For doctor in Congo's overlooked conflict, 'crisis fatigue' isn't an option

A few years ago, conflict here didn't rank high on a list of the world's crises, or even Congo's. That's changed, although aid groups have struggled to attract attention. On the ground in Kasai, though, there are remarkable stories of generosity.

Ryan Lenora Brown/The Christian Science Monitor
Dr. Elvis Badianga Kumbu sees patients in the child malnutrition ward of the Presbyterian Hospital of Dibindi, in the Congolese city of Mbuji Mayi. He says the number of severe malnutrition cases has tripled in the past year as conflict has spread across the region.

Dr. Elvis Badianga Kumbu can tell a lot about what’s happening in this part of Congo by the stories women tell him.

In normal times, as he presses his stethoscope gently against the chests of their wispy babies, the women speak of the personal tragedies that landed them here, in the malnutrition ward of a scruffy public hospital. They tell of husbands who died in car accidents, or divorced them, or simply went away to work in the local diamond mines and never came back. They explain how the money dwindled to nothing. How they cut back from two meals a day, to one. How finally, they – and their babies – ate nothing at all.

“There is always a story,” the doctor says, folding his stethoscope around his neck after rounds. “But now they are more terrible than before.”

These days, they often begin with a mother watching her village burn as she hid nearby, praying the baby wouldn’t cry and give them away. Or with the glazed eyes of a child soldier, pressing the tip of a machete against the baby’s soft head and barking a command: Run. They describe months in the grasslands, eating the rotting crops from abandoned farms and trying to hide – from Congo’s army and a motley assortment of militias fighting against it, and each other, here.

Until recently, Kasai – a diamond-rich swath of central Congo about the size of Germany – didn’t rank high on a list of the world’s crises. In fact, it didn’t even rank high on a list of Congo’s crises. Poor but peaceful, Kasai wasn’t the Congo of global headlines. There were no marauding militias or squalid settlements of displaced people, no horror stories of mass rapes and drugged child soldiers. 

Over the past year and a half, that has changed. More than a million people have fled their homes, and thousands have died. Meanwhile, international organizations struggle to win attention for what some foreign donors perceive as one more restive region in a nation full of them.

But for Kasaians like Dr. Kumbu, the idea that they can’t wait on someone else to save them is a familiar one. 

He takes home about $600 a month in salary, and sometimes goes a few months without being paid, but in 10 years has rarely thought of going anywhere else. “Of course, it’s true that we sometimes have to spend our own money in the hospital, but what we are called to do above all is to save lives, so we do it,” he says, a warm smile cracking his face. 

'Congo fatigue'

Aligned for decades with the political opposition, Kasai has never been of much interest to Congo’s national government, nor a prime recipient of its (limited) largesse. The few paved roads that run through the region are cratered with potholes as deep as small swimming pools. In province capital Mbuji Mayi, much of the city’s ramshackle infrastructure is left over from the days when it was a Belgian mining company town in the 1930s, and teachers, doctors, and nurses work in sagging buildings with few formal supplies. At Kumbu’s hospital, for instance, rats skitter across the dark wards, and the electricity comes on just a few hours a day. He is lucky if he sees running water at all.  

Organizations like UNICEF, the United Nation’s children’s fund, have tried for decades to sound the alarm about the poor quality of life here – half of the region’s children, for instance, are permanently stunted from poor eating. But what has mostly brought the most outsiders here is not to bring in aid, but to take away diamonds. 

But that status quo changed in August 2016, when Congolese security forces killed a powerful local chief in central Kasai, touching off a bloody conflict that quickly pulled many other regional leaders – and their many varied grievances – into its orbit. Since then, as many as 5,000 people have reportedly been killed and about 1.4 million people have fled their homes. UNICEF estimates that 400,000 children are now severely malnourished here – as many as in the entire country of Yemen.

Ryan Lenora Brown/The Christian Science Monitor
Christophe Kayembe, a resident of the village of Kapangu in central Congo, says his village has welcomed new arrivals fleeing the conflict because 'like us, they're just trying to survive.'

And yet, compared to the humanitarian crisis there, or in South Sudan, or even in nearby eastern Congo, Kasai has received almost no outside attention, and nearly as little money. UNICEF’s current $88 million appeal for the region is only a quarter funded. And the World Food Program only has the funds to reach about 425,000 of the 3 million “severely hungry” people in the region.

“Our point is not that children could die here, it’s that many children are already dying,” says Christophe Boulierac, a spokesperson for UNICEF currently on mission in Kasai. “The time for discussion has passed; we have to act.”

On April 13, the UN, along with the European Commission and the Dutch government, will hold a pledging conference in Geneva for Congo, where it hopes to convince the world’s wealthiest countries and organizations to shake off their “Congo fatigue” and reach into their pockets again for a country that has spent decades in turmoil. (Last year, humanitarian organizations asked for about $800 million. They got half that. This year, they’re asking for twice as much.)

Being present

And so for now, Kasai relies on the people who do show up – like Kumbu, who shares a stuffy two-bedroom apartment at the hospital with his wife and five children and is on call every hour of every day. 

It’s also people like Narcisse Ngudi Kinzambi, a blue-eyed psychologist who drives out to the charred sites of recent firefights to collect child soldiers the militias left behind. In a year and a half, he has saved more than 200. Dozens now stay in brightly colored dorms in the transit center he helps run in Mbuji Mayi, their days a mix of hardcore counseling and the equally serious business of learning to be children again – playing soccer, drawing landscapes, singing. 

Look around in Kasai, and these stories multiply – tales of local generosity as vast and remarkable as the war is cruel and brutal. The families who take in children separated from their parents in the war, though they themselves barely have enough to eat as it is. The teachers who still show up to school each morning, though they haven’t received a salary in years. The villagers who make space for new arrivals fleeing the war in their own hometowns.

“Like us, they have seen terrible things,” says Christophe Kayembe, shrugging. In recent months, his village, Kapangu, has welcomed several new residents. “Like us, they’re just trying to survive.” 

Of course, war also tests the limits of altruism. Part of the conflict’s power has been to knot together many reasons people here are angry – among them poverty, political marginalization, ethnic divides, and local leadership tussles – into a kind of nebulous rage with no clear target. Militias have destroyed about 400 schools and 600 public clinics – the clearest symbols of state power here. But they also fight among themselves, torching villages and abducting children. Meanwhile, government security forces have looted entire villages under the auspices of searching for militants, slaughtering anyone who stood in their way. The UN has discovered more than 80 mass graves in the region.

“When a family reaches you, after all the terrible things they have seen, they trust you. For them, you are a brother and a father to their child, because you can take care of him,” says Kumbu. “When a baby dies in those circumstances, you want to cry with them, but you cannot. They need you to be strong.”

On those days, he says, he sometimes walks out of the ward and simply goes home. There, he wraps his arms around whichever of his five children is closest and puts on an episode of his favorite anime show.

Then, a few hours later, he heads back to the hospital and begins again.

Still, scattered among the many difficult days of work over the last year and a half are some that give him hope.

One in particular is seared in his mind. January 5, 2018. That morning, Kumbu was in town when he received an emergency call. He was needed urgently at the hospital. So the doctor dropped what he was doing and rushed back.

When he arrived, he ran straight to the patient, a woman in labor. Another doctor had already arrived to begin the delivery, so he stood back and talked her through it. Breathe. Push. Breathe. 

At 3:17 p.m. the baby arrived, squirming and pale, and the other doctor immediately handed her to Kumbu.

For the first time, he got a good look at his daughter, Prinelle, tiny and wailing.

“At that moment, I forgot everything else,” he says. “I felt the greatest joy.”

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