The war in the Congo is a humanitarian disaster, but has drawn little response from the international community. Richard Brennan (International Rescue Committee, New York, USA) and colleagues report the findings of a nationwide household mortality survey done between April and July, 2004. 19 500 households were visited. The national crude mortality rate of 2•1 deaths per 1000 per month was 40% higher than the sub-Saharan regional level, corresponding to 600 000 more deaths than would be expected during the recall period and 38 000 excess deaths per month. Total death toll from the conflict (1998–2004) was estimated to be 3•9 million. The mortality rate was higher in unstable eastern provinces, showing the effect of insecurity. Most deaths were from easily preventable and treatable illnesses rather than violence.
Dr Brennan comments: This is the fourth in a series of surveys since 2000 that have consistently drawn the same conclusion--Congo is the deadliest crisis anywhere in the world over the past 60 years. It is a sad indictment on us all that, seven years into this crisis, ignorance about its scale and impact is almost universal, and that international engagement remains completely out of proportion to humanitarian need. Major governments, the United Nations, the African Union, humanitarian agencies, and the international media must all play a role: improved security is essential to lower the death toll; greater political engagement is urgently required; the parties to the conflict must be held to account; and the level of humanitarian aid must be increased dramatically. The citizens of DR Congo must finally be given the chance to live their lives in peace and security, and to achieve their full potential". (quote by e-mail; does not appear in published paper).
In an accompanying Comment, Evelyn Depoortere (EPICENTRE, Paris, France states: "Rich donor nations are miserably failing the people of the DRC, even though every few months the mortality equivalent of two south-east Asian tsunamis ploughs through its territory…[this] paper should spur the UN and member states to intensify efforts to prevent a resumption of widespread hostilities, currently a realistic scenario. We can no longer claim ignorance about this and other wars' profound and protracted effect on human health. In this sense, mortality studies could play a pre-emptive role to provide further justification for peace initiatives when conflicts threaten to break out. We encourage the mass media and civil society to critically monitor global humanitarian and political responses to the DRC emergency, and to not switch off the lights yet again on what may well be the world's greatest humanitarian crisis.'
Dr Richard Brennan, Health Director, International Rescue Committee, 122 East 42nd Street, New York, NY, 10168 USA; 212-551-3019; rbrennan@theirc.org
UK contact: Lydia Gomersall, 44-207-692-2741 or 44-777-985-5021; Lydia@ircuk.org
Comment: Dr Evelyn Depoortere, Epicentre, 75011 Paris, France; 322-475-3624; evelyn.depoortere@brussels.msf.org
Journal
The Lancet