The price of tin has contributed to a cholera outbreak in Walikale in the Democratic Republic of the Congo (DRC) and a period of insecurity in the country has meant a delayed response. Since August 10, an eight-person team from Médecins Sans Frontières (MSF) has been in Walikale, Democratic Republic of the Congo (DRC), responding to a cholera epidemic in the area. Over the last couple of months, there has been a rapid increase in the extraction of cassiterite (a mineral base for tin) with large amounts being flown out of Walikale every day.

There has been a stampede of people to the Walikale mining area as the international price of tin has risen dramatically since the start of the year. With a lack of clean drinking water and people living in makeshift shelters in places such as Bisie, diseases such as cholera can easily spread. Bisie is a mining village of 10,000 people located two-days walk (or 45 km) deep into the forest along a tiny path. Deplorable living conditions there have led to the outbreak of the water-borne disease. Many people are dying on the route back from Bisie, according to those with whom MSF has spoken.

The outbreak was further complicated when, on June 4, fighting broke out between rival elements of the newly integrated Congolese army in Walikale (North Kivu). Insecurity fell across most parts of eastern DRC, putting the fragile peace process in the country in jeopardy. A breakdown in medical reporting during this period meant that the local authorities were not alerted to the cholera epidemic sooner.

The vast majority of Walikale’s inhabitants have still not returned to the town after they fled the fighting and remain in the forest where they have sought refuge. Bisie is, for the moment, inaccessible for MSF, but support is being given to local health authorities to get urgently needed medical supplies and staff there quickly. Since the beginning of July, there have been 354 cases and 38 deaths reported from cholera in four health sub-districts being targeted by MSF in the Walikale territory.

Many more people are thought to have died who have not been able to access the limited health care there is available. MSF has organized and supported the control of the epidemic in the accessible areas in cooperation with the Provincial Inspectorate for Health and the local health authorities.