Eye on Africa: SOS D.R. Congo
WASHINGTON -- Unless we act more forcefully to save the children, the Democratic Republic of Congo, formerly Zaire, has no future. Half of Congo's 60 million citizens are under 18 years of age, with an estimated 10 million children under the age of 5. About 14,000 of these children die every month. This mortality rate is unacceptable.
According to the International Rescue Committee's recent Congo Mortality Survey, 3.8 million Congolese have died since 1998 as a consequence of armed conflict. That is the equivalent of the population of Los Angeles, Calif.
The result of the survey confirms what the world already knows. "Congo remains by far the deadliest war in the world since World War II, but year after year the conflict festers and the international community fails to take action," says Dr. Rick Brennan, head of the IRC Health Unit and one of the study's authors. "The world's response does not reflect the enormity of the crisis. In 2004, Congo received a total of $188 million in humanitarian aid, a mere $3.23 per person."
The survey reflects the period between January 2003 and April 2004. Some 500,000 people died during those 16 months. That is, more than 31,000 people every month. Forty-five percent of them are children under the age of 5, though they represent only 18.7 percent of the population. Mortality does not relent as the fighting continues.
Before the war, Congo enjoyed one of Africa's lowest mortality rates. The study shows that Congo's present crude mortality rate of 2 deaths per 1,000 persons per month is 67 percent higher than the country's prewar rate of 1.2. Because of the recurring conflict, the eastern provinces have a 2.7 mortality rate, which is 80 percent higher than sub-Saharan Africa's 1.5.
"We feel more confident than ever in our statement because of the greater precision and accuracy of this study," says Dr. Brennan. "This is our fourth survey in Congo. We selected a large sample, 19,500 households in 750 communities across the country, to reflect the whole population."
Most of the victims in Congo are civilians, and 80 percent to 90 percent of them die of preventable causes such as infectious diseases. Due to an acute shortage of immunization, safe drinking water and other basic health services, outbreaks of epidemic diseases such measles, typhoid and cholera are common. The United Nations also reports a resurgence of both the plague and sleeping sickness.
Poor management under the late President Mobutu Sese Seko weakened the national health system. Beginning in the late '70s, his government invested little in public health, leaving the country vulnerable to epidemics.
However, war and violence fuels greater mortality in the country. Congolese children face a grim future. Thousands of them face a certain, but preventable death. Insecurity and the lack of basic healthcare will kill them.
According to the World Food Program, 16 million people have critical food needs. Over 70 percent of the population suffers severe food insecurity and malnutrition is rampant among children.
"Violence and insecurity are the biggest problems for healthcare delivery," says Tony Gambino, former USAID Congo mission director (2001-2004). "People do not have access to basic health services because of security risk. Every day, I had to make a choice whether to place my personnel at risk to help the population in distress. Often the risk was too great."
In 1996, the Rwandan army invaded eastern Congo in pursuit of the perpetrators of the 1994 genocide. Their presence in the region and the threat they posed provided Rwanda with justifiable grounds to invade eastern Congo. Seizing on the opportunity, Uganda also joined the invasion and claimed to pursue Ugandan rebels based in Congo.
Rwanda accuses both the United Nations and Congo of failing to disarm Hutu militias and threatens to launch another large-scale invasion. But U.N. reports allege Rwanda's military and political leaders benefit from the illegal exploitation of Congo's natural resources and use the war as a cover for business ventures.
"The U.N. has done a great job with the disarmament and repatriation of Hutu militiamen. Twelve thousand of them have been sent home back to Rwanda," says Gambino. "Every time Rwanda cooperates, more militiamen disarm voluntarily and repatriate. But for whatever reason, Rwanda no longer wants to support the U.N. repatriation program. There is a growing awareness in the United States that Rwanda's involvement is destructive. This is a major obstacle to peace in Central Africa."
In a 2002 agreement that established a power-sharing government in Kinshasa, the foreign troops were supposed to withdraw while the United Nations and Congo pledged to send home the insurgents. Evidence suggests Rwandan troops are still in Congo. Rwanda's military presence and its support of militias opposed to the democratic transition fuel the violence and threaten to derail the peace process.
Rwanda's eight-year involvement in Congo has only exacerbated the already tenuous situation in the Great Lakes region, but has yielded no security for Rwanda. Both Uganda and Rwanda continue to arm Congolese militias, further destabilizing Congo.
For the civilians, these actions ushered apocalyptic atrocities impacting the entire country. In 2004, Congo had 3.2 million internally displaced persons and 440,000 refugees.
"There is a direct connection between the instability and the mortality rate," Brennan says. "The city of Kisangani, Congo's third largest, had a mortality rate of 6.2 under Ugandan and Rwandan occupation in 2002. But after foreign troops withdrew, the rate retracted to 1.3, once security, health, water and sanitation services were restored."
Another obstacle to peace is the transitional government in Kinshasa. With one president, four vice presidents and more than 60 ministers and vice ministers representing various political and armed factions, the government is unable to implement policies that benefit the average Congolese.
"There is not a great deal of commitment to the peace process in Congo's transitional government. Great divisions persist among the leaders: personal, ethnic and economic," says Brennan. "Too many of them benefit from the insecurity. We should hold these leaders accountable. Clearly, the responsibility rests with the Congolese. But only through a concerted political and diplomatic engagement between local, regional and international actors will we find a viable solution."
The size of the United States east of the Mississippi River, Congo borders nine countries. The country is rich both in natural and human resources. Because of its great potential, a stable Congo would positively affect all its neighbors.
"We have to stop the violence. It is time for all actors who signed peace accords to abide by the agreements, Gambino says. "We already have 3.8 million dead. We have to make 2005 a good year for Congo. Failure will have immeasurable consequences for the entire region."