Democratic Republic of the Congo

The Democratic Republic of the Congo (DRC) borders nine countries in the heart of Africa and is approximately the size of the United States east of the Mississippi. It is home to vast natural resources and mineral wealth, but it is still one of the poorest countries in the world, beset recently by the deadliest conflict since the end of World War II. The DRC’s vast size, poorly developed road and communication systems, and fragile stability have contributed to the low quality and small number of basic social and health services in many areas. In addition to the low access to family planning and maternal health care, which leads to obstetric fistula, the prevalence of brutal sexual violence in the east of the country has led to an epidemic of traumatic fistula.

USAID-supported fistula services in the DRC began in July 2005. Fistula Care was invited to implement these activities starting in 2008. The program seeks to reduce the number of new fistula cases and to rehabilitate women who have been disabled by obstetric or gynecologic trauma in the eastern provinces of North Kivu and South Kivu. Work is underway at two facilities:

• The General Referral Hospital of Panzi, Bukavu, South Kivu
• HEAL Africa Hospital, Goma, North Kivu

Program Results

As of June 2010:

• USAID funding has enabled 2,967 fistula repair surgeries.
• 31 doctors and 64 nurses were trained on fistula surgery and management
• 296 doctors and nurses were trained on fistula counseling and safe motherhood
  
  Note: Repairs conducted in the Democratic Republic of the Congo prior to 2009 were funded by a USAID/DRC bilateral agreement with the International Rescue Committee.  

Supported Sites

The General Referral Hospital of Panzi is located in Bukavu, the capital of South Kivu. It opened in 1999, and in spite of numerous setbacks during the wars, it has grown to a 334-bed faith-based hospital that offers a diverse array of medical and surgical services. More than 70% of Panzi patients are survivors of sexual violence. Given the facility’s expertise in repairing fistula, patients now come to Panzi from all over two Congolese provinces and beyond.

HEAL Africa Hospital is a faith-based hospital in the North Kivu capital, Goma. HEAL Africa began as a small surgical training clinic in 1996, and over time it has expanded its services to become a 180-bed hospital that performs more than 280 fistula surgeries per year. Local volunteers help to identify patients and bring them to the hospital. At any given time, between 120 and 160 women are waiting for fistula repair at the hospital. HEAL Africa also works with village and religious leaders to develop plans to care for the area’s vulnerable populations.

For a film about traumatic fistula in the Democratic Republic of the Congo, click here.

Program Activities

Strengthening services

Fistula Care is supporting HEAL Africa Hospital and the General Referral Hospital of Panzi to expand fistula repair services and ensure the provision of transportation, counseling services, and follow-up care. The hospitals are also working with rural clinics and other partners to strengthen referral systems. Fistula Care is supporting the hospitals to train doctors and nurses in obstetric care and continue as centers of excellence for fistula repair in the DRC.

Improving fistula prevention

The HEAL Africa and Panzi hospitals work with doctors, midwives, and nurses to improve their case management for complicated pregnancy and birth. The hospitals also try to improve referral systems and to reintegrate fistula survivors into their communities. A regional workshop for hospital staff and rural health workers is planned.

Encouraging a supportive policy environment

The dedicated work of the HEAL Africa and Panzi hospitals has inspired the media to bring the problem of traumatic fistula into the international spotlight. Fistula Care advocates for greater attention to the problem of traumatic fistula on the world stage.