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"The blood keeps flowing"

Baby being weighed at MSF feeding centre, Masisi Hospital, North Kivu, DRC.
(Nicholai Lidow/IRIN)

Semivumbi Ntawiheba never used to be interested in politics. Growing up on a mountain farm close to Masisi town in the Democratic Republic of Congo's restive North Kivu, Ntawiheba lived only for his cattle.

Then, two months ago, soldiers loyal to dissident General Laurent Nkunda attacked his village and took away some of the men aged between 12 and 50 for "conscription". "I didn't want to be one of them,” Ntawiheba says. "So I decided to flee."

Ntawiheba ended up in a camp for the internally displaced, a squalid settlement near Masisi. Conditions are tough, he says as he hops over the muddy brooks that crisscross the camp, built on the only piece of flat land in town. "I never used to care about politics, but now it's been shown to me in real life - now I'm interested," he says.

Young people such as Ntawiheba are among the worst-hit in North Kivu's escalating humanitarian crisis. When his village was attacked, the 25-year-old's cattle farm was doing well; he was almost self-sufficient when the conflict reversed all his gains. Now he lives with 1,500 others in the IDP camp, relying on agencies to bring him what little food there is.

Masisi - one of the most isolated towns in North Kivu - is cut off from the rest of the region by political insecurity and poor road conditions. It is just 58km from North Kivu's main town Goma, but the mountain pass is crowded with soldiers from the competing factions and muddy throughout the rainy season. Until the World Food Programme (WFP) convoy arrived in Masisi on 21 November, there had been no food delivery to the camp for three weeks.

"We stayed alive. But there wasn't a lot to eat and there wasn't anything to do," says Ntawiheba. Women living at the camp set up a modest market, selling yams, some goat meat, a bunch of bananas, a single pineapple. Even the strip of land adjacent to the camp that once served as the town's football pitch can no longer be used because it has to function as an emergency landing strip for the UN Mission in the DRC (MONUC) helicopters that sporadically fly in and out.

Photo: Nicholai Lidow/IRIN
Women walk along the high mountain passes of Masisi town

"Conditions have been terrible at the camp. For two weeks there was no food - absolutely nothing. And life is probably no worse here than for Masisi's general population," said Philippe Havet, project coordinator for Médecins sans Frontières (MSF) in Masisi.

In any other town, MSF would probably be dedicating all its resources to medical needs. But as few NGOs are operating in Masisi, MSF has been forced to expand, handing out non-food items such as blankets and tarpaulins as well as coordinating free healthcare at the 120-bed Masisi hospital and adjacent nutrition centre.

"Often cut off from the rest of the region, the situation here is exceptional," Havet said.

Circulation has been helped by a new MONUC mobile base in Mushake, established in late November on the road between Goma and Masisi. "The base will help goods and people to move more freely," said Sylvie van Wildenburg, spokeswoman for MONUC.

A checkpoint set up by forces loyal to dissident general Laurent Nkunda, le Congrès National pour la Défense du Peuple (CNDP) in Mushake partially cut off the Goma-Masisi route, taxing trucks and passenger vehicles passing through the town.

Malnutrition rising

The hospital is perched on a cliff top overlooking the valley that is home to most of Masisi's 26,000 people. Specialists at MSF's nutrition centre see 40 cases a day - mainly children younger than five, who have been surviving on a diet of sorghum wheat, cassava and maize, which lack the nutrients they need.

Gakaru's mother is one of them. She and her son walked through persistent rain for 30km to reach MSF's nutrition centre. At two years old, Gakaru ought to weigh 7kg. He is 1kg lighter and shows signs of oedema, a build-up of excess fluid characterised by a puffy face, belly and ankles. It is a textbook case of malnutrition.

"He is one of twins. The other baby died shortly after birth," his mother says, looking on anxiously as Gakaru rejects a spoonful of Plumpy’nut, the peanut derivative often given to malnourished babies in sub-Saharan Africa.

Photo: MONUC
North Kivu Province

Inside the hospital, Save the Children runs a feeding centre for the sickest children. Sekabamdu Utamuleza is inside, a shadow of an eight-year-old girl cradled by her mother. Three weeks of treatment have failed to improve her condition, and she is taken to a main ward by a nurse.

"She throws up her food every night," her uncle, Musanga Khami, says. "We just don't know what to do any more." Khami says there are not enough nurses at the centre to care for all the children; Sekabamdu's mother had to choose between staying at home with her other children, who have had little to eat since the conflict came close to their farm, or coming to the centre with the girl.

"If these mothers leave their homes, they don't know whether there will be an attack while they are gone. That's the choice they have to make," says Havet.

Localised fighting has meant many local people are unable to reach their cattle farms, restricting food supplies further. Road conditions and spontaneous clashes prevent access to MSF's nutrition centre, so the organisation also manages an ambulatory feeding programme targeting 1,200 vulnerable children in the district.

Inside the hospital are the other victims of the war - wounded rebels, Congolese army soldiers and civilians caught in the crossfire. An attack on the neighbouring town of Lushebere killed seven civilians on 13 November. MSF brought the survivors here.

Among them is Namagi Kima Nizaine, a widow in her 40s, who lost all her children in the DRC's most recent war, which ended in 2003. "She was caught in the fighting and sustained a bullet injury to her arm," says nurse Anne Koudiakoff.

''Masisi has become a restaurant for flies. Everyone keeps getting hurt and the blood keeps flowing''

In the surgical ward, James is recovering from a leg injury sustained during an attack by CNDP soldiers on his village on 16 October. For two days he hobbled along some of the most dangerous roads to reach the hospital.

"Masisi has become a restaurant for flies. Everyone keeps getting hurt and the blood keeps flowing. They feast on it. After the elections in 2006, everyone in Masisi cried out for peace. But look at Masisi now," he says.

By the end of November, MSF will have been working in Masisi for nearly four months; longer than its emergency remit of two. "Usually emergency operations cease after two months. But how could we possibly leave when there is hardly anyone else here?" asks Havet, rhetorically.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

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