The Spine Africa Project Helps Triathelete Reach Finish Line

April Houston shares a striking similarity to those in theCongoshe is about to help – they run.  However, the reasons for their journeys are very different.  On July 15, April will be taking part in the King Orthopedics Big Shark New Town Triathlon.  She will be competing in her first triathalon that includes a 4-mile run, a .62-mile swim, and a 20-mile trek on her bicycle.  April is currently raising money through this triatahlon for The Panzi Foundation, an organization that aids the victims of sexual violence in theCongo.  While April pushes her body to the limit she knows it pales in comparison to the distance and the fear those in theCongomust conquer to escape the genocide and the violence being perpetrated there.

April has long been interested in genocide prevention.  She notes, “I have always been opposed to injustices of all kinds, even as a child.  I moved toSt. Louis and in 2006 I met a group of young men who were refugees from the Democratic Republic of Congo (DRC).  I heard their stories of fleeing attackers in the middle of the night, running for days, seeing their friends and neighbors slaughtered in front of them, not knowing if their parents were alive or dead.  At that point I told them that I would commit myself to do everything possible to help.”  April is a former recipient of the Carl Wilkens Fellowship, an opportunity that “provides a diverse set of emerging citizen leaders with the tools and training to build sustained political will to end genocide.”  The Fellowship was formerly offered through United to End Genocide (previously known as The Genocide Intervention Network).

For the past decade the Congo has been engaged in a power struggle between opposing political parties and armed militias from surrounding countries all of whom are interested in Congo’s vast wealth of unmined resources.  The result has been the deaths of over 5 million Congolese natives, the rape of millions of women, and the displacement of hundreds of thousands more.

The Spine Africa Project has seen firsthand the catastrophic consequences of this violence during the organization’s many trips to the Eastern Congo.  The Spine Africa Project is aNew Jersey based non-profit organization that provides spinal surgery to those injured as a result of the atrocities withinCongo.  Unfortunately, the basic provisions for spine surgery do not yet exist inCongo despite the alarmingly high number of injuries.  Sadly, the life expectancy of someone in the Congo with an untreated spinal injury is less than two years.  The goals of The Spine Africa Project are to provide medical treatment for those in need as well as educate the local physicians in the field of spine surgery.  This will allow them to address and treat spine related injuries within their communities.

Through a mutual friend at the Panzi Foundation, The Spine Africa Project learned about April’s endeavor. “Here was someone who was well aware of the situation in Congo and was doing something to help.  To us, the value is not only in the financial contributions people make but also in raising awareness about what is happening in Congo.  It is obvious that April is doing both of these things,” says Daniel Goldberg of The Spine Africa Project.

April’s website highlights her desire to raise funds and outlines what those funds could provide for the women of Congo.  For example, as little as $340 will cover all the costs for a fistula surgery at Panzi Hospital.  The Spine Africa Project strongly believes in April’s cause and donated enough money for her to reach her initial goal of $1,000.  Shortly thereafter, April set her sights higher and doubled her fundraising goal to $2,000.  Together, April and The Spine Africa Project are teaming up to raise awareness through social media and other marketing channels to spread the word of April’s mission and encourage further donations.   As of today, April has raised $1,540 of her $2,000 goal.  When asked what would be a single overriding goal to help those in theCongo, April didn’t hesitate, “Empowering the women.  The Congo is full of strong women who have survived extreme emotional and physical trauma.  Giving them the knowledge and tools to take control of their own destiny would put their entire country on a different trajectory”.

Grassroots fundraising projects such as this one truly make a difference in the war-ravaged areas of the Eastern Congo.  This is because the funds are given directly to the institutions they support and not to governments which have been riddled with corruption. Donations can be made up until the day of the triathlon via April’s website.  Please help support April as she endeavors to help those truly in need.

To Help Congo Heal, World Must Have Faith in Grassroots Projects

Recently, Severine Autussere wrote an article in regard to how grassroots organizations are vital to aiding those in Congo.  Severine Autesserre is assistant professor of political science at Barnard College, Columbia University, and the author of “The Trouble with the Congo: Local Violence and the Failure of International Peacebuilding.”  The article paints the picture of grassroots groups being the largest providers of resources that go directly to those who need it.  We could not agree more.

