Isolated Équateur province
of mission Tommaso Santo. MSF says that more than 30000 people are still affected by cholera nationwide and there have been more than 500 deaths.
MSF’s attempts to fight the outbreak have been focused on the worst-afflicted provinces, which do not include Équateur.
“There are just not enough resources. We are one of the only actors that is responding [to the epidemic] at the moment, but MSF is not enough on its own,” Santo says.
Yves Willemot, head of communications for the United Nations Children’s Fund (Unicef), says that, although the cholera epidemic has been mostly contained in Mbandaka since July this year, “in reality, it’s a cyclical thing — it comes back every three years with the floods”.
The province’s health facilities are increasingly unfit to deal with such resurgences. “They lack everything: qualified caregivers, essential medication, salaries, medical ethics,” Willemot says.
In Basankusu, a two-day journey upriver from Mbandaka, British missionary Francis Hannaway says that the late rains this year, combined with the spiralling financial crisis, has also seen an increase in the number of malnourished children being brought into town from surrounding villages.
Unicef claims that across Équateur more than 23% of children under the age of five are suffering from chronic malnutrition. In Basankusu, some of the most severe cases of malnutrition are admitted to a filthy, fly-infested ward in the town’s central hospital, where they lie listlessly on broken mattresses that stink of old sweat and urine.
“The state has never really been capable of meeting the need, and nowadays even less so,” Hannaway says. “The hospitals in Basankusu don’t receive anything from the government.”
Along with former local radio presenter Judith Bondjemo, Hannaway has helped to set up a day centre that offers essential support to the inadequate hospital facilities.
The centre has treated more than 700 malnourished children since 2014, but can only accommodate about 100 children at a time. “That’s not enough,” says Hannaway.
Outside the centre, children are slumped on raffia mats in the shade, waiting to be fed. Local women who volunteer at the centre distribute mugs of maize porridge mixed with peanuts and sugar.
Once they’ve eaten, the children perk up noticeably, but many of their mothers still appear to be exhausted. Bondjemo says that they probably also haven’t eaten for days, but the centre cannot afford to feed them as well.
“In truth, perhaps 80% of people here in Basankusu are not even aware that there’ll be elections in 2018,” Hannaway says. “They’re just busy with surviving.”
In the DRC’s Équateur province, they are not the only ones just trying to survive.