AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 36

1997 FORCED FLIGHT: BRUTAL 1997STRATEGY OF ELIMINATION

Following the outbreak of the Kabila led rebellion and the attack of the refugee camps at the end of 1996, an esti- mated 900,000 Rwandan and Burundian refugees had gone back to their country. However, more than 340,000 remained in , hiding in the hills and the forests of the Kivu or fleeing northwest, ahead of the advancing frontline8. Makeshift camps were set up in Shabunda and around Kisangani. The refugees who reached the Kisangani region in late March and early April were in an appalling condition. Diarrhoea, malnutrition, malaria, as well as severe foot and leg injuries were widespread. From early 1997 the ADFL attacked and emptied those new camps, reportedly killing thousands of people. Large numbers fled into the forest and thousands attempted to return to on foot. Many times since October 1996, ADFL forces had prevented relief organisations from bringing humanitarian aid to the refugees. In other instances, they had clearly used humanitarian aid as a bait to force the refugees out of the forests – and elimi- nate them more easily. To MSF it appeared that Kabila troops were deliberately following a policy of extermina- tion of the refugees, including women and children. According to an MSF estimation, at the end of May 1997, some 190,000 refugees had still not been localised, scat- tered in the forest and largely inaccessible to humanitar- ian organisations. Mobutu was overthrown by Kabila’s forces on the 17th of May, 1997; Zaire then became the Democratic Republic of the Congo (DRC).

8 See maps of the refugee movements on page 65

36 MSF © Kadir van Lohuizenn AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 38

THE MASSACRE OF RWANDAN REFUGEES Nurse? Guard? Guard? At that time I was working in Biaro refugee camp, 42 One night at around two o’clock in the morning, we Before ADFL forces entered Shabunda area, a massive km. away from Kisangani. In the camp, there were at found out that Lola camp was surrounded with ADFL group of Rwandan refugees arrived in the village least ten deaths per day; the people were living in mis- forces; at four thirty they entered the camp. Some of where I was living, 50 km. north of Shabunda town. erable conditions, it was cold, there was almost noth- the refugees were so scared of being caught, that they They settled in a football field; the population of the ing to eat, and the NGOs didn’t spend the night there, plunged into the latrines; others managed to flee to the village and a missionary Father were assisting them. because of the insecurity. The were surrounding forest. The humanitarian staff was held by the military Little by little, we were hearing that Kabila’s troops the camp. One day, they dropped bombs on the camp; – they took our walkie-talkies. Then the military were moving forward. One morning, several weeks everybody fled, leaving everything behind and scatter- gathered together the refugees they had caught and after the refugees’ arrival, we heard that the troops ing in the equatorial forest – there were many dead. escorted them to Kisangani airport. The people were were only 30 km. away from our village; a lot of refugees The AFDL put the cadavers into mass graves and sitting on the ground, on the tarmac; the men on one left the camp, fleeing towards Shabunda, but some of burnt them. side and the women on the other side. The humani- them stayed in the village, hiding in the houses together tarian staff was not allowed to talk to the people. If with the local population. I myself was hiding two they saw you talking to refugees, they would give you a children whose parents had fled to Shabunda – I was THE (FORCED) REPATRIATION OF RWANDAN REFUGEES beating. Then the refugees were put into single file and hiding them in my house in the forest, where we have Nurse? herded onto the plane to Rwanda. our fields. Then Kabila’s forces arrived; they started to From Biaro refugee camp, 42 km away from Kisangani, look for refugees in all the houses and in the houses in we would bring the refugees all the way to Kisangani the forest – mostly at night. A lot of people were killed. airport for their repatriation – first by UNHCR truck, Three days later, the military left towards Shabunda, then by ferry across the , and by truck I myself was hiding two children whose parents where there was a big refugee camp. We heard from again to the airport. The refugees who were scattered had fled to Shabunda – I was hiding them in my our brothers there, that a terrible massacre took place in the bush were also called out of the forest; they were on the Ulindi bridge. told that the situation was calm in Rwanda, that there house in the forest were trucks waiting for them, and they were directly Logistician? brought to the airport. There, the Antonov planes were In 1997, some 50.000 Rwandan refugees were located waiting for the refugees; the plane would open from in a huge camp 7 km north of Shabunda. When Kabila the back, we would lay plastic sheeting inside, disinfect forces entered the area, they started to empty the camp the refugees’ feet before they got in, give them two to flee westwards, towards ; but the camp was on blankets, a box of energy biscuits, plus a bucket if ever the other side of the Ulindi river, and the bridge they had to vomit. Then we would take off to Rwanda. between the camp and the road had been blocked. The I cannot say that this repatriation was voluntary, refugees were driven back, then massacred by the mili- because the refugees didn’t really know the situation in tary. When I took to the road to the north two weeks Rwanda – when we would land in and they later, it was strewn with dead bodies. would see that there were only Tutsis on the ground, they were surprised and shocked. Infact, I think these This episode lasted approximately three months; as people were in danger in Rwanda; some of them were and when the military caught the refugees, they gath- directly put in jail. One day the expatriate who was ered them together, put them in single file and drove with us wanted to accompany the refugees to the camp them down to the river. Then they would stab them to where they were supposed to be brought, but the death and throw them into the river. Some of the dead Rwandan Army refused – they even slapped him in bodies floating on the river still had their babies on front of my eyes. They surely didn’t want him to see Kadir van Lohuizen

© their back. the reality.

38 MSF DRC 39 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 40

1998“AFRICA’S FIRST WORLD WAR”

After the takeover of power by Kabila in 1997 political tensions in the area soon became evident. In particular, Kabila’s failure to control the militias and the “ex- Forces Armées Rwandaises” (FAR) soldiers, who were still perpetrating violence and massacres in the east and threatening the borders of Rwanda, was strongly criti- cized by Rwanda. In July Kabila ordered the Rwandan troops to leave the country, triggering a rebel insurrec- tion which started on August 2 from the east. The “Rassemblement Congolais pour la Démocratie” (RCD), backed by Rwanda and , soon occupied a large part of DRC. The rebels’ attempt to overthrow the govern- ment in Kinshasa failed only when Angola, Zimbabwe and Namibia sent troops into Congo to assist Kabila. Heavy fighting occurred in many parts of the country leading to displacement. The situation was so unstable that aid organisations were often unable to reach the victims. In the beginning of 1998 a cholera outbreak in a military camp near Kisangani revealed that some 3000 children were being detained in overcrowded and “dangerously unsanitary”9 conditions in Kapalata training camp. Although the epidemic had already been raging for months, killing hundreds of children, the military author- ities guarding the camp consistently blocked the efforts of humanitarian agencies and the local health authorities to access and assist the children. At the end of January 1998, of the 767 patients who had been transferred to the MSF cholera treatment centre, more than 16% had died.

