As years of violence hopefully come to an end with the signing of a new peace agreement in the Democratic Republic of Congo, a survey of mortality estimates that the ongoing humanitarian crisis has claimed some 5.4 million lives since 1998.
According to figures released last week by the International Rescue Committee, the legacy of conflict continues to result in as many as 45 000 deaths every month.
“The conflict and its aftermath, in terms of fatalities, surpass any other since the second world war,” said the relief agency’s president, George Rupp.
“Congo’s loss is equivalent to the entire population of Denmark or the state of Colorado perishing within a decade. Although Congo’s war formally ended five years ago, ongoing strife and poverty continue to take a staggering toll. We hope this week’s peace agreement in North Kivu will mean an end to the hostilities and a restart of reconciliation and recovery efforts.”
The latest survey was conducted last year in association with the Melbourne based public health research body the Burnet Institute, and it covers January 2006 to April 2007.
Researchers visited 14 000 households in 35 districts in all of the Democratic Republic of Congo’s 11 provinces. The final toll combines figures from four previous mortality surveys with data from the newest study.
The survey found that mortality remains “highly elevated” throughout the country, which currently hosts the world’s largest United Nations peacekeeping operation in an attempt to end a conflict that has seen neighbouring states, renegade warlords, and tribal militias fighting over the impoverished country’s vast mineral resources.
“Since our last study in 2004, there’s been no change in the national [mortality] rate, which is nearly 60% higher than the sub-Saharan average,” said Richard Brennan, director of the agency’s global health programme.
Overall, an estimated 727 000 people “died in excess of normal mortality” during the latest survey period. Almost half of the deaths were among children under the age of 5, even though they comprise only 19% of the total population.
Dr Brennan told the BMJ that most of the deaths had non-violent causes, such as malaria, diarrhoea, pneumonia, and malnutrition, which are “easily preventable and treatable conditions when people have access to health care and nutritious food.”
The increased disease burden is blamed on the social and economic disturbances caused by conflict after years of economic and political decline, resulting in “disruption of health services, poor food security, deterioration of infrastructure, and population displacement.”
The UN High Commissioner for Refugees, António Guterres, cautioned that considerable challenges remain in the wake of the latest peace deal, including building “an environment conducive to the return and reintegration of displaced populations” and “fostering reconciliation between different ethnic groups.”
Dr Brennan stressed that recovery from such devastation is a protracted process: “When war destroys a country’s economy and infrastructure, there’s no quick fix. Significant improvement in Congo’s health and mortality will require years of unwavering commitment from the government and the international community and substantial financial investment.
“Sadly, the humanitarian crisis in Congo continues to be overlooked and funding remains disproportionate to the enormity of need.”