The Spine Africa Project is an organization based in New Jersey that provides spine surgeries for those injured in the Eastern Congo as a result of civil violence and conflict mining.  Several times per year our small teams of physicians travels to the Panzi Hospital to perform life saving spine surgery for those injured.  Currently, there are no provisions for spine care in the Eastern Congo despite the staggeringly high rate of spinal injuries.  Due to this lack of care the average life expectancy of someone who suffers a spinal injury is less than two years.

Our goal is not only to immediately address these injuries but to educate the local physicians as to how to treat these injuries themselves.  A large part of our organization is focused on the education of the local medical personnel utilizing a combination of both expanded formal education as well as a hands on approach to the surgical cases performed by The Spine Africa Project team.  More information can be found on our website as well as in the video below.

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Severine Autesserre | June 25, 2012

The situation in Congo keeps deteriorating even though its civil war has officially been over for years and the United Nations’ second-largest peacekeeping mission is based there. The international community has failed to help Congo achieve peace and security because it fundamentally misunderstands the causes of the violence. 

Since the end of the transition to peace in late 2006, living conditions in the country (formally the Democratic Republic of the Congo, formerly Zaire) have become the worst in the world, according to the most recent Index of Human Development. 

Average life expectancy at birth is 48 years, and close to 80 percent of the population survives on less than $2 per day. Various armed groups, including the Congolese army, are committing horrific human rights violations, especially in the eastern part of the country. About 200,000 people have fled their homes since late April to escape the fighting and abuses. 

The civil war in Congo was the deadliest conflict since World War II, and it created the largest humanitarian crisis in the world. More than five million people died from 1998 to 2007 as domestic and foreign armed groups fought to control the territory, destabilizing much of Central and Southern Africa. 

Babies and elderly grandmothers were raped. Some two million people — and as many as 80 percent of the inhabitants of Congo’s eastern provinces — fled their homes to escape the violence. 

African and Western diplomats, along with UN officials, actively supervised negotiations to end the war. In 2002, they brokered a peace deal, and in 2006 they organized the first democratic elections in Congo’s history. 

To this day, the peacekeeping mission they set up is the only force capable of protecting the population from the ongoing violence. 

But it has been a case of misguided intervention. One reason is that foreign diplomats, UN peacekeepers and many NGOs tend to view the fighting exclusively as a consequence of national and international tensions — especially power struggles among Congolese and foreign elites — and a spillover from the Rwandan genocide. And they typically consider intervention at the national or regional levels to be their only legitimate responsibility. 

They neglect to address the other main sources of violence: distinctively local conflicts over land, grassroots power, status and resources, like cattle, charcoal, timber, drugs and fees levied at checkpoints.

Most of the violence in Congo is not coordinated on a large scale. It is the product of conflicts among fragmented local militias, each trying to advance its own agenda at the village or district level. Those then percolate and expand. 

Consider tensions between the Congolese of Rwandan descent and the so-called indigenous communities in the eastern provinces of South Kivu and North Kivu. These have roots in a long-standing competition over land and traditional and administrative power that began in the 1930s under Belgian colonial rule. 

The conflict escalated after Congo’s independence in 1960 as each camp recruited allies outside the province. With the 1994 Rwandan genocide, the crisis in the Kivus took on a regional dimension: local actors forged alliances with various Congolese and Rwandan armed groups, to promote their own agendas. 

Rather than address these issues, though, international peacemakers have lately singled out three features of the ongoing conflict: as a primary cause of violence, the illegal exploitation of natural resources by Congolese and foreign armed groups; as a main consequence, sexual abuse against women and girls; as a central solution, reconstructing state authority. 

International programs have thus emphasized three priorities: regulating the trade of minerals, providing care to victims of sexual violence and helping the central government extend its authority. This approach has provided a simple narrative that was easy to sell to audiences and donors in the West. 

It has also backfired. Perversely, attempts to regulate the trade of minerals — like Section 1502 of the US 2010 Dodd-Frank Act and a temporary mining ban imposed by the Congolese government from September 2010 to March 2011 — have enabled armed groups to strengthen their control over mines. 

These measures focused on stopping the illegal trade of minerals but did nothing to destroy the actual power base of armed groups. 

In the absence of any broader political, economic or social reforms, local military leaders have managed to remain the principal power brokers in the rural areas of eastern Congo. In some cases, they have even expanded their mining operations while vulnerable populations lost their livelihoods. 

The international community’s disproportionate attention to sexual violence has also raised the status of sexual abuse in a dangerous way. Some combatants now use it as a bargaining tool by threatening to commit mass rape if they are excluded from negotiations. And state-reconstruction programs have done little more than boost the capacity of the authoritarian central government. 

