While recent spotlights in the Democratic Republic of Congo were focused on the historic elections, some 20,000 displaced people are surviving painfully in makeshift camps and in villages around Mitwaba, in the western province of Katanga. MSF continues to offer emergency assistance to the local and displaced populations.

Tina* (name has been changed) arrived early in the afternoon at the MSF health centre in Mitwaba. Her clothes are dirty and torn. Her skin is covered with a white film of dust. Tina has an empty stare. Her child is lying in her arms. He is four years old but weighs just 5.6 kg. With oedemas on his feet and his discoloured hair and skin, he shows obvious symptoms of severe malnutrition.

Tina has walked over 200 km before coming out of the bush to seek refuge in Mitwaba. Several months ago, Mai Mai militiamen attacked her village, Muvule, where she was living with her husband and their child. The armed men forced the people of the village to follow them to serve as "human shield" against the Congolese army. Sick and exhausted of this long journey in the bush, Tina's husband died.

Tina and her child are what the international legal jargon calls "internal displaced". Over the last two years, some 150,000 of them have fled the conflict between the Congolese regular army and the Mai Mai militias, and the exactions committed by both parts. Violence has caused several waves of displacement in the Mitwaba/Upembe/Manono triangle, sadly known as the "triangle of death".

MSF teams have been providing humanitarian assistance in several sites where displaced populations have congregated, including the areas of Mitwaba, Dubie, Upemba, and Pweto.

8,000 monthly consultations

Since October 2004, MSF has been running medical aid programmes around the villages of Mitwaba and Sampwe (central Katanga). Around 20,000 displaced people have sought refuge in makeshift camps or in the neighbouring villages, where they have made a painful existence.

MSF programmes are meant not only for the displaced but also for local populations, who also live in extremely poor conditions.

In Mitwaba village, MSF runs a health centre and supports a health post located at the entrance of Makanda camp. In the village of Kasungeshi, further south, MSF runs a health post, as well as three additional health structures in the health zone of Mufunga Sampwe. Care is offered free of charge.

"Out of more than 8,000 monthly consultations, we are confronted mainly to respiratory tract infections, diarrhoeas and verminosis. These pathologies are directly linked to the poor living conditions," explained Ann-Sophie Iuel Brockdorff, MSF medical coordinator in the region. "Many patients are also treated for malaria or sexually transmitted infections."

At the reference health centre in Mitwaba, several surgical interventions, including a significant number of caesareans, are carried out each month.

In order to improve access to drinking water and hygiene conditions in the overcrowded camps where the displaced populations live, MSF teams specialised in water and sanitation have rehabilitated five water sources and have built two wells. A programme for the construction of latrines has been put in place, based on the active involvement of the displaced population. In total, about 200 latrines have been built in the camps in and around Mitwaba.

In addition, 50 community health workers raise awareness among the displaced and local populations about the importance of basic hygiene practices and inform them on the services offered by MSF.

"Start again with life"

Each morning in the centre of Mitwaba, the stalls of the small market are getting emptier. Food is becoming scarce and prices are going up. Having had no access to their fields for a long time and seen all their stocks plundered, the displaced populations of Katanga now entirely depend on external aid. Still, the last distribution of half-rations of food by the United Nations World Food Programme (WFP) took place in June and no new distribution has been announced yet.

"Every day, the people come to us to openly complain about hunger", explained Meinie Nicolai, MSF Operations Director. "They tell our medical teams in the dispensaries and our health workers in the camps that they haven't eaten for two or three days."

With the surrender of Mai Mai chiefs and the disarmament of many militiamen these last months, security has improved in the areas around Mitwaba and Sampwe. Some men are now occasionally returning to their fields to prepare the next harvest and bring some food back to their families.

"Here, it's difficult to find something to eat. So we go to our former fields to pick up some roots, what has remained, to feed our families", said a man who arrived in March 2005 at the Kananda camp, in Mitwaba.Ã? "But it would be better to return home, to cultivate and start again with life."

However, most of the villages are in ruins. Huts have been burned down and plundered; schools and health structures have been destroyed. Most of the time, only the church has been spared.

"We see a humanitarian crisis, with a population who has literally lost everything", says Nicolai. "The elections and the setting up of development aid programmes should not make us forget the huge and urgent needs faced right now by the populations of Katanga."

On 30th July, a number of displaced people in Mitwaba voted to choose a Congolese president and parliament. But beyond this historic moment, Tina and the 150,000 displaced of Katanga know that it is their entire life they will have to rebuild.

* This name has been changed.

MSF has worked in the Democratic Republic of Congo since 1981.
Currently, MSF teams are running programmes in Kinshasa as well as in the provinces of North Kivu, South Kivu, Orientale and Katanga, and respond to emergencies that can occur throughout the territory.