Didier Revol in Mbujimayi
The views from Mbujimyayi are breathtaking. Located on a plateau in the south of the Democratic Republic of Congo, the city overlooks the endless African plains.
The scenes within this city of over 2 million souls are no less breathtaking: diamond trading stalls line up, side by side, along the main streets. Behind these walls of wealth, hundreds of thousands of people live without a sewage system, toilets or running water.
Most of the inhabitants of Mbujimayi, are probably unaware that this is International Year of Fresh Water, yet they would benefit hugely from latrines and a supply of clean water. Since October 2002, some 240 people in this diamond centre have died of cholera.
“Strangely, the cholera epidemic here is not a waterborne disease but has been transmitted man-to-man,” says Dr. André Zamouangana Banimba, the International Federation medical coordinator in Mbujimayi. “However it is clear that poor access to clean drinking water and bad hygiene habits have facilitated the spread of cholera.”
The first casualty occurred last October when a diamond “digger” died in a mine. The family took the body back to town. Unfortunately, the father, convinced that this death was related to witchcraft, ordered every member of the family to drink water from a bucket in which he had placed his son’s soiled garments, saying ‘the murderers of my son will die’.
“I had to drink this water,” says Marie-Josée Maputu, 38, the deceased’s sister-in-law. “But I took very little, maybe it saved me.” Of the 30-or-so people who drank from the bucket, seven died, including the father. The epidemic started from this fateful act, since when, 4,329 cases have been recorded.
As a DRC Red Cross worker, Marie-Josée is uneasy. “I knew what my father-in-law forced us to do was wrong but this is our first cholera epidemic. I was not in a position to understand what was going on.”
Since then, Marie-Josée has been trained along with 150 other volunteers by Dr Zamouangana and now spends most of her free time encouraging neighbours to adopt safe hygiene habits.
“Wash hands, boil water, cook food, these are basic messages I repeat everyday to people I meet,” she adds. “I am glad our efforts are paying off. The epidemic is not over yet but people are not dying in great numbers as they did before.” According to the Federation medical co-ordinator, more than 500,000 people have heard the message of the Red Cross volunteers.
“Kasai-Oriental is a region where diamond miners and the military are always on the move,” says Dorothea Rumpf, head of the Federation’s office in Mbujimayi. “Every time people hear that diamonds have been found somewhere, there is a rush and you can quickly find 3,000 guys digging an area of 1,000 square metres. Of course, there is not a single latrine.”
Cholera might have originated in Shaba region, brought by the diamond miners operating there. In the cities of Lubumbashi and Kolwezi, people are dying of cholera every day. “We have reached many workers through their families in Mbujimayi but we also need to reach the military, who roam the area and defecate anywhere they can,” Rumpf says.
The Federation and the DRC Red Cross are working with other humanitarian agencies such as MSF-Belgium and Oxfam-UK, sharing expertise and human resources to fight the epidemic.
Cholera treatment centres have been set up in the most affected areas. Volunteers help in all kinds of ways: raising awareness, disinfecting premises or caring for patients.
In one neighbourhood, at the end of March, the cholera treatment centre was overwhelmed with patients just a few hours after a heavy downpour. “This is always the same,” explains one volunteer. “When it rains, water points get contaminated in a very short time because people continue to defecate everywhere. There are very few latrines and protected wells, so cholera spreads like wildfire. We had three patients yesterday, we have 27 today.”
If properly re-hydrated after violent diarrhoea and vomiting, no one should die.
With the emergency phase over, some agencies are in the process of pulling out and closing down treatment centres, but the Red Cross is staying put. “The Federation is identifying existing medical structures that can take the workload over and Red Cross volunteers will continue their work in collaboration with government medical staff. In some cases we will have to support these structures,” says Zamouangana.
“It is our will not only to strengthen the Red Cross branch in Kasai-Oriental but to collaborate with health authorities as part of an integrated approach in order for all to be more efficient and less dependent on external aid on the long term,” he adds.
An appeal for 160,000 Swiss francs (US$ 112,000) launched by the Federation in December 2002 has not been fully covered and more funds are needed to ensure that the epidemic is contained if not eradicated.
“We achieved a lot,” continues Zamouangana. “We built collective latrines in big market places, the population is now aware of the problem. Some people have even started digging private latrines in their backyard and we would like to persuade more to do the same by providing concrete slabs. But here again we need funds. We are on the right track, but we should keep our guard up.”
Related links:
DRC cholera outbreak appeal: final report
Profile of DRC Red Cross
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