Addressing the consequences of sexual violence and these other abuses is important, of course, but donors should do more to address their underlying causes. Most important, they should approach the resolution of conflicts in Congo from the bottom up. 

They should assist local groups — official authorities, NGOs and civil-society representatives — with the funding, logistical means and technical capacity necessary to implement narrowly tailored programs. 

As the UN Security Council convenes this week to renew the mandate of its peacekeeping mission in Congo, it should refocus its efforts on supporting grassroots projects directed at resolving local conflicts, especially over land. If the international community continues to address the consequences of the violence in Congo rather than its most important causes, it will only add to the death toll.

Duke University Takes Investment Stand on “Conflict-Minerals”

The pressure is mounting on companies to create conflict-free products with minerals from the Democratic Republic of Congo. This week, Duke University joined 10 other colleges calling for responsible monitoring of corporate supply chains that may be funding violence in the Democratic Republic of the Congo.

So, what’s the connection between Duke, supply chains, and the DRC?

The DRC is home to one of the deadliest conflicts in recent history, where war has claimed the lives of almost 6 million in the last fifteen years. UN administrators have called eastern Congo the “rape capital of the world,” and it continues to be one of the most dangerous places to live as a woman or child.

The conflict’s historic roots are complex, but the control of natural resources–including what are known as “conflict minerals”–has remained a compelling incentive for warfare amongst armed militias. These minerals, some essential components in electronics products, are smuggled through supply chains with little oversight or regulation. To date, the UN, OECD, and U.S. government have all formally recognized the role resource extraction has played in contributing to conflict.

Last Friday, after a yearlong student advocacy effort, the Duke Board of Trustees approved an investment resolution supporting ethical sourcing of minerals from the DRC. The “proxy voting” guideline instructs those managing Duke’s $5.7 billion endowment to leverage its stake as an institutional investor to vote in favor of conflict minerals-conscious shareholder resolutions in relevant corporations.

Duke is only the second university to pass this type of conflict-free resolution at the Board of Trustees level, after Stanford did so in 2010; 10 other schools, most recently Emory University in Atlanta and University of St. Andrew’s in Scotland have passed conflict-free resolutions. More significantly, Duke is the first university to take action at the Board of Trustees level since the signing of the Dodd-Frank Wall Street Reform Act of 2010. The law included a provision requiring relevant industries to monitor supply chains and report efforts to avoid supporting human rights violations.

Though Dodd-Frank was passed two years ago, the Securities and Exchange Commission has yet to release regulations instructing companies on how to comply. And in a world absent of rules, we can’t be certain that companies are taking steps toward conflict-free from Congo.

Duke represents one of many universities calling for action. What started with Stanford in 2010 has become a movement for conflict-free electronics at campuses around the world. Over 100 schools across the U.S., UK, and Canada are working on getting their university to take the first step, and student voices are becoming increasingly hard to ignore.

At the University of Pennsylvania, Apple’s third largest education partner in the world, passing a conflict-free resolution in May 2011 has spurred the administration to conduct a more comprehensive sustainability overhaul of the university’s purchasing policy. At Yale, advocates led by Jason Stearns, former coordinator of the UN Group of Experts in the DRC, are pursuing aforward-looking investment policy that could set a new precedent in the movement.

We know there’s no such thing as “magic-bullet” solution to conflict in the DRC. Conflict minerals are not the sole cause of conflict, nor will they be a panacea. But they are a rallying point for all of us–as youth and consumers in the global marketplace–to stand in solidarity in any way we can.

We’re proud our university has not been paralyzed in the face of complexity. Indeed, supply chain reform is complicated, and we acknowledge the nuance of the issue; Duke has pledged to reevaluate its investment policies in five years to potentially take even further action when more context is gathered.

Yet, what’s important is that, in the midst of sustained human rights violations and an ambiguous regulatory environment, the Duke community made the collective commitment to speak now–and there’s no reason any and every other university cannot do the same.

As we think about the potential for students across the world to catalyze change, we’re reminded of one of Bobby Kennedy’s most famous quotes: “Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring those ripples build a current which can sweep down the mightiest walls of oppression and resistance.”

Duke’s action is just another ripple in the movement for peace in the DRC. But momentum is building, and collective university action is creating a current for justice that cannot be ignored.

