"For many of the local people, this is the first time they have ever received any kind of healthcare," continued Decoux. "The health zone covers over 80,000 people, but there are virtually no functioning medical facilities. Here, when you talk about a health facility, what you have is a building with a nurse but no drugs at all." The MSF emergency team has started assisting 9,000 displaced in the Mitwaba region of the Katanga Province, DRC.

The displaced fled villages during violence which began in late 2003 and many have been living without adequate shelter and food for months, unable to return home due to persistent insecurity.

"It is hard to say how many people have been forced to leave their villages due to continuing violence between the Congolese army and local militia groups (the Mai Mai), because many are still hiding in the forest," said MSF head of mission Alain Decoux. "The population is caught in the cross fire.

Both sides prey on the villages for their survival, with even the Congolese army being, at best, paid irregularly and insufficiently. When it is suspected that one village or another is backing the other side, the result is often that it is razed to the ground and the people forced to flee into the bush."

Since November 8, the emergency teams have set up four health centres in and around Mitwaba, providing 1,554 consultations in the first week alone. Currently, each centre is receiving between 60-120 patients every day. Pathologies treated are those common among people forced to live in the wild, such as bloody diarrhoea, malaria and acute respiratory infections.

The high levels of malnutrition add to the problems.

To give an example of the scale on which this is occurring, on the first day of treatment in the health centre in Mitwaba, 45 out of 54 patients were found to be malnourished. "Being forced to flee means that people can't tend to their crops," explained Decoux.

"Although even if cultivation was possible, harvests are prone to being pillaged by the numerous armed forces. It has reached the point that people prefer to eat seeds than risk attempting to cultivate." Symptomatic of the void in healthcare in the DRC, MSF is seeing villagers, as well as the displaced, coming for consultations.

"For many of the local people, this is the first time they have ever received any kind of healthcare," continued Decoux. "The health zone covers over 80,000 people, but there are virtually no functioning medical facilities.

Here, when you talk about a health facility, what you have is a building with a nurse but no drugs at all." The nearest hospital is located in Sampwe, which is 120km from Mitwaba in another health zone. "But given the impossibility of travel due to the lack of roads and transport, this may as well be on the other side of the planet," said Decoux.

"For example, to hire a vehicle for a day costs 25,000 Congolese Francs ($55US), equivalent to a yearly wage for much of the population. And this doesn't even include the petrol."

Even if a patient is able to make it to the hospital, the price of treatment is prohibitive. As Monga Kaseya, co-ordinator of a local NGO explains, "surgery costs up to 50 000 Congolese Francs ($110 US), and this represents a fortune for a local person." As a result, very few people make it to hospital and have no other choice but to die in their villages.

"The needs in this region are immense," concluded Decoux, "through the MSF health centres, we are barely scratching the surface. The displaced arrive in villages which are already barely able to support an impoverished population. Thousands may still be hiding in the forest too scared to enter villages and the violence continues."