1.      Social analyses

The Democratic Republic of the Congo is a region with many different ways of violation. Mainly in Eastern Congo, in the North-Kivu territories Masisi, Rutshuru, Lubero and Beni, the number of incidents is increasing, as is the level of aggressions. Innocent people are violated and kidnapped on their private fields, while working on their harvest. Some are killed in an instant; others must suffer in captivity before being released by death.

The following rebel groups are active in certain regions: 

Masisi: Mayi Mayi -Tcheka, Lubero: ADF-Nalu, Mayi Mayi - Nyatura, Beni: ADF-Nalu, FDLR, Rutshuru: FDLR                                 

Tribal conflicts in the Masisi region between Hutu, Tutsi and Nande add up to these rebel activities and worsen the situation in the region.

The majority of the people flee to Butembo, to the city or its periphery. It is relatively calm there; because of the economic stability or maybe because it is the village of origin of the North-Kivu Governor.

The challenges in the region are therefore still increasing, as already explained in the last report in August 2015 and during a meeting end of December in Cologne. There are forecasts seeing riots coming up this year before elections in November, maybe starting already in June. The role of the „Femmes Engagées pour la Promotion de la Santé Intégral“ (FEPSI) will be more important with every day closer to the announced day of the presidential elections; the local, provincial and national authorities stay passive, promise a lot, but don’t do much.

The increasing number of attacks shows that FEPSI must keep on realizing the reinforcement of capacities – in quality and quantity. It is the one and only way for FEPSIs future and the future of the people in the region; no other hospital helps the most vulnerable people as FEPSI does. Because of that, FEPSI must also keep the free-of-charge treatment of survivors of sexual violence, HIV-positive and Aids-infected people as well as internally displaced persons; the latter have less and less time between attacks against them, between fleeing and returning to (re)create a certain and sustainable living standard. They don’t have and can’t create capital to pay any medical treatment (or school fees).

2.      Status of the project

Aim of this project is the health improvement of children and mothers in Butembo and its periphery, in Eastern Congo. The enlargement of the FEPSI-building, a sustainable quality improvement of medical and psychological treatment as well as nutritional training in the “Centre Hospitalier FEPSI” in Butembo are aimed to reach that objective.

Within this project, three results are defined:

a)      Rooms, space and water storage are improved.

The construction of the new building is progressing well. The walls of the ground floor are constructed to the ring armature that connects the construction of the ground floor with the one of the first floor. The cistern is also completely constructed. Only the cover, the cleaning and the installation of the pump still need to be done. All in all 85 per cent of the planned activities are done.

b)     The quality of medical and psychological services and the autonomy of the hospital are improved

Since August 2015 FEPSI has seen 27 new cases of sexual violence. All patients have been treated medically, psychologically and socio-economically. The FEPSI team also followed up 18 old cases of violence, including five cases with pregnancy after their rape.

In December 2015 and January 2016, the Congolese hospital “HEAL Africa” (http://www.healafrica.org/) send two specialists for ten days each to Butembo to train doctors and nurses. They set the focus on an improved treatment of survivors of sexual violence as well as HIV-positive and Aids-infected people. The report of this professional exchange is annexed to this report (in French).

To increase their autonomy of the hospital, FEPSI is the owner of a field in Bunyuka. The team is busy installing a piggery and planting medical plants with focus on eucalyptus syrup. A veterinary and a pharmacist are responsible for the realization of the two projects.

c)      Reinforcement of nutritional knowledge

A nutritionist has been employed since the beginning of this year. He has been doing 29 trainings already with in total 458 participants (363 = 79,26 per cent women, 95 men). The training took place with patients of the hospital and also with the population of different villages in the area.

The participants of the trainings in the hospital can be defined as follows: patients with general diseases, survivors of sexual violence, HIV-positive and Aids-infected people, pregnant women and others. To know the different focus groups is important as they have different nutritional needs. A stigmatisation is always avoided though.

The theoretical part of the training includes food hygiene, food preparation, special nutritional needs during pregnancy, diet for aged people and food toxicity. The practical part of the training is in the preparation process.

In general, all the activities are proceeding well and successfully.

3.      Next steps

a)      The construction works will be finished end of March. There has been a side visit on 8^th February with the responsible engineer Faly Rahaingoson (see annexe for the minute and photos). Together with the three companies concerned they examined the construction side for an evaluation and adjustments of the planning. After termination of the construction phase trainings will take place about how to use and maintain the cistern and the pump.

b)     The nutritionist Kavusa Muhavirwa Emmanuel will give 45 nutritional trainings with women and their children. The participant focus is mainly on pregnant women and small children/ babies as they have a special and often severe nutritional need: they are vulnerable for illnesses and pervasive development disorders. After theoretical trainings the practical part be following soon.

c)      For the piggery on the FEPSI field in Bunyuka, the team is buying four sows and one boar. With the breeding FEPSI will gain some capital: every six months around 50 US-Dollar per piglet; with four sows and an average of six piglets per sow – this activity supports FEPSI on the way to autonomy. To secure this process, FEPSI also employs two guards. They will be living on the field and keep an eye on the animals and the field/ plantation itself. Their little wooden cottage will be constructed end of February.

d)     After the harvest of the eucalyptus plants the pharmacist Kavugho Safi Zawadi will start with the production of pharmaceutical products. She will also evaluate the plantation of other pharmaceutical plants on the field to enhance the autonomy of the hospital.

e)     Muhindo Masinda Justin, FEPSI employee and focal point for Welthungerhilfe, is planning a second visit to Mbarara/ Uganda to meet his colleague Dr. Oliver who is studying at the local university. He will be employed again by FEPSI after he finishes his studies. For the moment, Dr. Olivier is preparing his master thesis: “Prevalence and associated risk factors of hydatidiform moles among patients with abortion evacuated at Mbarara Regional Referral Hospital”.

f)       After the visit of two Congolese medical specialists there will be two more international experts: a Belgian laboratory assistant and a German doctor. They will stay for three weeks each – one in March, one in April - helping to reinforce FEPSI capacities in their field of expertise: laboratory procedures and technique, hospital management, anaesthesia, reanimation.

g)     The psychological and medical treatment of survivors of sexual violence will be continued and strengthened.

h)     FEPSI will also reinforce the collaboration with other institutions in the health sector: hospitals, governmental authorities and institutions – to build up networks and expertise and spread the word about FEPSIs mission in the area.

i)       Machines and medical equipment will be bought in the following weeks or – depending on prices and availability – the tender for the purchase will be published nationalle/ internationalle.

4.      Perspective

Unfortunately, the situation in Butembo and its periphery has not changed. Its still not possible to foresee the development of the security situation in the country even if some institutions have and give an opinion: Will there be elections? If yes, how will they take place? If not, will there be riots? Nobody knows what will be happening this year in this country; but one thing is for sure: it won’t stay calm.