Democratic Republic of Congo

DEMOCRATIC REPUBLIC OF CONGO

In the Democratic Republic of Congo (DRC), the regime of President Kabila engaged in violent crackdowns on protests against the government, while conflict continued among established and newly emerged rebel groups, leaving thousands of civilians dead.[1] The UN Office for the Coordination of Humanitarian Affairs calls the DRC conflict “one of the world’s most complex humanitarian crises,” with over 7.3 million people in need of humanitarian assistance and 3.8 million people internally displaced.[2]

In 2017, there were at least 20 attacks on health facilities and personnel and one reported event hindering access to care, when regional violence forced doctors in Fizi General Hospital to evacuate.[3] Of the 14 attacks affecting health infrastructure, ten involved armed entry into a medical facility. Other attacks included shots fired at a facility, the looting of medical supplies, and setting fire to a structure. Three attacks damaged hospitals or health centers, and one attack completely destroyed a health center.

North Kivu saw the most attacks of any province, with eight events during the year. In December, two MSF staff members were abducted on the road in the region, just one day after a violent robbery of their compound in Mweso. MSF was forced to suspend its activities, leaving 450,000 people without access to health services.[4][5]

However, the most violent attack occurred in the Kasai region on April 24. Approximately 60 members of the Bana Mura militia, an armed group closely tied to President Kabila, with significant training and arms support, attacked the hospital in Cinq, killing over 90 patients, at least two medical staff, and several dozen civilians. Militants committed atrocities such as torturing and brutally killing children and pregnant women, and sexually assaulting women and girls with sticks and firearms, including a woman who had just given birth four hours prior. Rebels set fire to the operating theater with roughly 35 patients trapped inside, then torched most of the hospital. One doctor who escaped and later returned to the scene recounted, “I found a mountain of bodies. Among the dead, there were people killed by gunshots, others by machetes, others burned.”[6]

MSF operational manager Gabriel Sànchez spoke in October of the devastating consequences of the Kasai conflict on access to health care, stating that, “Half of the health centres we visited over the past three months had been looted, burnt or destroyed.”[7] One looted and torched health center in Mayi Munene had been a referral center for approximately 128,000 people, according to Jean-Paul Buana, a nurse from the town. “From March to July all medical activities stopped,” he said. “Many people have still not come back. We are still missing drugs and other supplies. It is very difficult to start over again, and we need more humanitarian aid. The world has forgotten Kasai.”[8]

The Kamuina Nsapu, an opposition group in Kasai, attacked and looted two hospitals in the Kasai and Katanga regions.[9] [10] The Allied Democratic Forces, another opposition group operating on the DRC–Ugan­dan border, attacked and looted a North Kivu health center during an assault on Congolese military forces.50 The Mai-Mai Yakutumba, which leads a coalition of rebel factions against President Kabila,[11] attacked a hospital in South Kivu, sexually assaulting a lactating mother who had fled to the hospital for protection. In Mweso, North Kivu, armed men allegedly presenting as[12] the Nyatura, a Congolese militia protecting Hutu interests,[13] stormed the hospital, shot and wounded six people inside, and kidnapped a doctor who was found dead the next day.[14] [15]In addition, during a clash between local Pygmy and Bantu groups in Tanganyika province, two poisoned arrows struck and killed a nurse.[16]

Eighteen attacks against health workers affected more than 21 health care staff. In total, at least nine staff were assaulted or injured and six or more were killed, though this is clearly an underestimate, as the Cinq hospital attack alone killed an unknown number of medical staff.[17] In addition to the killings already described, unidentified armed men gunned down a physician in his home in South Kivu province,[18] and other unnamed armed rebels killed a nurse in an attack on the town of Pasidi in South Kivu.[19] At least three health workers were threatened by armed men during armed entries into health facilities or compounds, and at least one health worker was unable to return to work following the incident.

Three medical staff were kidnapped. In one event, armed men attacked a Congolese convoy, including some medical staff, traveling through North Kivu. The men opened fire, killing one unidentified member and wounding several others, including a pharmacist. They then kidnapped a doctor, who was released a day later.[20]

Patients bore the greatest burden of the violence, with nine assaulted and over 92 killed, although the vague nature of some accounts suggests that this figure is very likely underestimated.