9 Source: UNICEF DRC, 1998

40 MSF © Kadir van Lohuizenn AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 42

CHOLERA OUTBREAK IN KAPALATA TRAINING CAMP typhus, cholera, etc… I don’t know what happened to people. They told us that in a village half-way the Mai because the nurses there ask money for the consult- Nurse? the children who finally recovered. Mai were fighting against the RCD. With us, in the ation, and I haven’t got any. At that time I was working with MSF in Kisangani; the vehicle, there was a twenty year old soldier – he Now we still live in fear and insecurity. When the Congo River had overflown, and we were preparing a was carrying grenades, but he had taken his uniform Rwandan military and the Interahamwe arrive in possible cholera outbreak. Meanwhile, we heard that THE SECOND WAR BREAKS OUT off in order not to be caught. When we arrived in that our village, they take people forcibly to carry their soldiers were dying in a military camp in town; the Guard? village, the Mai Mai stopped us; nobody betrayed the things, and then these people disappear. The people boys who were in the so-called Kapalata camp had When the RCD soldiers launched the offensive against soldier. Unfortunately, the Mai Mai felt there was of my family who have been taken that way have been recruited in the forest to be trained and integrat- Kabila, the Mai Mai rebelled against them As the Mai something strange going on in the truck – they spotted fortunately come back, but many neighbours have ed in Kabila forces – they had allegedly been poisoned Mai had settled in Sake, 30 km west of Goma, where I him and killed him in front of our eyes, with a disappeared. Anything can happen, anytime. by the Rwandan army who was training them. was living, there were constant attacks in the village – machete, they decapitated him. After we left I heard At a certain point the humanitarian agencies took the the military would kill anybody. My own cousin died that the Tutsis coming from Goma had settled the Patient/, displaced (North Kivu) decision to pressurize Kabila’s army to have access to at that time. They would even go up to the mountains scores and started to kill everybody in the village. I’ve been displaced since 1998, when the Rwandan these dying children. They really had to put high pres- around the village and kill the people they met in the When I finally reached my house, I stayed three days Patriotic Army (RPA) started to spread violence in sure on Kabila’s government – these children were fields… When there was fighting we would spend the hidden – I was still terrified. the area. They took village after village; they would interned, because they were trained to resist the fore- entire following day burying the cadavers. At that time put all the inhabitants, the men, the women, the seen rebellion of the RCD. Only a few agencies were I decided to leave because it had become very difficult children, inside the houses, and they would burn allowed to visit the camp because it was very politi- to move in and around the village – all men were ON-GOING VIOLENCE IN THE KIVUS the houses down. They raped many women; they cised. suspected of being Mai Mai, only the women could Patient/, displaced and widow (North Kivu) would tell them to urinate in a bottle, and then The day we visited the camp it was horrible – there circulate freely; it was like we were in jail, we couldn’t I was pregnant when my husband was killed, in were dead bodies everywhere. The camp looked like a even go and look for food. When I took to the road 1998, by the Interahamwe. I was just a bride. Then I found my husband’s prison; the soldiers – who were in fact twelve to eight- towards the north there were many dead bodies on the I was just a bride then. One night the Interahamwe body in the backyard – they had caught him and een year old children – were living in houses contain- road. attacked our village; I knew it was them, and not ing hundreds of people; there were no beds, no mat- At the time when the UN people came to investigate another armed group, because of their peculiar way killed him with machetes tresses, the children would sleep on the actual floor. the massacres the Tutsis organised themselves to gath- of shooting. I fled with many other villagers, to There were no latrines in the camp; the children had er all the bones remaining from the cadavers and to escape from them; my husband was not with me, they forced the population to drink it. I don’t know to get out of the camp and relieve themselves in the burn them. but I thought he had managed to flee as well. After how many people have died, nor the reason why the bush. There was no water either – they would go and the attack, when we came back, at around four RPA did all this. This is war… collect water from a little river beside the camp. The Nurse-aid? o’clock in the morning, I found my husband’s body The RPA attacked my village again in 2001; they children were very sick and suffering from severe mal- When I fled from Goma with my father we were taken in the backyard – they had caught him and killed wanted to steal things from the families, and if the nutrition; the dead were buried in mass graves, inside as hostages by the Interahamwe; I stayed one week in him with machetes. I mourned for three days and people didn’t have anything to offer, they would camp. The very sick children were transferred to the the forest transporting luggage for them. They had then I went back to my family at K. torture them. I saw many men and children being general hospital, in the military ward; but they were killed two persons who were initially with me – two Two months ago my father also died because of the tortured, and many women being raped by the very badly taken care of. neighbours who had refused to give them money; they war. One day, as we were at home, the RPA. When we found out about these atrocities all the had beaten my father and left him almost dead on the Interahamwe attacked us. I fled with my family, Now, I am living in a village where I rent a house NGOs shared out the work; ICRC would go and side of the road. but my father stayed at home, he was drunk, and and some land; I pay the rent by selling the things I collect the sick children in the camp and bring them to I spent three days without eating; on the fourth day, he was sleeping – they killed him with machetes cultivate. My child is suffering from malnutrition, the cholera treatment centre that MSF had put in they gave me one litre of water to drink, and on the too. and I think it is due to sorcery – the people of the place. Ten to twenty children a day died in the first two fifth day I fled: I told them I had to relieve myself, and Now my mother is the one who goes out for food for neighbouring villages have certainly put a spell on weeks, because we didn’t know exactly what these I escaped. I was then twenty-three years old. the whole family, but she suffers from blood pres- me and my family, because of my ethnic origin. I children were suffering from – every day I would go sure, and therefore we don’t have enough food; I have two other children back home, in addition to back home exhausted and stressed out. Then, when we Nurse? cannot work, I don’t have enough money to have a the one I have brought to the feeding centre. My sent samples of faeces abroad we found out that there When the RCD launched the rebellion I fled from shop and I cannot cultivate because I suffer from other three children have already died of malaria. were many intermingled diseases involved – dengue, towards the north, in a truck, with many other pain in the chest. I haven’t been to the health centre

42 MSF DRC 43 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 44

1999 CONTINUED CLASHES AND 1999WIDESPREAD MALNUTRITION

Although 1999 was marked by several attempts to reach a peace agreement between the warring parties, tensions and clashes continued raging in the east of the country. From March to June, the fighting between rebel and governmental forces in Katanga province led between 20,000 and 50,000 people to cross the border with Zambia. In mid-August arguments between Rwanda and Uganda broke out into open confrontation in Kisangani, killing at least 50 civilians in the shelling10. Finally, the different factions at war signed a ceasefire in July 1999 in Lusaka, Zambia. The agreement was calling for an immediate cessation of hostilities, regulated by a joint military commission and the deployment of a UN peace- keeping force11; it was also demanding the withdrawal of all foreign forces from the Congo. Nevertheless, clashes continued and indiscriminate violence perpetrated by numerous informal armed groups remained on-going in the Kivus. They resulted in displacement, deprivation and continued suffering for the population. In Kisangani, as in many other towns in eastern DRC, trade soon came to a standstill as a result of the war. The roads, normally used to supply the city with goods com- ing from other provinces, became inaccessible due to insecurity; and the Congo River, historically connecting the city with Kinshasa, was blocked according to the frontline. As the town became landlocked, malnutrition rates rose dramatically; a survey conducted by MSF in January 1999 showed a global malnutrition rate of 13.4%, and a severe malnutrition rate of 9.1%.

