HPH NOW, February 17, 2006, Congo War Invisible and Deadly Crisis, Says Speaker

Richard Brennan

The war in the Democratic Republic of Congo (DRC) is the world's deadliest humanitarian crisis, with an estimated 3.9 million deaths over a six-year period, yet the gravity of the situation remains almost invisible in the eyes of the world, said Richard Brennan, health director of the International Rescue Committee, at a lecture on January 31 in Snyder Auditorium. The number far exceeds those from other recent crises or disasters, including the Bosnian war (250,000 dead), the Rwanda civil war (800,000 dead), and the South Asian tsunami (280,000 dead).

"The ignorance is almost universal,'' said Brennan, co-author of a mortality survey published in the January 7 issue of The Lancet that found the death rate in the Congo to be 40 percent higher than in sub-Saharan Africa in general. The study reviewed death rates from January 2003 to April 2004 and found that there were 600,000 more deaths in the Congo during that period than would normally be expected for the region.

Yet humanitarian aid to the Congo pales in comparison to that donated to other nations in crisis, he said during the lecture sponsored by the Harvard Humanitarian Initiative.

Aid to Aceh for tsunami relief has come at a rate of $136 per capita, for example, while the figure for the Congo is just $3.60, he said.

"Aid goes to where the TV cameras are, and there is no constituency for the DRC,'' Brennan said.

The new survey -- the fourth in a series -- sampled 19,500 households in 25 health zones throughout the country. "It was a daunting task,'' Brennan said. Some areas had to be left out because of the threat of violence.

Survey workers went door-to-door in randomly selected homes asking if the families had experienced any deaths over the study period and, if so, from what causes.

"It was tough, really tough,'' he said. "It was physically very demanding. We were literally on our hands and knees crawling through the vegetation to get to some places.''

In one unusual incident, an IRC office was set on fire by rebels, but documents were saved, he said. In general, the survey workers received good cooperation from residents.

The paper reported that the mortality rate was higher in unstable eastern provinces. For example, the crude mortality rate was 60 percent higher in the east than the reported baseline mortality rate for sub-Saharan Africa compared to 20 percent higher for the more secure western provinces.

Of the total 3.9 million deaths, only 1.8 percent were attributed directly to violence, with the others indirectly linked as a result of the precariousness of war. For example, people were unable to access food and health care. Most of the deaths were due to preventable and easily treatable diseases such as fever, malaria, diarrhea, respiratory infections, and malnutrition, the study noted. Sixty-five percent of deaths were among children.

There was no statistical evidence of any improvement in the death rate between 2002 and 2004 despite increases in humanitarian aid, he noted. However, trends indicated things might be improving, he said.

The report recommended further increases in humanitarian aid, and Brennan noted that the U.N. recently said $1 billion is needed. Last year, $246 million was received. Other recommendations included more and better trained peacekeeping forces.

"The challenges in the Congo are enormous,'' Brennan said. "But there is a lot of potential. A stable Congo can have huge implications for all of Africa.''

—ML