Aided by Uganda and Rwanda, Tutsis captured the
Zairean capital, Kinshasa in 1997. They renamed the country the Democratic
Republic of Congo and installed long-time activist Laurent-Desiré
Kabila as president. But in an attempt to appease his Congolese
constituency, who were displeased with the idea of a Rwandan-backed
government, Kabila abruptly cut his ties with Rwanda and Uganda and
allied himself with the Hutu militias instead. The Tutsi rebel groups
continued their advance, causing Kabila to enlist the help of neighbors
Zimbabwe, Namibia and Angola. Despite peace talks and a subsequent
peace agreement signed by all in the Zambian capital of Lusaka in
1999, the violence continued. The death-toll of this conflict, which
has been called by many as the first "African World War,"
has been greater than any other conflict since World War II.
2,600
civilian deaths per day Mortality Study, Eastern D.R. Congo (April-May
2000)
Background
and Synopsis
The most recent crisis in the eastern region of the Democratic Republic
of Congo dates from August 1998 when rebel forces, backed by Rwanda
and Uganda, launched a drive to overthrow the government of President
Laurent Kabila. Nearly two years later, the conflict continues to
ravage the region. The death toll from this war has been consistently
and woefully underestimated and the humanitarian response remains
disproportionately small compared to other recent crises.
The International Rescue Committee conducted a series of five mortality
surveys in eastern DRC between April 18 and May 27, 2000 in order
to quantify the levels of civilian death and violence and to guide
health programs for war-affected populations. The survey teams were
led by Dr. Les Roberts, a veteran epidemiologist with extensive experience
in conflict settings.
The areas surveyed included: the city of Kisangani
(in collaboration with MSF Holland) in Orientale Province, Katana
and Kabare Health Zones in South Kivu Province, Kalonge Administrative
Zone in South Kivu Province and approximately 1000 square kilometers
surrounding Moba in Katanga Province. These sites represent three
of five eastern provinces in DRC and have a collective population
of 1.2 million people. The estimated population living in all five
eastern provinces is nearly 20,000,000.
From these surveys, Dr. Roberts and the IRC calculate
that over 2,300,000 people died in these five provinces between
August 1998 and May 2000. Using a middle mortality rate of 1.5/1,000/month
as suggested by the Centers for Disease Control, (a conservative
rate compared to that of UNICEF in its report The State of the World's
Children 1999) 600,000 people would be expected to die in this area,
during this time. The shocking conclusion is that the war in eastern
DRC has directly or indirectly caused 1,700,000 additional deaths.
Dr. Roberts provides some background information
for the methodology used to support these numbers here.
Of the 1.7 million excess deaths, 200,000 were attributable to acts
of violence. The vast majority was due to the war-related collapse
of the region's health infrastructure and delivery of health and
nutrition services. Today, most health centers in the DRC do not
have drugs. Maternal and child health services are grossly inadequate.
Vaccination programs have ceased. Many health professionals have
fled the region. Health facilities are looted or destroyed by the
warring groups. This breakdown allows common illnesses such as malaria,
diarrheal diseases and respiratory infections to run rampant and
kill. The tragedy is that these deaths are preventable when help
is available.
The major findings of the survey are as follows:
1.7 million excess deaths or
more have occurred over the past 22 months as a result of the
fighting in the eastern DRC. This equates to 77,000 deaths per
month and the IRC believes this is a conservative estimate.
Young children are missing from
the demographic profile. Some 34 percent of the excess deaths
are children under five and, depending on the location, 30 to
40 percent are children under two years of age. In addition to
the violent deaths of children in battles zones, it is presumed
that excessive infant mortality rates and high maternal death
rates have contributed to this troubling discovery.
Violent deaths and "non-violent"
deaths are inseparable. In eastern DRC, war means disease. In
areas surveyed, the higher the number of victims of violent deaths,
the higher the number of victims from infectious disease and malnutrition.
Access to any kind of health service is severely limited in areas
where there is a high level of violence or for populations forced
to flee unrest.
Eastern DRC is an unchecked incubation
zone for disease. In the five surveys conducted, both endemic
and epidemic illnesses were rampant, with major outbreaks of cholera,
shigella, and meningitis reported by households. Suspected polio
was reported in two of the five areas.
Violence against civilians is
inflicted by all sides in the war. Among the deaths attributed
to violence, family members and witnesses reported that killings
were committed at a similar frequency by both government and rebel
forces.
Violence against civilians is
indiscriminate. Women and children constituted 47 percent of the
violent deaths reported.
The overall mortality rate in
the year 2000 is higher than it was in 1999. The numbers appear
to be climbing and none of the collected information indicates
a decline in the foreseeable future.
The International Rescue Committee is calling for:
Increased humanitarian assistance
in proportion to the horrific level of death and suffering in
the Democratic Republic of Congo.
Unconditional and unrestricted
access to needy populations in order to facilitate the delivery
of life-saving humanitarian aid.
International support for a robust
UN peacekeeping mission in the DRC.
An immediate ceasefire by the
warring parties and a renewed commitment to resolve the conflict.
Until then, 2,600 excess civilian deaths per day will mark the
time spent waiting for peace.
Background
and Synopsis