10 See the New African Yearbook 2001, p. 138 11 The Mission des Nations Unies au Congo (MONUC)

44 MSF © Kadir van Lohuizen AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 46

ON-GOING VIOLENCE IN THE KIVUS It was around the year 1999, I don’t exactly remember, The Mai Mai were drunk, and they had smoked Patient?, tortured by the Mai Mai (Shabunda) the Interahamwe started to come to our village and to hemp; they take aphrodisiac products, they have In December 1999, there was a Mai Mai ambush in loot our goods. At a certain moment we didn’t have never enough. They are demons, not human beings. our village; it became impossible for us to go back anything to offer anymore; they then threatened to kill I was liberated by the RCD in February 2001, in K. home, and we remained cut off in the bush for the us if we had nothing to give them. Thus we started to forest. Of my seven children, I only have four left; whole of 2000. In early 2001 a rumour informed us spend the night in the bush. At six o’clock in the the Mai Mai took two of my daughters, and I never that there was a safe way to go to Shabunda; as we evening we would pack a few things and some plastic saw them again. They were 23 and 26 years old. went out of the forest, we fell into the hands of the sheeting to cover ourselves; then we would go to the Two of my sons fled to the forest; one has just come Mai Mai, who accused us of collaborating with the forest and look for a hidden place where they could back, he is very thin. I don’t know what has hap- enemies. Then, 24 hours of torture began for my wife not find us. It lasted one week, then we moved from pened to the other one. and I – it stopped only when RCD forces arrived to this village because of the insecurity. Since then, I feel pain in the neck and the hips; I liberate us. suffer especially when I carry out my intimate First, I was given more than 300 lashes of the whip, Cook/ hygiene – there are parts that I can’t wash any- and so was my wife; then, they subjected me to all In 1999 the children of my mother in-law died because more, because of the open wounds. The medicines I kinds of humiliations. They took a torch and burnt my of the Interahamwe, who were in conflict over the was given in the health centre make me faint, because genitals as well as my armpits; they whipped me in the fields with the other populations. Here in the region I don’t have enough to eat; I suffer from hunger, and face, they gave me water mixed with ashes and live we don’t have many fields; if you have a field, you pay for the time being I cannot go to the fields anymore. embers to drink. One of the Mai Mai was standing in – the Interahamwe attacked the village where my rela- But more than anything, I suffer from shame. front of me, ready to put me to death with his tives were living, looted the tea factory and all the weapons. My fingers were broken due to the ropes that houses. They killed my relatives – the husband, the were binding my hands and my nose and ears were wife and four children. THE NUTRITIONAL CRISIS IN KISANGANI bleeding – I fainted. Then, they tied my hands together Guard? with my feet and let me spend the night in this terribly Nurse-aid/ In 1999 I was working in an MSF nutritional centre in painful position. My wife was tortured too, she had to In 1999 in Sake, 30 km away from Goma, some of my Kisangani. It was pitiful; the children have been the have two surgical interventions because of what they relatives were living in a camp of displaced people most affected by the consequences of the military did to her. coming from Masisi, and they were all living in plastic conflict and the economic collapse in Kisangani – no As of today, I still suffer the after effects of the torture. sheeting houses. One day the Interahamwe attacked supplies, no salary, no communications with the Becaue of the whiplashes I received on the eyes, my the camp – everybody got burnt alive in their shelters periphery… My own son was affected by the oedemas eyesight is not normal anymore; my genitals don’t made of sheeting. of malnutrition; he had to be transferred one month function normally either and I have recurrent night- to one of the feeding centres run by MSF. mares related to the events. I became a coward; as soon Patient/, raped by the Mai Mai (Shabunda) as tension rises around the village, I flee. I was walking in the forest with my husband and my Driver? The most affected people are still in the forest; many seven children when the Mai Mai showed up, in I have seen with my own eyes the status of the children people are like me, traumatised. I think a psychological August 1999. My husband had a communication when they were arriving at the feeding centres – it was treatment would be welcomed by the population. It radio that the Mai Mai wanted to steal from him; terrible. Some of the children were like skeletons; others will be difficult for us to become a healthy population they took my husband and they beat him – he has were completely swollen with oedemas. One really felt again, because our spirit has been exhausted. disappeared since then. Then they took me, and they like working hard with these children, like helping them. raped me in front of all my children. They took the Nurse/ virginity of my daughters; they sexually mistreated Before when I was hearing stories about families who my sons – I think that some of my sons are now had to spend the night in the bush because of the impotent because of their ordeal. Then the Mai

© Remco Bohle insecurity, I didn’t believe it; and then, one day it Mai dragged me for 65 km, raping me anywhere, at happened to me as well. any time; I was raped by more than a hundred men.

46 MSF DRC 47 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 48

2000TORTURE, RAPE AND FORCED LABOUR

The year 2000 saw the persistent violation of the cease-fire con- cluded the previous year by the warring parties. Fighting increased, resulting in further internal displacement and refugee movements At the end of the year more than a million people were displaced in the entire country. In January the Congolese “Mai Mai” militias launched an attack against the town of Shabunda, , in an attempt to over- throw the Rwanda backed military controlling the city. As they had fled Shabunda to avoid the fighting, most of the people remained cut off in the bush, victims of forced labour, torture, rape, and even murder. Since then reportedly 2000 women have been raped and used as sexual slaves over several months by the Mai Mai. Traumatized, stigmatised by the population, many of the women contracted sexually transmitted infections during the rape, and some of them were so badly injured that they even required recon- structive surgery. As part of a wider battle for regional supremacy, in June 2000, Rwandan and Ugandan soldiers started fighting in Kisangani, despite ceasefire promises to the United Nations. Reportedly 6,500 bombs were dropped on Kisangani; the intense fighting killed up to 250 civilians and wounded more than a thousand peo- ple. In May 2000 heavy shelling between Rwandan and Ugandan troops had already killed at least 27 civilians and wounded 155 civilians. As a result of the insecurity, which forced many people to recur- rently flee from their villages and prevented them from cultivating their fields, the health and nutritional status of the population was appalling. A nutritional survey conducted in October 2000 in Kitshanga12, North Kivu, showed a global malnutrition rate of 11,5%, and a severe malnutrition rate of 7,3%.

12 See the article “Kisangani compte toujours ses morts », C. Braeckman, in Le Soir, 20 December 2000.

48 MSF Chris Keulen © AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 50

THE STORMING OF SHABUNDA BY THE MAI MAI the forest at that period, together with her three Guard? children. The one she was still breastfeeding died of It was around ten o’clock. At that time the people from malnutrition soon after she came back. In December the village were attending a meeting with local author- 2001 my sister fell ill, we don’t know exactly what she ities. Suddenly it started to rain, then a lot of gunshots was suffering from – she was in great pain. She died were fired. The Mai Mai entered the village singing. soon after. The people started to run away to the forest, abandon- ing everything. I was in the centre, at the market, with Since then I have never gone back to the forest again, my second wife when this happened; we fled to the and neither has my wife. We cultivate in our little gar- forest, and we spent the night there, traumatized, den, inside of town, to avoid going to the fields far in together with a big part of the population. But my the bush. But life is very difficult; as many of my close children were not with me; when the Mai Mai entered relatives have died in the last years, mostly due to Shabunda, they were home with my first wife, and diseases and lack of health care, I am responsible for they fled with her in another direction. They crossed all their children – 23 people in total. Sometimes we the river, and they spent one year in the forest, cut off don’t eat anything the whole day. My stomach has by the Mai Mai before they finally made it to a camp become so used to it that I can’t eat big quantities of near Bukavu. I haven’t seen them since then. As for food anymore. me, I spent six weeks in the forest, in a little hut I had made out of leaves. When I went back to Shabunda, I As many of my close relatives have died in the found my house completely looted. My sister also fled to the forest; but as her husband last years, I am responsible for all their children works with the military, he stayed in town with other – 23 people in total soldiers. When military activity started in the bush, the Mai Mai approached my sister and told her “It is your Patient/, displaced, raped by the Mai Mai fault if the military is here, it is your husband looking (Shabunda). for you !”.She was taken as a prisoner, and used as a It was one week after I had given birth to my first slave for four months. She was mistreated in all kinds baby, in July 2000. I went out to present the baby to of manners. She was raped by four to ten men every my family, and accomplish the traditional purifica- day. tion rituals with them; on the way, I met a group of Mai Mai who asked me where I was going. They On the 25th of January the RCD took over Shabunda told me: “You’re coming out from Y. to spy on us ! and the attacks started to be more frequent in the area Women are the first spies in this war”. Then they It was impossible for the people to go out of town. The took my baby and they told me: “you’re going to eat last fighting in Shabunda town took place in it”. They tied me up and six men raped me. The December 2000, at around 2 o’clock in the morning. It maternity sores were not healed yet; with the rape, was very violent fighting; the Mai Mai faced a bitter my flesh just tore, opening from both sides – even defeat – they lost many men in the river. now, I cannot control urination or defecation, and After Kabila’s death, in January 2001, a “standby” both have been coming out from the front. My baby period began, during which the population tried died soon after; I stayed one year and a half in the harder and harder to look for family members still forest, until February 2001, when the RCD soldiers hiding in the bush. They spread the news that the arrived. situation in town was good, and that people from the When I arrived in Shabunda, they first sent me to © Sven Torfinn © Sven Torfinn forest could make it safely back home. My sister left the nutritional centre, so that I could gain some

