Crisis in North Kivu: mobile clinics providing essential care

An alarming security and health situation

The security situation in North Kivu province in eastern DRC has been unstable for more than 30 years. However, the fighting between the March 23 Movement (M23) and the Armed Forces of the Democratic Republic of Congo (FARDC) has intensified since November 2023; there are regular clashes in the Masisi, Rutshuru and Nyiragongo territories, triggering new population movements towards the city of Goma, the provincial capital.

The Intertnational Organisation for Migration (IOM) recorded almost 630,000 individual displacements in North Kivu between 29 January and 13 March 2024 due to the recent conflicts. By March 2024, more than 1.6 million people had been displaced by the M23 crisis, almost 785,000 more than in 2023.

To cope with this explosion in the number of arrivals, new informal displaced people’s camps sites are springing up. These camps do not have the infrastructure needed to provide decent living conditions for displaced people. As for the camps managed by international organisations, they have some infrastructure, but they do not have the capacity to cope with this continuous influx of people. 

"Over the last few months, the equivalent of entire towns have poured into the camps around Goma; the situation there is chaotic. Households of six people are living in one or two square metres of space," says Héritier Djunga, head of HI's mental health project in North Kivu.

Displaced people living in extreme precarity

Existing services are under severe pressure, exacerbating humanitarian needs. Access to food, shelter, drinking water, sanitation facilities and healthcare is restricted for hundreds of thousands of people due to physical and financial barriers and a lack of staff and equipment in health centres. Living conditions in the camps are extremely difficult and the humanitarian situation is alarming.

This context of violence and population displacement has consequences not only for people's physical health, but also for their wellbeing and mental health. HI notes that, on average, 75% of the people supported by its interventions in North Kivu show signs of psychological distress. 

"Psychological distress manifests itself differently from one person to another: some people experience somatisation and show physical signs of their ill-being, such as headaches, pain or insomnia. Others adopt defence mechanisms or show signs of depression, such as tiredness and profound sadness. Four people have already committed suicide at the Lac Vert site in recent weeks," explains Héritier.

People with disabilities and injuries face heightened risks, as they may lose access to their assistive devices, medication and rehabilitation services. 

"People with disabilities are particularly vulnerable. Some injured people have lost their mobility aids, such as their crutches, and the need for prostheses and orthoses is enormous. At least 95% of people who undergo HI physiotherapy sessions also receive psychosocial support," continues Héritier.

Deployment of mobile clinics in North-Kivu

It is against this backdrop that HI, in collaboration with the NGO Première Urgence Internationale, has set up two mobile clinics to provide care to displaced people, particularly those living to the west of Goma. This free assistance, provided on sites where displaced people have taken refuge, helps to relieve congestion in existing health facilities and to overcome the physical and financial barriers of accessing care for displaced populations.

The clinics are providing a response to needs that are otherwise largely unmet today. Première Urgence Internationale provides primary health care and treats malnutrition. The teams deployed by HI are made up of psychologists who run mental health awareness sessions for displaced populations and group or individual psychosocial support sessions for people experiencing psychological distress, and physiotherapists who identify people in need of rehabilitation care. This care includes physiotherapy sessions, the provision of mobility aids, such as crutches or walking sticks, and advice on how to use them to improve people’s autonomy. 

"The situation in North Kivu is dramatic. The needs are huge and the humanitarian response is not yet satisfactory. We don’t have the financial resources necessary to  assist the thousands of displaced people properly. We need a large-scale mobilisation," concludes Héritier.