DR Congo

Mortality in eastern Democratic Republic of Congo

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Executive Summary: Mortality Study, eastern Democratic Republic of Congo (February-April 2001)
A protracted and violent conflict has raged in the eastern Democratic Republic of the Congo since August 1998, involving numerous rebel groups and at least seven neighboring nations. The International Rescue Committee (IRC) has been providing assistance to those affected by war in DRC for five years. Between February 1999 and April 2001, the IRC has conducted 11 mortality surveys in the five eastern provinces of DRC, and one survey in the rebel-held area of Kasai Orientale Province. Interviews with over 2,800 households have been conducted. These samples, which represent 1.3 million people in seven different areas, indicate that: =B7
  • The rate of mortality in eastern DRC is extraordinarily high. Four of seven areas surveyed showed 8% or more of the population dying each year. Five of the seven areas visited experienced fewer births than deaths. Such findings indicate dramatically elevated mortality - these areas had experienced a population growth rate of approximately 3% per year before the onset of this conflict.

  • The level and indiscriminant nature of violence from August 1998 through April 2001 is disturbing. It is estimated that one in every eight households has experienced a violent death since the start of this war. Approximately 40% of these deaths have been women and children. Murders were attributed to soldiers on each side of this conflict at a similar rate.

  • Children have suffered a disproportionate amount of the reported mortality. The death rates among children reported by the interviewed families were shocking. In Moba and Kalemie, it is estimated that 75% of children born during this war have died or will die before their second birthday. In each of the survey areas, we found a dearth of children under two years of age. This unusual demographic profile is attributed to the extraordinary mortality experienced by the youngest children since the outbreak of fighting in August 1998.

  • War means infectious disease in eastern DRC. While only 10% of all deaths, or 14% of the excess deaths, were attributed to violence, there is a strong association (across both time and space) between higher violence rates and higher death rates from infectious diseases. Febrile illness (presumably malaria for the most part), diarrhea and malnutrition were the most commonly reported non-violent causes of death.

  • The overall rate of mortality has increased over the past year. In the three areas surveyed in 2000, and then again in 2001, two have experienced a dramatic increase in mortality while the third has remained unchanged. The number of deaths-per-month in Kalemie and Kalima (surveyed by IRC for the first time this year) indicates that mortality has increased during the recall period. The data collected during 2001 indicate a decline in the health conditions in eastern DRC.
When the findings of these surveys are considered in the context of the five eastern provinces of DRC, the investigators conclude that:

Between August 1998 and April 2001, approximately 2.5 million deaths have occurred because of this conflict. Using a set of assumptions stated in this report, we estimate that 3.5 million deaths have occurred among the 19.9 million residents of eastern DRC, 2.5 million more than expected during this period. It is estimated that 350,000 of these excess deaths have been from violence.

The magnitude of suffering associated with this war has been previously reported by the press. This report only adds depth, breadth and certainty to the fact that a humanitarian crisis has developed. This emergency is perhaps worse than any to unfold in Africa in recent decades. This situation demands the world's attention and the IRC urges humanitarian and diplomatic action in proportion to the magnitude of this crisis. The recent positive political developments provide an opportunity. However, without a marked improvement of conditions for Congolese civilians, the recent past will likely foreshadow the near future.

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