50 MSF DRC 51 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 52

strength again; then I went to the health centre, were also detained – during two months, the men his hand. They looted everything they could find; then and they gave me pills, but it had no effect. Now I raped me, one after the other. Then, they forcibly they left, saying that they would come back. have to be transferred by MSF plane to Bukavu allocated a “husband” to me, of whom I was the The next day we heard on the radio that the war was hospital to be operated on, and I still don’t know slave for three months. over. We could finally go out; just beside our house, six when this will be possible. In the camp, we would sometimes spend two days to eight shells had fallen. There were many dead – I have no enthusiasm anymore and no self-esteem without eating anything; there was no soap, we some of them had been buried quickly anywhere, even because of my helplessness in controlling my couldn’t wash ourselves – we had lice all over their inside the houses. Fortunately, we found my sister’s excrements. I don’t even know where my husband body. As our clothes had been taken, we were children again. is, I haven’t seen him again since what has happened almost naked, with only a piece of cloth to hide our to me; but even if I would see him again, what use genitals; all the mosquitoes and germs were creep- would it be? I can’t even have sexual relations any- ing into the wounds left by the lashes. We were more. sleeping on the actual floor, without any mat. The infected wounds and the cold weather provoked Cook/ rheumatism – now I walk with difficulty. I have Human life is not good to see in times of war. War contracted a sexually transmitted infection because disturbs people psychologically – people are killed for of the repeated rapes; my periods are not regular nothing. anymore, and when I take a bath I have vaginal I haven’t had any news from my husband for more pains – as if I had burned myself. Fortunately, my than two years – precisely, since the 17th of January daughter was not subjected to violence in the camp; 2000. That day, as the Mai Mai were walking towards but she fell ill because of the living conditions there. Shabunda, I fled to the forest with my children; but my husband stayed in the village – everybody thought that the Mai Mai were government forces, and when they THE SIX DAY WAR IN KISANGANI entered Shabunda, my husband became part of the Driver? movement. On the 25th of January, the Rwandan mili- I was at home when the war started. Early in the morn- tary took over Shabunda, and my husband fled with ing we heard gunshots and shellfire in the city. When I the Mai Mai to the forest. I don’t know what has went out at eleven o’clock, to pick up my sister’s chil- happened to him. dren at school, I saw that an entire house in the neigh- Now I am alone with my two children; in addition, bourhood had be crushed by a shell – there were at least one year ago, the priests gave me four orphans to take six dead bodies. At the school, there were no children in care of. The parents of three of the children died of the building anymore; so I went back home alone. From disease – one died of cholera during the outbreak in then on it was impossible to get out of the house; gun- 1997. The parents of the youngest one, who is seven shots and bombing were incessant. The neighbours also years old, are cut off on the road north of Shabunda; sought refuge in our house – we were around hundred we don’t have any news from them. and twenty people hiding there. We stayed six days hiding in the house. We had no food and no water. Patient/, held as a sexual slave by the Mai Mai On the sixth day a group of Rwandan soldiers knocked (Shabunda) at my door looking for a generator. I didn’t have one, I was caught by the Mai Mai with my eleven year- so they left – they came back three hours later, and this old daughter, in December 2000. As I tried to time they pointed their gun at my head. “Where have escape, they gave me lashes of the whip; I still have you hid the Ugandans?” they asked me. They the scars on my legs. They took me with my daugh- rummaged through the whole house; we all had to sit © Sven Torfinn © Sven Torfinn ter to a big Mai Mai camp, where other women down. One of the soldiers had a Chinese grenade in

52 MSF DRC 53 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 54

2001TENSION REMAIN, VIOLENCE CONTINUES

On the 16th of January 2001 President Laurent Kabila was shot dead by one of his bodyguards. When his son Joseph took over a glimmer of hope passed over DRC, but although he had expressed his intention to revive the peace process the tensions remained and violence continued to affect thousands of civilians in the east of the country. At the beginning of January a new round of violent clashes, following those of early 2000 between the Hema and Lendu tribes, restarted in Ituri district. Mainly rooted in a conflict over land, and further fuelled by some of the military controlling eastern DRC, the conflict between the two ethnic groups had already cost the lives of thousands and displaced some 150,000 people at the beginning of 2000. In January 2001 at least 200 civilians were killed with machetes. Whilst carrying out an assessment mission, in April, six workers from the International Committee of the Red Cross were found dead and mutilated by machetes next to their burnt out cars. The team consisted of two expatriates and four Congolese workers. Meanwhile, the tensions in the Kivus remained on-going. In the north clashes between the Rwandan army and its RCD allies, the “Interahamwe” and the Mai Mai continued spilling over to the population. Pillaging, harassment, torture and massacres forced more people to flee their villages time after time. Between the months of August and December of the average 136 children monthly admitted in the MSF Therapeutic Feeding Centre, 22,8% were currently displaced or refugees. This figure didn’t even includ those who, without being literally displaced, were forced to go often to the bush for a few days or a few hours, because of the insecurity. In Shabunda area several attacks on villages by Interahamwe and Congolese Mai Mai militias caused the dis- placement of a thousand people, some of them bullet-wounded.

54 MSF © Remco Bohle AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 56

ETHNIC STRIFE IN ITURI DISTRICT ON-GOING VIOLENCE IN THE KIVUS Since I’ve been here at the Nutritional Centre there Nurse? Patient?, displaced and tortured by the has been an attack in N. The Interahamwe persist; In the beginning of 2001 we carried out an exploratory Interahamwe (North Kivu). the situation will remain the same, I have no hope mission in Bunia, north of the eastern DRC, where a I’d been at the Nutritional Centre for three weeks for the future. I don’t even think about the possibil- conflict between the Hema and Lendu ethnic groups with my three year-old son. His mother was at ity of a better life. was, and still is, raging. 10 km from Bunia we bumped home with our six other children, in N., where we into a group of people carrying machetes, spears, and have been displaced for three months because of Patient/, raped by the Mai Mai (Shabunda). maces; they stopped us on the road, and they asked us Interahamwe attacks. I was caught by seven Mai Mai in January 2001, where we were going. We got very scared because it One night the Interahamwe arrived in our village north of B., whilst I was on my way to visit my sis- was a big group, they were hardly talking to us, they and surrounded it There was a large number of ter. One after the other, the men raped me; they were very well armed… We talked with their chief and them, they looted everything in the village. They even used wooden sticks to torture me. They left me we explained our objectives – finally, he accepted that entered our house and they took all our possessions, in agony, lying in my blood – some people passing we could continue our trip. our animals, our clothes – we were completely by took me back to the village. Nurses from the In B., which is a Hema village, we found around twen- naked. Then, so that we would give them our local Red Cross examined me, but as I had no ty seriously wounded people. Just before we arrived money, they tortured us. They beat us, my wife and money to pay, they didn’t give me any treatment; there had been a fight between Hema and Lendu – the me, with the butt of their rifles; they kicked us, and yet I was suffering dreadfully, and I had a terrible people had almost no medical assistance. We therefore they slapped us too. haemorrhage. gave them medicines, and we even helped to treat one The Interahamwe knows exactly what is available in Because of insecurity and frequent Mai Mai of the wounded. We spent the night there. The next the villages, and where the resources are. They had day we had a meeting with the local authorities, and spies who watched the Rwandan military; the popu- If you are very sick, the nurses accept we explained that we wanted to go to J., in Lendu lation recognizes them, but we were not allowed to to treat you, but only if you cultivate their territory. That was the hard part: they didn’t want us say they were there, because if we do, they put “a to go to the Lendu, who were harming them, killing padlock on the mouth” – that is, they decapitate us. field in exchange them and who wanted to exterminate them. One day The population feels constantly threatened. the wounded had told us, there had been a massacre of After this attack we resisted one month; then the attacks, I had to move to Shabunda; there, I was forty people who were out in the field in the middle of Interahamwe came back to attack us, and many examined by the nurse of the hospital, who said the day. After many discussions they finally accepted neighbours were decapitated. It is only then that we that I needed surgery. Unfortunately, this interven- that we go to Lendu territory; and they even asked us decided to leave. tion costs fifty US dollars, and I am not able to pay to transmit a message of peace to the Lendu, to ask Since we have arrived in N., my wife and I work in for it. As for my husband and my three children, them to cease hostilities, because the population was someone else’s field, while the children stay at they have been abducted by the Mai Mai and they suffering from the fighting. home; it gives us an income of 300 Congolese are still in their hands. When we arrived in J. hospital we found around ten Francs a day13, which enables us to pay for the rent seriously wounded people who told us the same story of the house, an old house about to fall apart. In as the Hema. To the Lendu as well, we gave medicines the evening, after work, I go to buy some food, but and medical support; and we had a meeting with the we don’t have enough money to eat sufficiently. We community leaders. At the end of the meeting, they try to have at least one meal a day – mainly colcase asked us to transmit the same message as the Hema. and cabbage. We don’t easily have access to health We finally managed to open a project in Bunia, which care; there is a health centre at N., but you need lasted three months; only a few weeks after the project money – if you are very sick, the nurses accept to was closed, six ICRC workers were massacred – among treat you, but only if you cultivate their field in whom someone I had studied with. Everybody was exchange.