Eastern Congo mutiny rakes over regional, ethnic wounds

(Reuters) – When Faustin joined a recruitment drive in his village in Rwanda, he thought he was headed for a stint in the Rwandan army.Instead, he says he was marched at night into neighboring Democratic Republic of Congo to fight for a mutinous general against the government there, in a conflict that is once again stirring up one of the world’s most war-scarred zones. Faustin, whose name has been changed to protect his identity, said it was only when day broke that he found he was on a low hill called Runyoni within sight of the Rwandan border where hundreds of mutineers from Congo’s army are holding out. ”They said we were joining the Rwandan army, when we realized we’d been tricked into coming to Congo, that changed everything and we ran away,” said Faustin, who gave himself up to peacekeepers from the United Nations.

congo child soldier

His story is part of a growing body of testimony pointing to the involvement of Rwandan military officials in providing arms, ammunition and recruits to the two-month-old revolt in eastern Congo by the rebels who call themselves M23. The latest fighting, in a conflict zone known across the world for brutal killings and rapes, has forced more than 100,000 people to flee their homes. The Red Cross say the humanitarian situation could – once again – become “disastrous”.  Rwanda’s government strenuously denies allegations it is backing the mutiny initiated by General Bosco Ntaganda, who is wanted by the International Criminal Court (ICC) for war crimes.  But Kigali’s alleged involvement, after a thaw in relations with its former arch foe Congo, is fanning fears of a slide back to war in a region that is a tinderbox of ethnic violence.

Like a larger eastern rebellion from 2004 to 2009 by another renegade Tutsi general, Laurent Nkunda, the current mutiny has its roots in unhealed ethnic and political wounds dating back to Rwanda’s 1994 genocide. Later invasions of Congo by Rwandan forces and Kigali’s backing of Congolese rebels fuelled two successive wars that killed several million people.  The trigger for this year’s revolt was moves to arrest Ntaganda, nicknamed “The Terminator”, following international pressure on President Joseph Kabila, who was re-elected last year in a vote widely seen as flawed by foreign observers.  ”Behind everything, the reason for Kabila’s push to arrest Bosco (Ntaganda) was the contested elections,” said Philippe Biyoya, a professor of politics at Kinshasa University.

He said major donors, like the United States and Britain, reluctantly accepted Kabila’s win, “but they wanted a gesture in return”. Hence the move against Ntaganda, a militia warlord who had been serving as deputy chief of Congo’s integrated army despite a lack of success so far at the ICC in prosecuting others for alleged crimes committed in the conflict.  ”What does concern the international community is Bosco Ntaganda,” said Human Rights Watch’s senior Africa researcher Anneke Van Woudenberg. She added his capture would give additional impetus to the ICC’s efforts to bring other wanted war crimes suspects to justice, for example in Libya and Sudan.  In a clear reference to the allegations of Rwandan backing for the rebels in North Kivu province, the United States expressed concern over “reports of outside support to M23″.

RISKS OF MILITARY SOLUTION

The conflict risks rupturing what some observers have called a “volatile calm” in eastern Congo since the government signed March 23, 2009, peace agreements with several rebel groups, including Nkunda’s Rwandan-backed CNDP insurgents.  The M23 mutineers, who deny they get help from Rwanda, took their name from the date of the accords, saying Kinshasa did not respect commitments about salaries and treatment in the army.  While Nkunda’s rebellion, which involved 5,000-6,000 combat-hardened fighters, for a while posed a serious military threat to Kabila from the east, the latest mutiny is much smaller, numbering around 600-1,000 members.  Nkunda once held sway over large swathes of territory, but M23 only occupy a handful of hills on the Rwandan border. They were driven there after being pushed out of strongholds in Masisi by the Congolese army, known as the FARDC.

The army is now apparently better trained and more confident than a few years ago, but the rebellion draws attention to delays and deficiencies in faltering security sector reforms as some Rwandaphone soldiers refuse to leave their native east.  Many villages in the area are deserted as locals flee bombardment of rebel positions by the FARDC. Nearby roads are full of army pickups and FARDC troops wearing Wellington boots and toting AK 47 automatic rifles and rocket launchers.  Despite outnumbering the rebels 10 to one, the FARDC has been unable to dislodge them from hilltop hideouts. Some troops complain of shortages of food, medical supplies and ammunition.  ”We must militarily finish with these mutineers,” North Kivu province governor Julien Paluku told Reuters.

