies of humanitarian staff on the main road. An estimated 186,000 people in Masisi are not currently receiving assistance, including 33,000 displaced persons in camps and thousands others who have sought refuge in host families.
In Rutshuru territory, several enclaves within the Bwito area, west of Nyanzale, are particularly unsafe and problematic to access. The civilian population there is often too scared to sleep in their villages and instead hide in the surrounding forests at night.
Impunity for human rights abuses is widespread in eastern Congo. Since January only a small number of perpetrators have been arrested for crimes of sexual violence and only a small number of Congolese soldiers and policemen have been tried and prosecuted for their crimes. Many women do not seek justice for the crimes they have suffered because they are afraid that the perpetrators will target them again should they escape from prison. Those who live in remote areas frequently have no access to judicial services.
No high ranking officials have been held to account for the serious crimes they or soldiers under their command have committed.
The Congo Advocacy Coalition makes the following recommendations to the parties to the peace agreements, the international facilitators, coordinators of the peace process and international donors:
There, on the shore behind what's left of a half-constructed mansion, the chug-chug-chug of a diesel pump holds the promise of clean water for 11,042 people at Buhimba camp. They are just some of more than one million villagers forced to flee their homes as conflict has swept across the eastern provinces of that vast country. A short distance away, a second pump, submerged deep in the lake, provides water for an additional 18,016 people in two other camps known as Mugunga I and II.
Without clean water, without decent sanitation, and without the public health outreach that helps people understand the link between the two, waterborne diseases could ripple through theses camps with devastating consequences. That's what Oxfam, together with its local partner, Action Santé Femme, or ASAF, was determined to prevent when it helped establish the water systems for these three camps—and a fourth, Bulengo—outside Goma, the capital of North Kivu province. Through a network of rigid plastic pipes, storage tanks, and outdoor faucets, water from Lake Kivu now gushes into the jerry cans of thousands of families with the turn of a tap.
At the top of a short but steep hill at Buhimba, where two massive water storage tanks frame the sprawling camp below, Helene Kanyere Ndakas stands ready with a notebook in hand. She is the manager of this storage station—and knows better than almost anybody the importance of making sure the system runs smoothly.
What gives her that special knowledge?
Ndakas herself relies on the water that flows from it. She and her family are among the thousands of people who are now making their homes temporarily at Buhimba.
Flipping her notebook open, Ndakas points to the careful records she keeps each time she opens the valves to refill the tanks with lake water. And she notes the amount of chlorine that goes in to guarantee its cleanliness. Hired by Oxfam, Ndakas is on water duty from 6am to 4pm each day—a job she takes very seriously.
"People are depending on her," says Charles Mampasu, an Oxfam program manager in Goma. "And they're happy with her job."
In a place where there was little or no infrastructure to support a water system, supplying tens of thousands of people with clean water on an emergency basis has been no small feat. And making sure they continue to have access to it when Oxfam moves on to its next project is one of the organization's central concerns. That's why Oxfam is working hand-in-hand with ASAF to help it build its ability to handle the water system on its own, particularly in Mugunga camps.
A tour through Mugunga I shows how important a steady supply of clean water can be—especially when people are struggling with such harsh living conditions. Built on fields of sharp volcanic rocks, the shelters many people now call home are not even tall enough in which to stand. Made from grasses and dried banana leaves flung over a frame of saplings and topped with a plastic sheet, the huts offer only minimal protection from the elements. To keep warm—and to drive the bugs out—many people cook on small wood fires inside their huts, the smoke curling into their lungs and out through the cracks in the shelter walls.
At the health clinic, the nurse on duty reports that respiratory infections are among the most common medical problems he sees. About 150 people a day flock to the clinic with a host of ailments that also include malaria, tuberculosis, and diarrhea. The latter is what the clean water—and scores of latrines that Oxfam has also installed—help to fight.
Snaking across the rocks, over roots, and through the mud, a network of wide black plastic pipes carries the water from Lake Kivu. It's replacing a temporary supply that another agency had been trucking in daily and storing in two plump water bladders—they look like giant egg yokes when full—at a cost of $3,500 a week. Nearby, the water blasts from faucets when kids turn on the taps to fill plastic jugs before lugging them home.
