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Disease, hunger, violence threaten millions of refugees in Africa

WHO warns disease and hunger are at alarming levels in the Congo, where almost 10 million people are on the move.

Children are among the most vulnerable victims (AN/Michel Isamuna/Unsplash)

While much of the world focuses on the death and devastation in Gaza and Ukraine, a historic humanitarian crisis fueled by conflict, disease and weather is unfolding across central and northeast Africa.

Starvation, epidemics, climate change, civil wars, displacement and sex trafficking are upending the lives of millions of men and women, boy and girls.

In the Congo, where militant groups and government forces are fighting over territory and natural resources, the World Health Organization reports nearly 10 million people are involuntarily on the move. The spread of cholera, measles, yellow fever, anthrax, plague, mpox and other disease poses significant public-health threats.

"DRC is facing its worst cholera outbreak since 2017 with 50,000 suspected cases and 470 deaths recorded in 2023," Dr. Boureima Hama Sambo, WHO's representative to Congo, told reporters by videolink from Kinshasa. The risk is particularly high, he said, in camps where displaced people are living in grim conditions.

Demand for health care is overwhelming

Hospitals are overflowing with the sick and injured and humanitarian aid organizations are overwhelmed by the demand to feed and care for the millions of displaced people.

Humanitarian organizations say a quarter of Congo’s population – 25.4 million people – are directly affected by poverty and hunger. Around 6 million children in the Congo, or more than two of every five, are chronically malnourished.

Acute hunger and malnutrition have a lasting generational impact, WHO warns, increasing vulnerable groups’ risk of medical complications, such as stunting and cognitive development, and death from infectious disease outbreaks, such as cholera and measles.

Millions of dollars needed

During a recent visit to Goma, the largest city in North Kivu Province in Congo's east, World Food Program chief Cindy McCain said her agency is doing all it can but desperately needs more than US$500 million to keep operations running in the country.

Goma, she said, “is surrounded by tens of thousands of temporary shelters, and the numbers are growing every single day. The displaced people crammed into them urgently require food, clean water and sanitation.”

Matthew Saltmarsh, spokesperson for the U.N. Office of the High Commissioner for Refugees said the latest reports from the area were “alarming.”

“Families continue arriving at sites traumatized and exhausted by the attacks, scarred physically and psychologically. Many report being abused _ some sexually _ during their flight. New arrivals find refuge in makeshift shelters in overcrowded sites, in schools and churches, or with host families, stretching their meager resources," he said.

WHO's Sambo said the Congo has the “second-largest displacement crisis globally after Sudan, with more people forced to flee the violence since the start of the year.”

In addition to conflict-related challenges, torrential rains and historic flooding of the Congo River recently ravaged communities, uprooted thousands of people and exacerbated the risk of diarrheal and water-borne diseases, compounding the strain on the DRC’s already fragile health system.

Life is perilous for women and girls

For African women and girls caught up in the violence and displacement, everyday life is especially perilous. They face a constant threat of sexual violence, particularly when they search for firewood to sell to buy food for their families.

WHO says some 30,000 cases of gender-based violence were reported in the Congo last year, a rate that puts the country among the highest in the world.

In Sudan, where more than 9 million people have been displaced by the nearly year-long war between rival generals, officials with the U.N. Human Rights Council are seeing an alarming increase in reports of sex trafficking and slavery.

Sudan's slave markets

The council said it was appalled at reports of women and girls being sold at slave markets in areas controlled by Sudan's rival paramilitary group, Rapid Support Forces, and other armed groups.

It also reported an increase in forced marriage and recruitment of boys to join the fighting on both sides.

In South Sudan and Chad, international humanitarian efforts are stretched to the breaking point by the hundreds of thousands of refugees fleeing the violence in Sudan where WFP says some 18 million people face acute food insecurity.