© Chris Keulen very shocked because it could have been any NGO, and still could be, victim of this. 13 A bit more than 1 US $

56 MSF DRC 57 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 58

2002NO END IN SIGHT...

On the 17th of January in Goma the eruption of Volcano Nyiragongo forced more than 300,000 people to flee towards Rwanda in a few hours. Destroying nearly 15% of the city, the lava flow left some 60,000 people homeless, with hardly any resources to survive. While several thousand people immediately gathered in camps, both in Rwanda and in Goma, most of the victims sought refuge at a relative’s place, overcrowding the houses and stretch- ing family economies. From April 2002 “temporary shelters”, made of plastic sheeting and metal sheets distributed by relief agencies, popped up like mushrooms all over town. Although barely safe, these shelters were the only solution the victims had to start their lives again. Within the framework of the peace talks the government of Kabila and President Kagame of Rwanda signed an accord in July, com- mitting Rwanda to withdraw its troops from DRC and Kinshasa to address Rwanda’s security concerns in DRC. However, in the meantime, clashes continued all over the east of the country. In April fighting broke out in Shabunda area, South Kivu, between Congolese Mai Mai militias and RCD soldiers, pre- venting humanitarian organisations to bring relief for several months to a population already landlocked by the insecurity of the area. As the Mai Mai had been controlling the forest and harass- ing the civilian population for more than two years, cutting them off in the bush or in the villages with almost no food stocks to survive, malnutrition was appalling. A nutritional survey conduct- ed in February 2002 had alredy showed a global malnutrition rate higher than 20% in the area14.

14 Source: ACF-USA, February 2002

58 MSF © Marcus Bleasdale © Marcus AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 60

ON-GOING VIOLENCE IN THE KIVUS can, because I have no choice, since my wife was Patient/, suffering from third-degree burns on the the one in charge of it before. head and the body (Shabunda) In January 2002, I had to leave my village because of the insecurity; I fled to the forest, and I sought THE ERUPTION OF VOLCANO NYIRAGONGO shelter in a hut made of leaves and branches. One Guard? day, the Mai Mai attacked us – they wanted to loot For me the volcano eruption has been as bad as the our goods and our food. At that moment, my baby war itself; right now, my wife and my four little girls was sleeping in the house; I was so scared that I just are still living in a displaced camp in Goma, in a hut fled, leaving my baby behind. When I came back, made of rusty metal sheets. the pile of clothes that was next to the incandescent We lost everything in the volcano eruption; when she lamp was on fire and my baby’s skull was third- saw our house burning, my wife fainted – the neigh- degree burnt. My baby also lost a finger because of bours took care of her and brought her to Rwanda. the fire. She left Goma only with two “pagnes”15 and the children. We had to start from scratch once again. Our living conditions are very difficult right now – MALNUTRITION AS A CONSEQUENCE OF THE WAR how can an adult like me live with his wife in a Patient/, suffering from malnutrition (Shabunda) “house” where you can’t even stand, together with four My little daughter suffers from malnutrition; she has lost weight dramatically, she vomits after hav- ing eaten and her feet are swollen with oedemas. My children’s health is bothering me so much, My wife, her mother, was taken by the Mai Mai in that I cannot concentrate on my field May 2001, while she was working in the fields; she was out there with our oldest son and our baby, whom she was still breastfeeding. I have no idea little girls? Besides, the owners of the land where the what has happened to them. I remained alone with displaced camp lies want the field back – it’s a school, my three other children in Shabunda; unfortunate- and the children need it. I absolutely need to find a ly, one of them has died since then, because I was plot to settle down. With my salary, I will maybe be not used to being in charge of the children’s health able to buy a bed and a mattress soon, and four metal and I didn’t react in time when my son had measles. sheets to build a home… Now that my little girl is also sick, I am very afraid that the same thing will happen again and that I Domestic staff? will loose her too. My third child has no health prob- The eruption of the volcano is something that nobody lems right now, but he is not strong and healthy. can forget; everybody is still talking about it – it raised It is very difficult for me to find food to eat; for the many questions and problems. time being, it is dangerous to go to the fields and That day we were at home, we were listening to the what is more, at the time when I should have radio but it didn’t say anything about the volcano. We sowed, my son had died – I was too disturbed to could only see people pass by carrying their goods, think about cultivating. My children’s health is saying that the volcano was erupting. We didn’t believe bothering me so much, that I cannot concentrate on it was true and then, the radio finally broadcasted the my field. However, I will have go back as soon as I news – at 13.30 pm, whereas the eruption had started © Chris Keulen

