LUBERO, DEMOCRATIC REPUBLIC OF CONGO — War is eroding the foundations of the health care system in eastern Democratic Republic of Congo. Months of violence between government forces and M23, an armed group with backing from neighboring Rwanda, have spurred looting and closures of medical clinics around Lubero territory. Facilities that remain open are grappling with supply shortages, staff departures and mounting difficulties transporting patients.
Luseko Kakule, president of an association of pharmacy owners in Kirumba and manager of a health post there, says six patients have recently died en route to care. Blockades on key roads have complicated medical transfers and resupply of area pharmacies, where stocks of malaria medicines are dwindling. “We have to take roundabout routes and incur prohibitive costs that inevitably have an impact on patients who are already destitute,” he says.
Facilities accustomed to transferring patients with severe malaria or complications in pregnancy to cities with acute care have been forced to improvise. “The war is paralyzing our activities,” says Muhindo Muyisa, head nurse at the Kasando health center. “Access to vaccines and quality medicines is difficult because of the road closures. Even referring patients to more suitable facilities is a challenge.”
Since late 2021, M23 has advanced in a band stretching north and south along DRC’s eastern border, establishing parallel governments in captured territory. It now controls the capitals of both North Kivu and South Kivu provinces, and many smaller localities, including Kirumba, where the militia’s soldiers patrol in pickup trucks with fatigues, rifles and green rubber boots.
“The increase in product declaration fees imposed by the current administration makes our task even more arduous,” says Debora Kahindo Syaminya, who manages a pharmacy in Kirumba.
“The war is paralyzing our activities.”Head nurse at the Kasando health center
Common antibiotics have nearly doubled in price in recent months, while other medications, like insulin, have disappeared from the market altogether. “Since the escalation of violence, I can no longer find essential medicine for my mother, who suffers from diabetes,” says Kirumba resident Kavugho Lipanda, 40. With regular access to insulin, she explains, her mother is typically symptom-free. Now, she suffers from insomnia and an overproduction of urine known as diuresis, which leads to dehydration and headaches, and can cause kidney damage. “Her situation is getting worse,” Lipanda says.
M23’s advance to capture the city of Goma earlier this year led to looting of warehouses holding aid supplies. Some humanitarian groups evacuated staff. Fighting also forced the closure of Goma’s airport along with the main road leading north, shutting off a major resupply route to the rest of North Kivu province.
“For lack of medicines, we can often only write prescriptions that patients will never be able to fill,” says Kambale Muhindo, secretary of the Kayna health zone, which covers a vast area north of Goma and west of Lake Edward. “Some health workers, discouraged by the lack of resources and financial support, have left their posts.”
Some pharmacists fear they may soon have to close. “I had invested US$900 in my pharmacy. Today, I’m in danger of closing my doors because of the losses,” says Katungu Liso, who owns MBAHIPHAR pharmacy in Kirumba. Forced to flee at the height of the violence, she says depressed sales and rising prices have made it impossible for her to replenish her inventory.
Moïse Katembo Kapanza, head of Kirumba’s Tupone health clinic, says the violence has also disrupted farming, a backbone of the rural economy. “The war has ruined our patients’ livelihoods, making them insolvent in the face of disease,” he says.
Many have become afraid to visit local clinics or come to work, says Kibosile Muratusi Innocent, head nurse at the Kamandi health center. “Fear has emptied our facility of patients, deliveries and staff. We are witnessing bush births, an increase in post-operative infections and tragic loss of life due to the lack of basic medical assistance.”
In March, the World Health Organization deplored the near exhaustion of medical supplies in eastern DRC. During a recent visit to Goma, Thierno Baldé, head of the WHO Regional Emergency Hub, said that in North Kivu alone, “1.5 million people are directly affected by the disruption to essential health services.” Several mediation efforts are ongoing, including a recent meeting in Lomé, Togo, on May 17, under the auspices of the African Union. Meanwhile, M23 advances further into Congolese territory.
Kakule, of the pharmacy association, wants to see the international community step up both aid and diplomatic pressure: “The urgency of humanitarian action and a peaceful resolution to the conflict is acute. The world must not turn a deaf ear to this appeal from eastern DRC.”