Given the apparent weakness of the rebels, Fred Robarts, former head of the U.N. Group of Experts in Democratic Republic of Congo, says it is unlikely that Kabila’s government will agree to another peace deal like the one in 2009. “The government won’t be prepared to concede so much ground.”  But some see risks too if the government crushes the mutineers without regard to wider regional consequences.  ”Total victory would be a trap. If we destroy (the rebels) totally without Rwanda’s agreement, there will be war with Rwanda,” said political analyst Biyoya.

PREYING ON CIVILIANS

Robarts said the help provided by some members of the Rwandan military was helping to keep the mutiny alive. This looked like a replay of Rwanda’s old tactic of waging a “proxy war” inside its vast and unstable neighbor.  Experts say this Rwandan strategy serves the goals of keeping a buffer in eastern Congo against Rwandan FDLR rebels opposed to President Paul Kagame, and maintaining a stake in the neighboring region’s rich mineral resources and influence over the large Rwandophone population living there.  ”This can only challenge relations between the two countries. It comes down now to what extent the international community can speak with one voice and put Rwanda on a different course,” Robarts said.

Human Rights Watch and U.N. sources have estimated that half the rebels’ forces could have come from Rwanda. The M23′s Colonel Vianney Kazarama denied receiving cross border support.  A Reuters reporter spoke to numerous civilians who said they witnessed fighters with Rwandan identity cards being captured by the FARDC. The Congolese government’s official position is that it is investigating, but privately high-ranking army officers express rage at what they see as Rwanda’s interference.  As government troops redeploy to tackle the M23 mutiny, other armed groups still present in the region, including the mainly Hutu FDLR, are taking advantage to prey on civilians.  Hiding in the forest, a pregnant Tembeya Kiboko watched suspected FDLR fighters ransack and torch her village of Remeka in North Kivu. Her 12-year-old son, too sick to flee, was among at least seven people burned to death, survivors said. Escaping with her remaining children, Kiboko suffered a miscarriage.  Aid workers and U.N. officials say the latest conflict has touched off new ethnic violence which has already killed scores, perhaps hundreds, of civilians.

Self defense groups armed with spears and machetes, called Raia Mutomboki – “enraged population” in Swahili – are targeting anyone whom they view as Rwandan, and Rwandan FDLR rebels are retaliating by attacking villages, according to locals.  ”We hope the authorities can end this war quickly … If (not) people will turn into rebels,” said Jacques Niyo.

Human Rights Watch: Rwandan military aiding Congo fugitive

Rwanda’s military is providing weapons and refuge to an ex-warlord indicted for war crimes and whose fighters have launched a new rebellion in neighboring eastern Congo, an international human rights group said Monday.  The International Criminal Court has sought the arrest of Bosco Ntaganda for years, though Congo’s government had allowed him to operate freely as a general in its army, only recently vowing to capture him.  Human Rights Watch said Monday it also had evidence that Ntaganda and his supporters were evading capture with the help of the Rwandan military. The renegade general is believed to have been born in Rwanda and has close ties there.  The New York-based group said Rwandan military officials had given Ntaganda’s fighters machine guns and grenades, breaking a U.N. embargo. The group also said Rwandan army officials had provided up to 300 fighters, some of whom had been forcibly recruited.  ”Arming Ntaganda enables further grave abuses by a man already wanted for war crimes,” said Anneke Van Woudenberg, senior Africa researcher at Human Rights Watch. “The Rwandan government should investigate the serious allegations of support for Ntaganda by its military officials and help the Congolese government arrest and transfer him to the ICC.”

The Rwandan government has denied any involvement in the rebellion that has further destabilized a region long in turmoil.  Last week, Rwanda’s Foreign Minister Louise Mushikiwabo dismissed claims that Rwandans recruited and trained for the Rwandan army have been transferred to eastern Congo to fight for the rebels, as “categorically false and dangerous.”

Eastern Congo has been engulfed in fighting since the 1994 Rwanda genocide, in which at least 500,000 Tutsis and moderate Hutus were slaughtered by Hutu militias before a Tutsi-led rebel army took power in Rwanda.  More than 1 million Rwandan Hutus fled across the border into Congo, and Rwanda has invaded Congo to take action against Hutu militias there.  Ntaganda, who is a Tutsi, was once a feared warlord until he joined the Congolese army in 2009 as a general following a peace deal that paved the way for him and his men to be integrated into the military.  He was allowed to live freely in the provincial capital of Goma, where he played tennis and dined at top restaurants despite an International Criminal Court indictment for war crimes allegedly committed by troops under his command, including the forced recruitment of children.  In April, however, the agreement between the former warlord and the Congolese government disintegrated, and he and his troops defected.