15 Pieces of fabric that Congolese women use to dress

60 MSF DRC 61 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 62

at 7 am ! On top of everything, the radio was telling That night when I knew the people were starting to village two hours walking distance from here. They Congolese Dialogue but cannot follow what is the population not to worry, saying that the lava flow flee from Goma, I managed to call my wife on the leave at 05.30 in the morning to reach the school at happening. Only the responsible of the village has a wouldn’t reach Goma. They said that those who would phone She told me she was going to cross the border 07.30 when classes start. radio, but batteries are expensive, one pair costing be caught fleeing with their goods would have their with Rwanda. Then the battery for her mobile phone We have a very hard life without any development. 70 or maybe 50 FC16. possessions confiscated by the authorities. ran out and it became impossible to reach her. I evacu- Every one of us has his own field. One has to in So the best thing we have are our fertile fields and At a certain time, however, the radio told the people ated with the MSF team towards the south to Bukavu order to survive. We all have to eat, without food the worst are the conditions in which we have to from several neighbourhoods to leave their houses. From Bukavu, the next morning, I went to Kigali, in you cannot live. We are lucky with the very fertile live without any hope for improvement. When they went out of their house the lava flow was Rwanda, and from Kigali, the following morning fields we have, anything grows. already very near. Many people had their goods burnt returned to Goma. At around three o’clock in the We even used to have a coffee plantation and and they no longer have a house. My house was burnt afternoon I received a phone call; it was my wife, final- planted cotton. We would sell the product to a fac- aswell, and everything inside – I couldn’t rescue any- ly. She was crying on the phone, she could hardly tory in Kisangani. The factory doesn’t function thing. speak – she told me she was still across the border, and anymore and the owner, he was German I believe, Several NGOs distributed food and “reconstruction” was about to go back to Goma. She said she was going left in 1963 when the war began. kits to the victims of the disaster, but since the begin- to spend the night at a friend’s house. At six o’clock We had coffee for a while after that, but without ning, five months ago, I haven’t received anything. pm I arrived in Goma. First I went to the office and the insecticides everything was eventually eaten by The “chefs de quartiers”,who receive all the distribu- then I crossed the hot lava to go and pick up my wife. the insects. tion cards and are supposed to hand them out to the When we saw each other again, we cried together. We The military passes by here 5 to 6 times a week and people sell them instead. There are many people like had lost everything, and we didn’t know where to start we have to provide them with porters. It’s a bother. from again. Today you’ve seen them with eleven persons carry- I just hope I’ll be able to recover. My wife is still traumatised by this event; I try to com- ing their goods. Some are from the next village and Fortunately I still have my brain, I can keep fort her and to give her hope, I tell her that we are still some are from our village. They have to walk for alive… But she doesn’t want to stay in Goma anymore, them to Lobolo, 29 km from here, where they then on working and manage somehow she would like to move to Kigali or Kampala in sell the goods they took from us, chicken, meat and Uganda, but we don’t have the financial means for manioc and then they buy soap and salt for them- me. Besides, the “temporary shelters” distributed by that. The volcano made me very poor, and I just hope selves. They do not get a salary. the NGOs are made out of plastic sheeting and there- I’ll be able to recover. Fortunately I still have my brain, They do go after the unmarried girls as all young fore very unsafe – the young people come with knives, I can keep on working and manage somehow. Now I men do, but wouldn’t bother married women. tear the sheeting apart and steal everything inside the live in a house that a friend of mine rents me for sixty Two years ago the frontline with the FAC was right houses. dollars a months – it is less than half the normal price, here. That was a hard time. At night when our sol- because the owner knows I have lost everything and he diers were absent the FAC would sneak in and take Administrator? is willing to help me. all they could find. Many of us fled into the forest When the Nyiragongo erupted I was on special assign- for two months where we had to survive on the ment in one of our projects, in North Kivu – I had meat we could catch hunting and prepare it with- only one pair of pants and two shirts with me. My wife DESTITUTION AND MILITARY PRESSURE out salt Can you imagine that? I myself fled to was in Goma with the children She was convinced that Patient?, (Yahuma) Lokutu with my family. the lava flow would never reach the house and when I am a villager – jobless, no function and I am Whenever we are able to sell some of our products she had to flee from the city, she also left without tak- known by the name of Y. Nineteen years ago when in Lobolo we too buy salt, soap and sometimes ing anything. Unfortunately, the lava came down and I was 32 I came here with my wife and two clothes. That’s all they have anyway. The roads swallowed everything. Since I had stopped studying I children. We had another seven children after that used to be maintained by the government, nowa- had invested in buying some land, building two houses but due to the various epidemics here we are left days we have to do it ourselves for no pay. on it, equip the houses with a radio, TV, kitchen, etc… with four. The other five all died. There is no health We hear about the government and the Inter- It just destroyed eleven years of efforts – it gave me an care for us here. awful shock, I will never forget it. No school either; the children have to go to another 16 1 US dollar equals approx. 250 Congolese francs

62 MSF DRC 63 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 64

CHRONOLOGY THE MAIN EVENTS

November – December 1996 January – February 1997

1870s: Commissioned by King Leopold II of Belgium, the explorer 1995: Renewal of the ethnic war in Masisi. H.M Stanley establishes the King’s authority in the Congo basin. 1996: Revolt of the Zairian Tutsis “” in South Kivu; 1884-85: Leopold’s claim on the Congo is fomalized at the Berlin the ADFL’s (Alliance of Democratic Forces for the Liberation of Conference. The “” was created as a personal Congo-Zaire) “Liberation” war led by Laurent-Désiré Kabila fiefdom of the Belgian Crown. begins from the east.

1908: The Congo becomes a Belgian colony. 1997: Mobutu is ousted by the ADFL forces and flees in exile to Morocco. 1960: The Congo becomes an independent state, with Patrice Lumumba as Prime Minister and Joseph Kasavubu as President. 1998: Congolese rebel forces, backed by Rwanda and Uganda, start attacking Kabila’s forces and conquer the east of the coun- 1961: Lumumba is murdered, reportedly with US and Belgian try. Angola, Namibia and Zimbabwe come to Kabila’s aid and complicity. push the rebels back from Kinshasa.

1965: President Kasavubu is ousted by General Mobutu, army 1999: First confrontation of Rwandan and Ugandan troops in March – April 1997 chief of staff. Kisangani. Signature of a cease-fire agreement by all six of the May 1997 0nwards countries involved in the conflict; MONUC observers are 1990: Mobutu announces multiparty democracy but keeps deployed in the DRC. significant powers. 2000: Six-day war between Rwanda and Uganda in Kisangani. 1991: Anti-Mobutu sentiments explode in mass rioting and loot- ing by unpaid soldiers in Kinshasa. 2001: President Kabila is shot dead by one of his bodyguards; his son Joseph takes over. 1992: Riots and looting by unpaid soldiers in Goma, Kisangani, Kolwesi; ethnic tensions rise between the Hunde, Nyanga and 2002: Eruption of volcano Nyiragongo in Goma. Accord signed Nande and the Banyarwanda in North Kivu. between Presidents Kabila and Kagame of Rwanda committing Rwandan to withdraw its troops from the DRC and Kinshasa to 1993: Ethnic strife between the local populations and the address Rwanda’s security concerns in the DRC Banyarwanda breaks out in Masisi area. The coup in Burundi against new Hutu President Melchior Ndadaye results in the arrival of some 80,000 Burundian refugees in Zaire.

1994: Genocide of the Tutsis in Rwanda. Following the Tutsi led counter offensive, one million refugees, mainly , cross the 50 kms. border with Zaire. MSF Static – Refugees Moving – Refugees Road National Border Scale

64 MSF DRC 65 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 66

MSF PROJECTS IN THE EASTERN DRC 1992-200217 The following is an overview of the main projects carried out by MSF between 1992 and 2002; the main humanitarian issues are detailed in the text.

