Ituri province, in the east of Democratic Republic of Congo (DRC), has been gripped for decades by recurring cycles of violence. Since mid-February there has been a resurgence of attacks, many of them targeting civilians, resulting in significant casualties, especially among women and children. In response to people’s critical medical needs in the province, in June 2023 Médecins Sans Frontières/Doctors Without Borders (MSF) set up a centre specialising in trauma surgery and post-surgical care at Salama hospital in Bunia. One-third of the 863 patients treated by MSF teams in Bunia between June and December 2023 were direct victims of the violence.
Entering the grounds of Salama hospital in Bunia, immediately one is struck by the sense of bustling activity: outside, the families of patients are cooking and washing their dishes in large plastic buckets; inside, the corridors are busy and every single room is occupied. Many of the patients have very visible injuries – some have painful looking external fixators on their arms, shoulders or legs; others have limbs in plaster or bandages on their bodies.
The focus of MSF’s centre at Salama hospital is trauma surgery and orthopaedic care, but it also treats the victims of burns and road accidents – a decision driven by the significant prevalence of these types of injuries and the absence of specialist medical care for these patients elsewhere in the province.
As we are shown around the hospital by a doctor, the persistent and heart-wrenching cries of a child pierce the air. Unable to ignore the distressing sound, I look through a door and see a little boy of about five sitting on a bed beneath a mosquito net.
‘Why is he crying?’ I ask. A nurse explains that the boy, who has serious burns on his legs and chest from a domestic accident, desperately wants to get up and check if he will still be able to walk properly. However, his grandmother, seated next to him, has said no, following to the letter the doctors’ advice that generally he should stay in bed, sitting down or lying with his legs out straight.
The doctor suggests to the grandmother that letting the child use his legs will do him no harm, and she relents. The boy is gently lifted from the bed by his grandmother and the nurse. With cautious steps, he walks slowly across the room, looking like a little old man. The sense of relief on his face is palpable. As we offer encouragement and applause, his mood visibly lifts. When we leave the room with a wave, he has a smile on his face.
Further down the corridor, we meet another child, two-year-old Christelle; she is nestled in the arms of her mother, finding comfort amid the hospital's noise and bustle. Christelle and her mother Clarisse come from Drodro village, which was recently the scene of intercommunal violence. At first glance, nothing appears to be wrong with the child, but then her mother tells their story, which is nothing short of horrifying.
“My child fell victim to an attack by an armed group on my village,” says Clarisse. “Suddenly, I saw a group of men entering the courtyard where I was sitting with my five children and their grandmother. When I realised they were heavily armed with guns and carried machetes, I got scared and quickly gathered my children in panic. I grabbed the hands of my oldest daughter and another of my children and ran without looking back.”
Clarisse pauses and gulps for breath. Avoiding eye contact and visibly traumatised, she continues: “I managed to reach and enter the house of our neighbours, but the children’s grandmother reached the house too late. The armed men seized her and cut off her arm with a machete. Christelle cried out in fear and tragically also fell victim to the ruthless men, who tried to kill her with a machete.”
Christelle sustained deep cuts to her back, thighs and one arm. Her seriously injured grandmother managed to flee to the bush to hide.
“From the window of the house, I could see the armed men roaming around our neighbours’ houses further down the street,” says Clarisse. “I quickly went out to take my wounded child inside, then I went to retrieve grandmother, and we locked ourselves in the house again until late in the evening. When the armed men had left the village, we sought help and were escorted by MONUSCO [the UN’s peacekeeping] forces to MSF’s health facility in Drodro, from where we were immediately transferred to hospital here in Bunia.”
Looking at the child in her mother’s arms, I am horrified by what she has experienced. No child should go through this suffering and trauma. Yet women and children bear the brunt of the conflict in eastern DRC, with horrific violations committed on a daily basis.
According to the UN, DRC is one of the five conflict zones with the highest numbers of serious violations against children, alongside the Occupied Palestinian Territories, Somalia, Ukraine and Syria.
MSF’s project has played an important role in saving lives while offering tailored and quality care to reduce the level of functional disability that patients might otherwise face for the rest of their lives.
Names have been changed
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