UN warns that conflict, cholera and internal tumult have forced 4 million people and counting from their homes, with aid increasingly hard to deliver

Violence and ethnic and political unrest in the Democratic Republic of the Congo have propelled the country to the same level of crisis as Iraq, Syria and Yemen.

Cholera is raging at a rate never before seen in DRC and nearly 4 million people have been displaced from their homes by fighting, a quarter of them from the conflict-hit Kasai region alone. The UN refugee agency, the UNHCR, which revealed last month that the situation had been declared a “level-three emergency”, the highest grade of crisis, has warned that those numbers are likely to rise in the coming weeks.

“With widespread militia activities, and unrest and violence fuelled by ethnic and political conflict affecting many areas, the risk of further displacement is high,” said UNHCR spokesperson Adrian Edwards. “The challenges of getting aid to people in need are growing fast.”

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Level three emergencies, which are declared by the UN Office for the Coordination of Humanitarian Affairs, are considered the most complex and challenging humanitarian crises, and trigger an array of internal planning and funding procedures.

However, only one-fifth of the $236m (£178m) required to help refugees, people forced from their homes by conflict and others affected by the situation has so far been provided, according to the agency.

Amid the worst cholera outbreak in DRC’s history, ethnic clashes and the presence of increasing numbers of militias have had a particularly telling impact on the regions of Tanganyika, North and South Kivu, and Kasai, said the UNHCR.

At the end of October, Médecins Sans Frontières said it had treated more than 18,000 cases of cholera this year alone. That figure has since risen to about 21,000, with the total number of cases registered in the country expected to reach about 40,000 by the end of the year, a spokesperson said.

Facebook Twitter Pinterest People fetch water in the Funu district of Bukavu, where there is no access to running water. Photograph: Marta Soszynska/MSF

While cholera is endemic in some regions of DRC, it has never before persisted in 21 of the country’s 26 provinces, said Francisco Otero, MSF’s head of mission in the country.

“One of the main reasons why cholera has increased in such a way this year is the drought that has affected the country,” said Otero in a statement.



“Wells have dried up or lowered in level and many people have been forced to collect water from unsafe sources, such as lakes or rivers, because the authorities are not able to provide safe drinking water to the population. The response to cholera can’t only be medical treatment, it is also necessary to work on development to provide adequate water and sanitation to the population. Until that happens, cholera will remain a real threat.”

Despite the frequency with which cholera occurs in many regions, health workers are often unequipped to deal with cases.

“We have found some hospitals where cholera patients were mixed with other patients,” said Innocent Kunywana, who is leading MSF’s response to the crisis, “or the beds had no fluid drainage holes. Those affected can lose up to 10 litres of fluid through vomiting and diarrhoea, so the risk of infection to their companions or other patients was very high.”

Facebook Twitter Pinterest Victoire, one of 12 children in his family, is treated by a doctor in Bukavu. Cholera is slowing in South Kivu, but many still require treatment. Photograph: Marta Soszynska/MSF

The start of the school season may have also led to an increase in the number of cases, said Kunywana, as children may come into contact with contaminated food or drink on the way to or from school.

The number of severely hungry people has jumped 300% over the past 18 months in two of Greater Kasai’s five provinces, according to the World Food Programme, which has had to scale up relief efforts dramatically.

About 620,000 Congolese refugees have fled DRC and are sheltering in other African countries, while the situation in DRC has been compounded by the influx of refugees from neighbouring states. More than 520,000 people have sought refuge in DRC since early 2016, according to the UNHCR – notably from Burundi, Central African Republic and South Sudan, said Edwards.