The Congolese government has said that it believes Ntaganda to be the force behind a new rebel group known as M23. However, the group has said that theirs is a separate rebellion and Ntaganda is not with them, a claim that is countered by some who defected and later spoke to Human Rights Watch investigators.  Ntaganda’s whereabouts are unknown, though Human Rights Watch said witnesses report spotting him meeting with a Rwandan military officer inside Rwanda. Ntaganda is on a U.N. Security Council sanctions list, which should bar him from travel outside Congo.

Copyright © 2012 The Associated Press. All rights reserved.

DRC Suspends 2 China Trading Companies Over Conflict Minerals

The Democratic Republic of Congo has suspends two China-based companies from mineral mining and trading in the country for suspected involvement in the business of conflict minerals, anti-corruption watchdog Global Witness said in a statement late Monday.

The two privately-owned companies, TTT Mining — which has an export arm CMM — and Huaying Trading Company, are suspected of buying minerals without doing due diligence on their supply chains to ensure that they did not purchase conflict minerals, Global Witness said, adding that the two companies have operations in the DRC’s eastern North Kivu province.

North Kivu’s governor, Julian Paluku, could not be reached for comment Tuesday.

According to Global Witness, the DRC government has said the move was a preventative measure and has instructed provincial authorities to launch an investigation into the matter.  ”The Congolese government’s decision to suspend minerals traders for failing to do due diligence sends a strong message to other companies exporting minerals from eastern DRC that they must source responsibly, or face sanctions,” Sophia Pickles at Global Witness said in a statement. “The government should publish the findings of the investigation as soon as possible.”

The suspension follows a DRC government directive issued in September 2011 requiring all mining and mineral trading companies operating in the country to carry out supply-chain due diligence, in line with international standards set by the Organisation for Economic Cooperation and Development, to ensure their purchases are not supporting warring parties in the eastern DRC. In February this year, this directive was enacted into law.

This week’s crackdown followed a November 2011 report by the UN Group of Experts on the DRC, including findings indicating that TTT Mining and Huaying had made purchases that financed armed groups and criminal networks within the DRC army, Global Witness said. But the statement added that when contacted by Global Witness, an unnamed TTT Mining official denied any wrongdoing on the part of the company.

In 2010, the US passed a Dodd-Frank consumer protection act aimed at addressing the trade in conflict minerals mined in the DRC and other neighboring countries, which are used in electronics, and fuel the violence and mass rape in these countries.

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Congo Still Battling Unexplainable Malaria Outbreak

The world, for the most part, has made excellent strides against malaria over the past few years. Unfortunately, the Democratic Republic of the Congo is witnessing staggering increases in the number of new malaria cases.

At a time when malaria was believed to be in decline, the number of malaria patients has soared by a stunning 250 per cent in the Democratic Republic of the Congo since 2009, according to statistics at clinics run by Médecins sans frontières (Doctors Without Borders). Malaria is already the single biggest killer in Congo, with nearly 200,000 people dying annually, and now the trend is worsening. At one clinic in Katanga province alone, nearly 25,000 people were treated for malaria last year – more than triple the number in 2009.

In another district of the same province, MSF set up an emergency centre for malaria treatment this year, expecting 1,000 patients a week. Instead the clinic has been flooded with 3,000 patients a week since the end of March – in a district of just 218,000 people. It had to airlift medicine into the district to cope with the outbreak. “It’s completely shocking,” said Andrew Mews, head of the mission in Katanga for MSF Holland. “We were overwhelmed by the sheer numbers.”

Malaria outbreaks are normally worst in the rainy season, when mosquitoes breed in the water. But this year, with southern Congo already several weeks into the dry season, there is no sign of a slowdown in the malaria surge. Nobody knows why the malaria rate has skyrocketed. Some of the increase is due to population displacement: refugees fleeing from wars and economic migrants in search of jobs. Often they move unwittingly into malarial zones, unprepared for the risks. In eastern and southern Congo, where fighting has increased this year, many people are forced to take refuge in swamps and forests where mosquitoes breed.But this explains only some of the increase. The other causes are unknown and MSF is planning several studies to investigate. There is speculation that drug resistance could be rising.“The truth is, we really don’t know,” Mr. Mews said. “Are there more mosquitoes? Maybe the mosquitoes are more virulent? Are people becoming more susceptible to the disease? Malaria is a very old disease, but we still don’t fully understand it.”