Doctors Without Borders Part One was an overview of this humanitarian organization’s efforts to aid those in need of food, shelter and medical attention in many troubled spots around the world. Part two is their efforts within the Democratic Republic of Congo (DRC), and more specifically, the region of eastern Congo in the provinces of North and South Kivu.
DRC, formerly known as Zaire, has suffered through many periods of warfare. In more recent times, fighting spilled over the border during the 1994 Rwandan Genocide causing tens of thousands to flee. The Second Congo War, which began in 1998, involved 7 foreign armies and some 25 armed groups. Although an end to that conflict was officially agreed to in 2003, the fighting continues to this day. Over 5 million people have died in the past 10 years alone, mostly from disease and starvation, but many from the violence itself.
In August of 2008 fighting between forces of the rebel leader Laurent Nkunda and the Congolese army erupted in North Kivu, causing 250,000 people to seek the safety of camps designed to support Internally Displaced Persons (IPDs). There are now over one million displaced people in North Kivu.
Doctors Without Borders/Médecins Sans Frontières (MSF) has been operating in DRC for 15 years and has initiated a new humanitarian aid effort due to the escalating number of people forced to flee from the fighting. To understand the process of providing aid to IPDs, I contacted Andre Heller, a logistics coordinator for MSF. Having recently returned from DRC after spending 14 months supporting MSF’s efforts in the region, Andre provided insights on the difficulties of working in a conflict zone.
MSF has approximately 70 ex-patriots now in DRC working alongside an estimated 800 Congolese. This Congolese national staff is comprised of doctors, surgeons, nurses, and administrators, in addition to those contracted to build shelters and provide critical logistic support. Andre explained how important this partnership is for the region, as many of the local citizens are unemployed and this opportunity provides them with much needed work experience. The cultural exchange, which works in both directions, is also very beneficial to ensuring the operation’s success.
I was curious as to how MSF inserts a new operation into a live conflict. According to Andre, the organization maintains a close watch on all areas with the potential for conflict and typically learns that fighting has begun in advance of western media broadcasting a major story on the situation. MSF will then conduct exploratory missions in the surrounding areas in order to understand the logistic challenges and to perform a health assessment.
Information gathered from local inhabitants, government agencies and media sources is combined with the extensive knowledge gained from exploratory missions and a project proposal is written. This proposal will recommend the size of the operation, intended location, and supplies required to support the mission. The proposal may also include multiple locations to address the needs of different regions, warring factions or ethnic groups. Depending on the nature of the emergency, the entire process can take place quickly, and in some cases an entire emergency program can be essentially deployed in one week.
Creating the Infrastructure
As part of the preliminary process MSF staff must secure rights to use a particular area or existing facility to conduct activities. Discussions will involve government representatives, rebel leaders and/or militia groups along with the local population and community leaders. In those situations where MSF is not granted the permission they seek, Andre explained that the negotiating process will continue, even while alternate plans are put in motion. While they hope to eventually gain access to their desired location, it doesn’t always work out that way.
In most cases MSF will utilize existing structures, such as health centers and hospitals, to perform medical procedures. They may also convert a permanent structure into a healthcare facility or rehabilitate an existing medical facility. This process involves working with the local ministry of health employees, which in turn requires a clear memorandum or understanding with local and national health authorities.
Another key aspect of this engagement involves getting the word out and letting the media know the extent to which people are being affected. Their advocacy of such plights in the early stages can have far reaching effects on how governments around the world become engaged with efforts to stem the violence.
Once the project plan is approved the operation moves into high gear. The primary function of MSF’s logistics professionals is to coordinate and manage the broad range of resources required to achieve the mission’s goals according to humanitarian needs and the implementation time line. The necessary supplies are flown in from the MSF logistics centre in Bordeaux while required staff members arrive from various parts of the world.
The ability to move humanitarian supplies from one location to another must also be ensured before MSF can do their work. While UN efforts in the Democratic Republic of Congo contain a military element in addition to a humanitarian one, MSF does not rely on such protection nor participate in their partnership of affiliated humanitarian work. This allows MSF to maintain strict neutrality. When moving supplies within the region MSF does not rely on armed guards, nor do they carry weapons for protection.
Keeping their operations properly supplied involves a great deal of forward planning, a process in which the logistics team must anticipate the needs of those within the camp and the nature of the surrounding armed conflict. When transportation routes become untenable, MSF negotiates with warring factions in an effort to secure safe passage. Even so, there are times when movement is not possible and they must wait for the situation to stabilize.
Andre noted how vital it was that all conversations conducted with any faction, be it government, rebel or otherwise, must be strictly professional in nature, as any perception of favoritism with one group or individual may result in tensions with opposing factions. Once again, MSF’s neutrality must be maintained at all times if they are to operate within areas of conflict.
People in Flight
In situations where fighting invades an area, people quickly find themselves on the run in an effort to evade approaching soldiers, allowing them to take few of their possessions. Many are killed, raped or wounded during this frantic time; families are often separated and children may never be seen again. The journey to find a camp may take many days, walking along dirt roads or hiking through mountainous terrain with minimal access to food and water.
A new camp will rapidly increase in size as tens of thousands arrive in need of life’s basis necessities. And when shelter and food have been provided, disease is often present and represents one of the greatest challenges to living inside a camp. As to the timing of when they can return to their homes, there is no way to predict when that might happen, as conflicts can rage on for many months, if not years.
That so many lives are torn apart in this fashion is tragic, yet such conflicts continue to rage in many parts of the world and far too many innocent people become its victims. And while peace may come in a few years, the scars left behind will remain for generations, as the children who grow up amid such violence may never fully recover from what they’ve experienced.
Will It Ever End?
While Global Patriot honors and appreciates the work being performed by the courageous staff of MSF, we must hope that at some point our sense of global consciousness and social justice puts an end to the violent bloodshed that has disrupted and destroyed the lives of millions on this planet.
DWB/MSF has a website which includes an amazing video.
Please watch, and support their efforts to save lives – Thank You!