The water jug of choice for many kids has a familiar look: it's the container that once carried their family's allotment of cooking oil, doled out during the regular food distributions that displaced people have no choice but to depend on. Here at Mugunga, nothing goes to waste—not the jugs, and not the precious water they carry.
]]>But it wasn't until an 80-year-old woman from Walikale in North Kivu was brought to Masika that the full weight of what was happening became clear, galvanizing her resolve. In the war that was sweeping the region, rape was being used as a weapon not only to degrade women, but to humiliate their husbands and whole communities, too. Masika realized the women and girls of eastern Congo needed organized, pro-active help—and Synergie des femmes pour les Victimes de Violences Sexuelles was born.
Its mission, says Masika, its director, is threefold: to raise awareness about sexual violence toward women, to take care of those who have been sexually abused, and to push for the perpetrators to be brought to justice. Since 2003, the organization, an Oxfam partner, has worked with 7,018 women—women like the one from Walikale, who so desperately needed help and for whom there was none available. Raped and left dumped in a field, she was rescued by a hunter and eventually brought to Goma, the capital of North Kivu. But she was penniless, and despite her serious injuries, the hospital would not treat her. And there she died.
Hers is just one of too many stories of sexual abuse and abandonment—of violence that is still rippling through the remote hills of the eastern provinces, that continues to torture its victims with shame, and that now, in a newer twist, has begun to corrode the core of traditional communities, too.
In a small mudbrick building propped on the edge of a dirt road in Kilungutwe, a crowd of villagers has gathered. It's dark and sweltering inside, but every inch of every bench is taken, and more people crowd at the door and window. They have come to discuss the troubles in their village—the extortion they face at the hands of soldiers, the difficulty they have in getting enough to eat—and now the talk has turned to sexual violence.
With anger still in his voice, Elisha Ezigobe, one of the local chiefs, describes the abduction of his 12-year-old daughter. A soldier took her for his wife—without Ezigobe's consent. As soon as he learned what had happened, he headed for the soldier's camp, dismissing any concern about the repercussions he might face in confronting armed men. He was determined to rescue his daughter.
"I took my girl and left," Ezigobe said through an interpreter. "I had my machete. I was going to fight back." His outrage scared the soldier off, and Ezigobe returned his daughter—unharmed—to their home.
But the man sitting next to Ezigobe was not so lucky. His daughter, too, was taken by a soldier. A night passed before he was able to find her and bring her home. Now, at 15, she is pregnant.
There are many stories like this, says Ezigobe, and some fathers are afraid to stand up to the soldiers.
But it's not just military men who are the perpetrators, say others in the roadside hut. Community members have turned into culprits, too—with few serious consequences for their crimes. If the abused girl is 17 or 18, the solution is often to have her marry the rapist. If she's younger, the local chief could order the man to make some kind of reparation—such as a goat—to the girl and her family.
Why is all of this happening now?
"They're asking themselves that question," says Jacqueline Tshilemba, a community educator for APIDE, one of Oxfam's local partners that is working with the people of Kilungutwe. "What they can see is this culture has happened since the war. It happens all over the place and no one gets punished."
At the root of the problem, says Josee Lotsove, is a society that views women as inferior. Lotsove is the coordinator for a local women-based organization called Association des Mamans Anti-Bwaki, or AMAB, an Oxfam partner headquartered in Bunia. Along with those traditional attitudes about women, she says, is the Congo's weak judicial system, which often fails to hold offenders accountable.
When perpetrators are arrested, adds Marie Kanyobayo, it's possible for them to pay a little money to the authorities and buy their freedom. Kanyobayo is the head of another women-based organization called Union des Femmes pour le Developpement, also an Oxfam partner.
It's at this foundation of impunity that Masika, the head of Synergie, is chipping away. Part of Synergie's work involves educating village chiefs and other local opinion leaders—teachers, pastors—about the nature of what has been happening to women, about the catastrophe that it has become, and about the importance of villagers accepting survivors back into the community fold.