1992: Kivu Basic Health Care Project from Amsterdam. Five days later a cholera epidemic broke out As the health care system had completely collapsed due to the among the refugees, leading MSF to set up 4 out-patient clinics economic crisis in Zaire, MSF started to supply the population of and four cholera treatment centres in the first days of the epi- North Kivu with drugs and medical care. MSF also provided for a demic. Although each cholera centre was able to treat 500 contingency plan in case of an emergency situation (epidemics, patients a day, the scale of the epidemic was so huge that a thou- ethnic conflict, natural disaster…), which enabled it to intervene sand people died of cholera every day18. after the outbreak of cholera in Goma and Katana, of malaria in By the end of July MSF concentrated its activities in two of the the Beni region and of meningitis in the regions of Rutshuru and refugee camps. Over the year, MSF set up 3 clinics, 16 health Rwanguba. centres, a hospital and a paediatric hospital. As the security situ- ation in the camps started deteriorating, with former community 1993: Kivu/Displaced Persons Project leaders and Hutu militias terrorizing the refugees, the aid workers Following the outbreak of an ethnic conflict between the Hunde faced a moral dilemma: weren’t they supporting a guerrilla war, “autochthons” and the Banyarwanda “foreigners” in Masisi area, and were they really reaching all the vulnerable groups ? the MSF emergency aid programme supported the health centres Whereas the French section of the MSF movement decided to and hospitals with medicines and medical material. Some 40,000 pull out, the Dutch section decided to continue its aid while at the young children were vaccinated against measles, and in collabo- same time continuously and publicly advocating for the improve- ration with UNICEF, MSF improved the water supply in various ment of the situation in the camps. In November 1994 MSF locations. released a report called Breaking the Cycle to exert pressure on Uvira Burundian Refugees Project: Following the arrival of some the international community, calling for a better protection of the 80,000 Burundian refugees fleeing from ethnic violence in their refugees and the disarmament of soldiers and militia members in country, MSF outfitted 9 health posts and handled the supply of the camps19. medicines and medical material. As the leading cause of death On-going and side projects: Kivu basic health care project (start among the refugees was diarrhoea/cholera, caused by the poor 1992); Uvira refugee camps project (start 1993); plague inter- quality of the drinking water, MSF worked on a water treatment vention. system in various locations. On-going project: Kivu project (start 1992), with drugs and 1995: Goma emergency aid for refugees project medical supplies distributed among 282 health centres and 21 Over the year MSF continued working in Katale and Kituku hospitals refugee camps. The security situation in the camps showed little improvement since the report Breaking the Cycle had denounced 1994: Goma emergency aid for refugees project the militarisation of the camps and the violence perpetrated In July, as about one million Rwandan refugees crossed the bor- against the refugees. This report was followed in July 1995 by der with Zaire en masse, MSF distributed emergency supplies another report which concluded that extremist elements in the and first-aid posts were set up along the road. Before long rein- refugee camps were frustrating the repatriation process. In forcements in the form of staff and relief supplies, were sent in August 1995, seeing that the provision of humanitarian aid was

© Remco Bohle 17 These projects are mostly the ones carried out by the Dutch section of the MSF movement. 18 The estimate death rate during the emergency phase was 20/10,000/day in Katale refugee camps 19 See: Breaking the cycle: MSF calls for action in the Rwandese refugee camps in and Zaire, 10 November 1994

66 MSF DRC 67 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 68

helping consolidate the power structure within the camp, MSF icy of extermination of the refugees, MSF released in May 1997 a 2000: Orientale basic health care and nutrition tion project (start 1992); Bukavu STI/AIDS project (start 2000); decided to stop its relief programmes in the refugee camps in report called Forced Flight: A brutal strategy of elimination in projects Idjwi emergency vaccination campaign against meningitis. Goma. Eastern Zaire to alert the international community about the In January 2000 in the framework of a simmering conflict On-going and side projects: Kivu basic health care project (start appalling humanitarian situation and the massacres of the between the Hema and the Lendu tribes in Ituri district, accusa- 2002: Goma epidemiological surveillance and 1992); Uvira refugee camps project (start 1993); Plague interven- refugees. tions were partiality directed at MSF. MSF was forced to withdraw water/sanitation tion (start 1994); rehabilitation of solar panels. from an area where the team was providing basic healthcare for Following the eruption of Volcano Nyiragongo in January, leaving 1998: Kisangani Cholera intervention up to 150,000 displaced. some 60,000 people homeless, MSF focused on epidemiological 1996: Kivu/Masisi basic health care and nutrition Following the outbreak of cholera in Kapalata military “training” In Kisangani, after the outbreak of a six-days war between surveillance during the first weeks of the emergency. The organi- project camp in January, MSF set up a separate treatment centre outside Rwanda and Uganda, MSF established 16 feeding centres and sation also carried out water and sanitation activities in one of Over the year the team in Kivu mainly concentrated on the provi- the camp. This programme became highly sensitive as some of provided basic health care. the reception sites for displaced persons. sion of health care in the Masisi region, where ethnic tensions the “soldiers” were minors and all were said to belong to the Kivu basic health care, AIDS and nutrition projects: As a result Kivu basic health and nutrition projects: Faced with the on- between the Banyarwanda and the local populations had flared Mayi Mayi group, then opposed to the Government. MSF sus- of the instability in the area, leading to displacement of popula- going war-related malnutrition in North Kivu, MSF opened two up again in 1995. The region was so dangerous that MSF was pected that, because of this, they could have been ‘’voluntarily’’ tions and crucial lack of access to health care, malnutrition rates new Therapeutic Feeding Centres in Birambizo health zone, and unable to reach the town of Masisi until May 1996. From then on neglected. started to rise dramatically in Masisi area, North Kivu province. In continued supporting various health centres in the area. it set about distributing drugs and providing support for 20 Kivu basic health care projects: In North Kivu MSF continued its 2000 MSF started to run a feeding centre in the town of In Shabunda, South Kivu, the renewal of the clashes between the health centres. It also set up a Therapeutic Feeding Centre (TFC) support to the health centres when and where possible, depend- Kitshanga, where the population had quadrupled since the early Mai Mai and the RCD forced MSF to evacuate in April. for malnourished children. MSF continued supplying health cen- ing on the access granted by the different factions at war; in 1990s due to population movements. The recurrent shooting in the area prevented the team from tres and hospitals in five other districts in North Kivu. Shabunda, Bukavu, Mwenga and Walungu, MSF carried out the During the year MSF also started a pilot Sexually Transmissible resuming humanitarian assistance for more than three months. On 1 November 1996 MSF published a report on Masisi20, in training of local staff to perform such tasks as mother and child Infections (STI)/AIDS project in the town of Bukavu, South Kivu. On-going projects: Yahuma basic health care project (Start which it called international attention to the serious situation in care, laboratory and dispensary management, and preparation of 2001); Bukavu AIDS project (start 2000). the area and appealed for more humanitarian aid. Unfortunately, treatment protocols. After the rebellion of the RCD in August, 2001: Orientale basic health care and nutrition the appeal was smothered by the rebels’ offensive in Kivu and the MSF activities included the reconstruction of devastated clinics. projects subsequent refugee crisis. After tensions had subsided between the Hema and the Lendu Refugee crisis: As rebels among the Banyarwanda and 1999: Kisangani nutritional programme tribes in Bunia, Ituri district, MSF restarted a basic health care Banyamulenge took up arms and launched an offensive against As the town of Kisangani had become landlocked since the out- project in the area. The organisation left Bunia again in April after the refugee camps in Uvira, Bukavu and Goma, all aid workers break of the second war in August 1998, and the nutritional situ- transferring the work to other NGOs. Only a few weeks after MSF were evacuated from the area while hundreds of thousands of ation had consequently dramatically deteriorated, MSF opened had left, six ICRC members were massacred in the region. refugees were driven into the jungle by the rebels. In a report three Therapeutic Feeding Centres (TFC) and seven In Yahuma health zone, on the shore of the Congo River, MSF called Zaire: action rather than apathy, MSF called for military Supplementary Feeding Centres (SFC). It also supported three started a basic health care project to provide access to health intervention to establish safe heavens for the refugees and health centres in the surrounding areas. care to a population that had been neglected for more than twen- access to the refugees for the provision of aid. Orientale/Kivu emergency and basic health care projects: In ty years. On-going project: Uvira project (until August) Ituri district, as a war over territorial rights flared up in June In December MSF phased out its involvement in the nutritional between the Hema and the Lendu tribes, a measles epidemic programme in and around Kisangani. Over 20,000 malnourished 1997: Kivu refugee crisis broke out leading MSF to carry out a vaccination campaign. In children had been treated since December 1998. After the attacks of the refugee camps in Goma, Bukavu and the same area MSF improved the basic healthcare facilities and Shabunda basic health care project: Eighteen months after hav- Uvira in late 1996, MSF tried to give medical assistance to the provided health care for the displaced persons. ing evacuated from Shabunda, South Kivu, because of the clash- thousands of refugees fleeing from the ADFL’s bloody attacks. It In Shabunda MSF also focused on the reconstruction of health- es that broke out between the Congolese Mai Mai militias and the intervened both in the makeshift camps that were set up around care centres, nine in all. rebel RCD troops, MSF launched a new basic health care project Kisangani, in the transit camps for the repatriation of the Emergency preparedness: In 1999, the emergency team came in the area. Faced with the tremendous amount of women who refugees and by supporting health centres in the Kivu province. into action no fewer than 18 times to respond to epidemics. had been raped since the Mai Mai offensive, MSF launched a Convinced that the ADFL forces were deliberately following a pol- special programme to treat the ones who had contracted sexually transmitted infections during their ordeal. 20 This report was called Ethnic cleansing rears its head in Zaire On-going and side projects: North Kivu basic health and nutri-

