Lubumbashi/Brussels - As the number of deaths rises dramatically, the international medical aid organisation Médecins Sans Frontières (MSF) has sent extra staff and medicines to fight several epidemics in the Democratic Republic Congo (DRC).

Since January 2003 the local health authorities and MSF have registered an increase in cholera cases in Katanga province. The new outbreak follows a huge epidemic in 2002. "At the moment we count almost one hundred cases per week in Lubumbashi town and some three hundred in the whole of Katanga," said Alain Decoux, MSF Head of Mission in DRC.

"Meanwhile in East Kasaï province the epidemic does not show any sign of stabilisation, with an average of 250 new cases per week. "In Mbuji Mayi town the figures seem to have decreased slightly but in the periphery, especially the mine sites, there has been a new increase during the past two weeks.

"This means that cholera is continuing to spread from village to village. "The health care system in DRC lies largely in ruins", explained Luc Nicolas, operational coordinator for MSF in Brussels. "Cholera is now becoming a permanent reality in the two provinces."

The first outbreak of the current epidemic dates back to September 2001. Since then a total of 19,000 cases has been counted, with more than 1,200 deaths. During the last months of 2002 the epidemic spread from Katanga to East Kasaï province, where MSF teams have counted more than 3,800 cases and 209 deaths since then. "Diamond mining is the main economic activity in East Kasaï province, making it some kind of a 'Congolese Eldorado', said Alain Decoux.

"The population comes from all directions, hoping to find instant wealth. Water, hygiene and sanitation are not priorities, regardless of their social background or origin. The social structure is extremely weak and mobility very high. "In addition, the local population maintains traditional burial rites, which facilitates the spread of cholera. For instance, the first cholera cases appeared after a funeral ceremony. Therefore it is very hard for our teams to fight the epidemic.

They spend a lot of time and energy in developing awareness among the population and educating them on the basic principles of hygiene promotion. This may bear fruits on the urban level now, but the lack of sanitation in the mine sites makes us fear another huge outbreak of the epidemic in these regions." Twelve expatriates are currently working to fight cholera.

They are assisted by almost 100 national staff. In East Kasaï they supervise a total of 14 cholera treatment centres (CTC). But cholera is not the only ongoing health crisis. Epidemics of measles are also spreading.

MSF teams are now conducting mass vaccination campaigns targeting more than 250,000 children in the health zones of Kinkondja (Katanga province), Inongo (Bandundu province), Bikoro (Equator province) and Aketi (Oriental province). In addition a flu epidemic has hit Kinshasa since late 2002; at least half of the population is at risk.

To deal with this epidemic MSF is giving extra support in 37 health centres in Kinshasa in terms of guaranteed free access to treatment, training of staff and drugs supply.