But the work comes with great risk.
For speaking out about a problem that has devastated the lives of so many women, Masika and her family have themselves become targets. Last September, six military men came to her house in the early evening and tortured her two daughters, 22 and 20. Masika has since sent them to live in Nairobi, and an aid organization has paid to surround her house with barbed wire to protect her.
Masika admits that sometimes the challenges are so daunting that she's not sure she can continue with her advocacy. But she knows that her voice—and the voices of all the volunteers who work for Synergie—are essential in helping to protect the rights of women who cannot, or dare not, speak out for themselves.
In the Congo, the consequences of rape are far-reaching and affect whole families. Rape heaps shame upon its victims. Women often find themselves cast off by their husbands, and forced into complete self-dependence. Young girls who have been raped lose their chance for marriage and for having a family of their own—and the position of honor that being a mother brings.
At a medical center in Goma where Synergie carries out some of its work, women who are recovering from sexual abuse confront its ugly legacy: possible HIV infection and lives of hardship, including the need to find ways to support themselves. Here, they are learning to weave baskets from long strips of plastic, a skill that will help them earn a living when they are well enough to return to their villages.
But for some, the psychological wounds are so deep they don't want to leave the security and support in which Synergie has wrapped them. For others, the road home is crowded with obstacles that may prove insurmountable. One 36-year-old woman tells of in-laws who are trying to turn her children against her, accusing her of being promiscuous after she was abducted and held as a sex slave and later, in a second round of horror, raped and left pregnant by a government soldier.
For Amina, a volunteer who has been working with Synergie since its founding, the stories she hears from women and girls who have been abused weigh heavily on her. Many of them have become her friends, and she knows that Congolese culture will dictate the future they face—likely one of great difficulty.
Given how sweeping the problem of rape and sexual violence now is, might that culture become more understanding, and even forgiving?
Amina sits quietly for a moment before she replies. A weariness seems to frame her answer. Women are speaking out more, she says. In the past, they kept silent. But as for real change, she can't say when that will come.
]]>But not so long ago, he was a boy fighting a war in the Democratic Republic of Congo.
It's dark inside his shop: He works only with hand tools, as there is no electricity. But it's darker where he came from, and through memories spun from a tangle of languages—Swahili, French, English—the boyhood of Egiba Sango emerges. His real name is being withheld to protect his safety.
Sango's case is one of about 3,000 that the Concert d'Actions pour Jeunes et Enfants Défavorisés, or CAJED, has worked on since 1997. CAJED is based in Goma and is funded by Oxfam and UNICEF. Its mission is to help child soldiers recover from the trauma of their combat experiences and return to normal lives—a challenge in a place where years of conflict have left an estimated 5.4 million people dead since 1998. Between that year and 2003, about 33,000 children were among the ranks of various armed groups.
Successfully reintegrating them into community life will be essential to ensuring the lasting peace villagers in the eastern provinces long for.
And that's where Sango is now—joined again with everyday people doing everyday things—in a wooden shed perched on a heap of volcanic rock. A new bedstead and table stand in the dirt outside, announcing his wares and skills.
With a tool kit provided by CAJED—planes, saws, a drill, a vice, a square—Sango is making his living and paying $15 a month rent for this shed that he shares with a partner. A piece of cardboard, printed in a careful hand with project dimensions, is tacked to the wall, a counterpoint to the chaos in the shop—tools scattered on the ground, the blade of a giant knife glinting through the wood chips, a pile of chairs heaped along the back wall.
He speaks softly, his face nearly blank, as he tells a small crowd of visitors from Oxfam about the years he spent with the military—a choice he made as a very young boy to escape a life of misery.
The oldest of five children, he was 8 when his parents died—poisoned, he says, by neighbors who were jealous of his parents' efforts to improve themselves. Sango was sent to live with an uncle whose wife decided she didn't like him and treated him badly. Determined to find a better alternative, he joined a military group—and that's when his real trouble started.