68 MSF DRC 69 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 70

BIBLIOGRAPHY GLOSSARY

MSF reports and Publications (in chronological order) Other publications AFDL or ADFL: Alliance of Democratic Forces for the Liberation Hunde: Refers to the tribe who consider themselves to be the of Congo-Zaire, mainly Tutsi; ruling party of President Laurent- major part of the indigenous population of the Masisi region, in MSF annual reports, 1992-2002 Congo at war: A briefing on the internal and external players in Désiré Kabila on coming to power, in 1996-1997. North Kivu. In 1996 they represented around 20-30% of the the Central African Conflict, International Crisis Group (ICG), population of Masisi area. Breaking the cycle: MSF calls for action in the Rwandese refugee November 1998 Banyamulenge: Congolese Tutsis of Rwandan origin, mainly camps in Tanzania and Zaire, 10 November 1994 living in South Kivu. The Banyamulenge formed the basis of the Hutu: In DRC this term refers to one of the ethnic groups of Scramble for the Congo: Anatomy of an ugly war, International ADFL (Alliance of Democratic Forces for the Liberation of Congo- Rwandan expression living in Zaire (the other one being the Populations en Danger 1995: Rapport annuel de Médecins Sans Crisis Group, December 2000 Zaire, see above), group which brought Laurent-Désiré Kabila to Tutsis), who represented around 70-80% of the population of Frontières sur les crises majeures et l’action humanitaire, la power in 1996-1997. Masisi area, North Kivu, in 1996. In 1994, most of the Rwandan Découverte, Paris, 1995 The New African Yearbook 2001, pp. 129-144 refugees who arrived in Zaire were also from this ethnic group. Banyarawanda: Literally meaning “sons of Rwanda”, in this Deadlock in the Rwandan refugee crisis: Repatriation virtually at Mortality Survey, Eastern DR Congo (February – April 2001), report the term refers to populations of Rwandan expression ICRC: International Committee of the Red Cross a standstill, July 1995 International Rescue Committee, 2001 (both Hutu and Tutsi) who were living in North Kivu before the refugee crisis of 1994. Interahamwe: Meaning, in Kinyarwanda language “those who Ethnic Cleansing rears its head in Zaire: Population in Masisi fight together”. Often used by the local population of North Kivu suffers untold hardship, 1 November 1996 Coltan: Abbreviation for “Columbite-tantalite”. The coltan is a to refer globally to Hutu refugees living in the Kivus mainly since Zaire: Action rather than apathy – How many more deaths will it metallic ore found in major quantities in eastern DRC; when 1994 (in the Goma camps or otherwise), this term initially refers take?, 15 November 1996 refined, it becomes metallic tantalum, a heat-resistant powder to the Rwandan Hutu militias responsible for most of the mas- that can hold a high electrical charge. These properties make it a sacres which took place in Rwanda during the genocide in 1994. Forced Flight: A brutal strategy of elimination in eastern Zaire, vital element in creating capacitors, the electronic elements that May 1997 control current flow inside miniature circuit boards. Tantalum Mai Mai: Meaning “bullets turn to water”, this term initially capacitors are used in almost all cell phones, laptops, pagers and referred to Congolese Hunde fighters using traditional systems of Kisangani, Congo: Cholera outbreak in military camp reveals many other electronics. mystical power or fetishes to empower themselves. Nowadays, food and sanitation crisis, Press release, New York/Nairobi, the term has gained a broader sense as Mai Mai groups have January 29, 1998 DSP: Division Spéciale Présidientielle (Special Presidential multiplied throughout eastern DRC, without any apparent coordi- Division); elite military corps of President Mobutu in Zaire. nation between each other; allegedly fighting the Rwandan Civilians in Democratic Republic of Congo under fire, Press occupants, these Mai Mai seem closer to banditry than to real release, Kisangani/New York, 8 May 2000 FAC: Forces Armées Congolaises (Congolese Armed Forces), mystical fighters. DRC’s governmental army since Laurent-Désiré Kabila took over Accès aux soins et violences au Congo (RDC): Résultats de cinq from Mobutu. Malnutrition (Global/Severe): Global malnutrition means that the enquêtes épidémiologiques, Décembre 2001 ratio of weight for height is inferior to 80%; severe malnutrition FAR or ex-FAR: Forces Armées Rwandaises (Rwandan Armed means that the ratio of weight for height is inferior to 70%, or Forces); Rwandan Hutu army involved in the genocide of 1994. that oedemas are noticeable on the limbs.

FAZ: Forces Armées Zaïroises (Zairian Armed Forces), President MONUC: Mission des Nations Unies au Congo (Mission of the Mobutu’s army. United Nations in the Congo). Following the signature of the

70 MSF DRC 71 AZG/DRC02/opmaak engels 12-11-2002 17:06 Pagina 72

Lusaka Ceasefire Agreement in July 1999, MONUC was set up by the UN Security Council in November 1999. Its size and mandate were expanded in 2000, giving it the responsibility to monitor the implementation of the ceasefire agreement and investigate viola- tions of the ceasefire.

NGO: Non Governmental Organisation

RCD: Rassemblement Congolais pour la Démocratie (Congolese Rally for Democracy) ; rebel movement, initially backed by Rwanda and Uganda, who launched a rebellion against the government of Laurent-Désiré Kabila in 1998. Since then, the RCD has been through several divisions; the term RCD now gen- erally refers to the so-called “RCD-Goma”, backed by Rwanda with headquarters in Goma, who is occupying a large part of eastern DRC, especially in the Kivu region.

RPA or APR: Armée Patriotique Rwandaise (Rwandan Patriotic Army) ; armed forces of Rwanda since the victory of the Tutsi-led RPF ( party) in 1994.

RPF or FPR: Front Patriotique Rwandais (Rwandan Patriotic Front); Tutsi-led party in power in Rwanda since 1994.

TFC: Therapeutic Feeding Centre

Tutsis: In DRC, this term initially referred to one of the ethnic groups of Rwandan expression living in Zaire (the other one being the Hutus). However, since the outbreak of the war in 1996, the term “Tutsis” often refers to the Rwandan military occupying a large part of the east of the country. The Rwandan Tutsis were the main victims of the genocide that took place from April to July 1994, in Rwanda.

UNHCR: United Nations High Commissioner for Refugees.

Publication MSF-Holland Author Humanitarian Affairs Department/Vanessa Kanoui Photo editor Evelien Schotsman Design Karin Hackfoort, Amsterdam Coverphoto Chris Keulen Print Drukkerij Mart Spruijt bv, Amsterdam Paper Freelife Vellum White (100% recycled) © 2002

72 MSF