DRC: “We all end up living in fear"
Masisi General Hospital is overflowing with patients.
In the malnutrition ward, two or three children share each bed. A little further on, medical tents are being set up to treat patients with gunshot or stab wounds.
Everywhere you look, the situation in the hospital reflects the violence and displacement affecting the area outside: North Kivu in the Democratic Republic of Congo (DRC). In recent months, this reality has been further aggravated by a surge in fighting between the Congolese army and the many armed groups in the area, including M23.
Located five hours' drive away from Goma, North Kivu’s provincial capital, Masisi General Hospital is the referral centre for all 26 surrounding ‘health areas’. With its 310 beds, this facility is where patients in critical conditions or with medical complications are sent for care.
Day after day, within these walls, Médecins Sans Frontières / Doctors Without Borders (MSF) teams work to provide expert medical aid to men, women and children coping with years of regular violence.
More patients than beds
The sounds of cries and screams echo in the hallway leading to the malnutrition ward. This unit has an 18-bed capacity, but, over the past weeks, up to 40 children have been hospitalised at once. All around, nurses try to create extra space and set up new beds.
This influx of young patients is a direct result of violence. Following armed clashes in January, at least 41,000 people fled to the Masisi area in just a few weeks.
Thousands of families were suddenly cut off from their fields and livelihoods as they fled to displacement camps in Masisi-Centre, Lushebere and Katale. These sites were already hosting tens of thousands of people, some for many years.
Louise* and her 18-month-old son fled armed clashes in Kitchanga, a town 18 miles from the area, finding shelter in the Masisi-Centre displacement camp. A few weeks after their arrival in March, the boy started developing malnutrition and was admitted to the hospital three days ago.
“In Kitchanga, I used to grow beans, cassava, sweet potatoes... But here, I can only earn a little money by carrying firewood,” says Louise.
“I don't earn enough to make more than one meal a day. Sometimes, we just go to sleep with an empty stomach. War brought us this life of misery.”
A rolling emergency
Two years after a “state of siege” was declared in the provinces of North Kivu and Ituri – effectively bringing in martial law – violence and the spread of weapons continues unabated in the Masisi territory.
From January to March 2023, 110 people have been treated at Masisi General Hospital for gunshot wounds. Among them, two of Agathe's* young children, aged two and three, lay on a bed with their legs in plaster.
“Bandits came to threaten our neighbour. It turned ugly and they started shooting blindly in the street”, says Agathe, holding her one-month-old baby.
“Bullets pierced the floorboards of my house and hit my children who were asleep in the same bed. One was shot in the shin and the other was shot twice in the heels.
“I feel dizzy seeing them suffer so much. I can't understand how we got there.”
MSF began supporting Masisi General Hospital in 2007 when the area was the scene of violent clashes between armed groups. More than 15 years later, peace is still elusive in this part of the DRC.
Help us prepare for the next emergency
According to the most recent estimates, the Masisi territory is now home to 470,000 displaced people – around 20 percent of all displaced people in the North-Kivu province.
The reality is that insecurity has never stopped in Masisi, and neither have the lifesaving needs. However, over the years, almost all humanitarian organisations have left the area.
Psychological strain
After a relative period of calm in 2021, all indicators turned red again in 2022. Last year, MSF teams treated more than 740 survivors of sexual violence in Masisi, and there have already been 165 cases in the first three months of 2023.
“Some [patients] are coming back for the second or third time already,” says Alice, a mental health specialist and one of the hospital's psychosocial counsellors.
“Sexual and physical violence, displacement, loss of loved ones, lootings… there is a constant repetition of traumatic events. We all end up living in fear of the next violent episode.”
Out of sight, behind some colourful curtains, Alice and the other psychosocial counsellors work to alleviate the invisible wounds that often add to physical conditions.
“Living in Masisi is extremely stressful. No one is safe. Most people we treat suffer from anxiety, hypervigilance and sadness,” says continues Alice.
“Some have suicidal thoughts. Many have just lost all hope.”
A thunderstorm is now roaring over the heights of Masisi and the rain begins to fall heavily on the sheet metal roof of the hospital. Patients hurry back to their beds.
For a few more days, Agathe and Louise will benefit from the precarious shelter offered by the hospital while their children recover. After that, they will go back home.
“I am afraid to go back there, but what can I do?” says Agathe.
“We have no choice, we have nowhere else to go.”
* Names changed to protect identity
MSF and the Democratic Republic of Congo
The second-largest country in Africa by area, the Democratic Republic of Congo (DRC) is plagued by conflict. It has endured decades of multiple overlapping crises and severe limitations in medical capacity.
In DRC Médecins Sans Frontières/Doctors Without Borders (MSF) continues to run some of its largest programmes, working in 20 of the country’s 26 provinces.
We provide services ranging from basic healthcare and nutrition to treatment for victims of sexual violence and people living with HIV/AIDS.