Sango was just 10 at the time, and life among the soldiers was brutal. He told about how he was made to walk day and night, sometimes without food. He was forced to carry heavy loads and bore frequent beatings. One time, the soldiers punished him by cutting his leg. Pulling up his pant leg, Sango reveals an ugly scar on his right shin.
Five times he tried to run away—once getting as far as 80 kilometers from his unit before stumbling into soldiers who recognized him and forced him to return. Finally, on his sixth attempt, he escaped for good. That was in 2005.
For two years, Sango was on his own, surviving by his wits around Goma with two other boys who had also fled their military units. They would beg for food from house to house and when one received a handout, he shared it with the others. Occasionally, they would steal to stay alive.
Eventually, one of the outreach workers from CAJED found Sango on the streets and convinced him to come to the center. Sango said he knew he needed a way to become self-sufficient. The first stop was a three-month stay at a transit center in Goma, the capital of North Kivu, where staff members work with youngsters on psychosocial issues and help prepare them to return to their families. They also track down those families and work with them to be ready to welcome their children back.
But Sango had no parents—and no place to go. Instead, he enrolled in CAJED's training program and after six months had gained enough skill to launch his own small furniture-making business.
He finishes his story, and for the first time in nearly an hour of talk, life seems to return to his face when one of the visitors asks if Sango could make him a table.
Sango flashes a smile. He's back—in his shop, in control of his life, his boyhood behind him for now.
On the hilltop behind Sango's shop, how many other stories like his can be found among the children and teenagers learning to be carpenters or bakers or any of several other skills CAJED is imparting through its training programs there?
Rain pelts the metal roofs of the workshops as Gilbert Munda, CAJED's coordinator, leads a tour from the wood-fired brick oven to the electronics-repair room and into the room where girls are learning to sew on big black sewing machines.
The reality of many of the trainees' lives becomes clear in a visit to CAJED's infirmary housed in a small wooden shack with a concrete floor. There Dorotheé Mushesha, one of two nurses in a dark room with plywood walls, is pounding a root into powder. She says when the center runs out of modern medicines, she treats her patients with traditional ones from plants, and she keeps a small garden right behind the infirmary for that purpose. The root she is pounding helps the kidneys, she says.
About 20 children a day come for care. Malaria, typhoid, worms, respiratory illnesses, skin issues—Mushesha sees the gamut among the young patients.
In his office, Munda talks about the pressures that have pushed kids into the arms of military men willing to exploit their loyalty for murderous ends of their own.
Many children don't have the opportunity to go to school, he says. Poverty has a stranglehold on their families, and often the kids are unable to find work.
Human rights advocates says the recruitment of child soldiers stems from a host of deeply ingrained attitudes that hold little respect for the lives of individuals, including those of children. And compounding that is a widespread lack of basic services and social support networks.
But Munda is optimistic that with the kind of help programs like CAJED offer, children swept up in the horrors of war can recover their old lives and become productive community members.
The rain has stopped by the time the Oxfam visitors take their leave of Munda. On their way home, they again pass Sango's shop. The table and bedstead are still there. But now they are beaded with rain. No one thought to bring them in, or cover them with plastic. Maybe there was none to spare.
]]>Byakupita Wabinwa, president of the management committee that oversees the Kabimba health clinic, is standing below the sign. He is a small and serious man with a serious problem—one that plagues not only his community but that crops up frequently in this region of Democratic Republic of Congo: cholera.
Here, in the eastern provinces where years of conflict have taken a toll on social services, outbreaks of the waterborne disease are just one of the consequences of underinvestment in everything from roads, to health clinics, to clean water.
Sometimes, if maintenance of the simple delivery system has been lax, the water at this clinic doesn't run at all. That's why an enormous black cylinder is lying on its side in the clinic's front yard. It's a storage tank, waiting for installation as part of Oxfam's program to help ensure the clinic has a reliable reserve of water as well as decent sanitation facilities. In the back of the yard, a pair of pit latrines and two bathing stalls are under construction. And nearby, deep in the ground, lies the newly dug "placenta pit"—the local solution for disposing of hazardous medical wastes including afterbirth from the maternity ward.
Though it has no doctor and just five nurses, this is a busy place—serving an area with nearly 14,000 people. About 75 make their way here each week—some walking two hours down from the mountains—to receive treatment for malaria, to get tested for tuberculosis, to fight the cholera that erupts from time to time, especially during the rainy season.
Tacked to the door of one of the buildings is a sign, warning with explicit detail in Swahili, about the symptoms of cholera. It urges those who've got them to head for the nearest health clinic as soon as possible.
On this day, there are no cholera sufferers at the Kabimba clinic. But sometimes, during outbreaks, as many as 20 people a week come for treatment, though there is hardly the space for them. People lug their own bedding with them and spread it on the floor. A small building—about 30 feet long by 15 feet wide—serves as a quarantine area.
"But how can you put 20 people in that building and keep them healthy?" asks Wabinwa.
Inside, the walls are grimy with stains and the ceiling is collapsing. Of the original 10 cholera beds—mattresses with holes in the center beneath which buckets can be placed—only three remain. The plastic covering on one of the mattresses has pulled away, exposing the foam around the hole and leaving it like a sponge to sop up germs. A rickety wooden rack serves as a post for the intravenous drip.
As primitive and ill-supplied as the Kabimba clinic is by western standards, Trish Morrow, Oxfam's public health team leader for rural villages around Uvira, assures visitors that it's better than many that serve some of Congo's 62 million people, vast numbers of whom live in poverty. Few have the resources to pay for much medical care at all, but many live at risk of contracting serious diseases—like cholera—to which that poverty, with cruel irony, exposes them.
Nowhere is that more clear, perhaps, than along the stretch of land between the Mulongwe and Kavimvira rivers just outside of Uvira, South Kivu province.
It's there, between those two central sources of water, that the greatest number of cholera cases in the area erupt, says Jill Markvorsen, Oxfam's program manager for Uvira. During the first week of January, an outbreak almost reached epidemic proportions. At the cholera clinic in Uvira, workers charted 64 cases of the disease&mdasdh;one shy of the number that would have triggered the implementation of Uvira health zone's cholera contingency plan. Instead, officials, staffers from Oxfam and other aid groups, and volunteers from the Red Cross managed the flare-up by chlorinating water sources, making public health announcements on the radio, and providing information to people about measures they could take to improve hygiene and sanitation.
A few months later, in mid-March, both banks of the Mulongwe River are teeming with activity. Not far from one edge, a bare-bottomed boy dashes behind a bush and squats to relieve himself. Pigs root in a heap of rubbish that inches, black and slippery with mud, almost into the water. It rushes by filled with silt. Men wash their clothes. Others drive trucks and cars into the shallows to rinse off the dust and dirt. Up stream, a market crowded with people hugs the bank.
For those who have no other source, the Mulongwe River also serves as their supply for drinking water. It's no wonder then that cholera, caused by ingesting water or food contaminated by the bacterium vibrio cholerae, is one of the ugly facts of life for people living in this war-torn region.
At the Uvira cholera clinic, Oxfam helped to install a large tank that stores a backup supply of water—collected from the roof during rainstorms and precious for its relative purity. Two large rooms—one for men and the other for women—serve as sick wards. Simple beds—wood frames with sheets of rugged plastic stretched taut across and cut in the center with a hole—are scattered about the rooms. Others are piled outside.
The wards are empty on this mid-March day—a good sign.
Morrow, the public health team leader, says that the medical staff in Uvira has been trained well to provide patients with good care. Though there is not so much it can do to prevent people from contracting a disease that's so closely linked to the lack of public services—like potable water—the staff has been successful, says Morrow, in stemming the tide of cholera deaths.
And in a place where basic precautions take on ominous importance, blue buckets filled with a mixture of water and a heavy dose of chlorine dot the perimeter of the clinic's yard. All visitors are advised to scrub their hands with that solution before they leave. Most do—and duck out smelling like a swimming pool in the western world, but grateful for it.
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