Humanitarian Situation in the Kivus and Maniema Province Snapshot report, 25 February 2011 A publication of the Humanitarian Information Group (HIG) produced with OCHA s support The crisis at a glance Main causes: chronic instability, recurrent waves of fighting, human rights abuses by all belligerent parties At least 1.2 million IDPs now in the Kivu provinces (as of 31 December 2010) More than 700,000 recently returned IDPs (last 18 months) now in the Kivu provinces (as of 31 December 2010) Approximately 30% to 40% of beneficiaries not accessible, due to insecurity and logistical constraints 200 attacks involving humanitarian during 2010, compared to 179 during 2009 Context The humanitarian crisis is, for the most part, the result of the current armed conflict between the Armed Forces of the Democratic Republic of the Congo (FARDC) and the Rwandan armed opposition group Forces démocratiques de libération du Rwanda (FDLR), as well as other foreign and domestic armed opposition groups. In January 2010, the FARDC launched military operations called Amani Leo against these groups, some of which are conducted in coordination and with the support of the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), and formerly with that of its predecessor (United Nations Organization Mission in the Democratic Republic of the Congo, MONUC). These operations were preceded during 2009 by Kimia II also supported by MONUC, and before then by Umoja Wetu, carried out jointly by the FARDC and the Rwandan armed forces. The FDLR and other groups carry out continuous attacks against civilians, sometimes as a reprisal for allegedly supporting an enemy faction, and often as a modus operandi aimed at terrorising the population. These groups, as well as bandits, continue to impact very negatively on the situation of the local populations, by threatening their security and livelihoods. A context of widespread instability and weak control by the national authorities in several parts of the Kivu provinces compounds this situation. Since July 2010, the FARDC has also conducted military operations called "Rwenzori" in North Kivu's northern territory of Beni, against the Ugandan armed opposition group Allied Democratic Forces (ADF). This led to ADF elements being scattered, forcing an estimated 80,000 to flee as IDPs. Until early 2009, conflict also existed between the national army and the domestic opposition group Congrès national pour la défense du peuple (CNDP). The "Goma agreements" of 23 March 2009 provided for an end to hostilities, and for the integration of the CNDP and other groups into the FARDC. The agreements led to improved stability in some areas, particularly those formerly controlled by the CNDP, such as parts of the Masisi and Rutshuru, thereby prompting hundreds of thousands of IDPs to return. However, significant difficulties remain in implementing the agreements, as former CNDP elements are often not fully integrated into the national army, and the former CNDP maintains a system of parallel administrations in some of its former strongholds. Altogether, most areas of the Kivu provinces remain unstable, and the security situation is highly volatile. The Kivus are also an area where significant natural disaster risks exist, including earthquakes, volcano eruptions, or methane gas explosions from Lake Kivu. Protection concerns House burnings, lootings, abductions, sexual assaults, are constantly reported in almost all territories of the Kivu provinces. In several territories of South Kivu, especially Fizi, Mwenga and Shabunda, civilians are often kidnapped temporarily, and forced to transport military equipment and other goods by members of the belligerent parties. In North Kivu, the areas with the greatest incidence of human rights abuses are Lubero, Masisi and Walikale, with the FDLR and FARDC reportedly being the main perpetrators. In early 2010, violence and high instability have returned to the northern part of the Rutshuru territory, previously calmer. Sexual and gender-based violence (SGBV) is one of the greatest concerns, but only one symptom of a much broader protection and humanitarian crisis. According to the best available data (produced by UNFPA), during 2010 over 8,000 cases of SGBV were reported in the Kivu provinces. A majority is committed by armed groups, including the national army, and many are mass rapes and particularly brutal. During 2010, several highly publicized cases of mass rapes committed by armed elements became internationally known, but humanitarians fear that many more may occur and remain unknown. Many rapes are also committed by civilians. South Kivu's Fizi Territory is one of those most affected by mass rapes, with five instances of mass rapes recorded between 01 January and 20 February 2011, affecting over 150 women, men, and children. Protection concerns remain on top of the agenda of all humanitarian actors, considering the high number of human rights abuses and widespread violence that characterise the situation in both Kivus provinces. Population movements Displacement, caused mainly by lack of protection, lies at the core of the humanitarian crisis in eastern DRC. Over the past years, millions of civilians have fled from their areas of origin (including many who later returned to
areas that had become calmer), due to actual and potential human rights violations. According to the most recent statistics (dated 31 December 2010), over 1.2 million IDPs are present in the two Kivu provinces, as well as over 700,000 recently returned IDPs (having returned in the last 18 months). Many families have already fled the war several times, moving back and forth, or in circles, in order to avoid armed groups. More than 80% of displaced people are living with host families, which poses a burden on local communities and sometimes leads to tensions, in a context of already scarce resources. More than 75,000 IDPs are hosted in camps managed by humanitarian partners, mostly in North Kivu's territories of Masisi and Rutshuru. It is difficult to produce reliable estimates of IDPs, newly displaced IDPs, re-displaced IDPs, returning IDPs, etc. This is due to several factors: the fact that the vast majority live with host families rather than in camps; the frequency of waves of displacement and return simultaneously; the re-displacement of current IDPs; the phenomenon of pendular movements; the high dispersion of IDPs across the provinces. While persons are being newly displaced or re-displaced in some areas, other households formerly displaced have returned to their villages mainly to areas that were previously controlled by the CNDP. There are now more than 700,000 recently returned IDPs in the Kivu provinces (who returned since September 2009). For the most part, returnees demand the restoration of state authority and security before a decision to return. The strengthening of humanitarian assistance, especially in terms of livelihoods support and rehabilitation of basic services (education, health, water and sanitation) is essential in areas of return or prospective return. However, some returns hide another reality: the phenomenon of pendular movements, which is believed to have increased during 2010. Because they are tired of living in camps or in host families, and need to access to their fields, some IDPs choose to work in their villages during the day despite insecurity, and sleep in the forest or in neighbouring villages at night to avoid being attacked. Rwandan refugees are still present in the Kivu provinces. Approximately 10,000 refugees were repatriated to Rwanda during 2010, and approximately 105,000 since the beginning of the operation in 2001. Access to beneficiaries Humanitarian operations are severely restricted by armed fighting and rampant banditry, thereby inhibiting access to vulnerable populations, and leaving many intended beneficiaries without assistance. Logistical obstacles, including the poor state of roads and other infrastructure, compound this situation. Humanitarians are frequently the victims of armed robbery, looting, and other incidents. The major consequence of these attacks is the temporary or definitive suspension of humanitarian activities in areas where population are in great need of humanitarian assistance. In 2010, 200 incidents against humanitarians were reported in the Kivu provinces (including 95 armed robberies or looting), compared with 179 incidents during 2009. NGOs are more affected by this insecurity than United Nations agencies, because of their greater presence in the field and the fact that they do not use military escorts. Violence against humanitarians is often worsened by the drunken or drugged state of combatants. Especially in North Kivu, an additional major obstacle to access is posed by the poor condition of the roads, which are heavily damaged every year by rainfall. This contributes to render the north-western part of the Masisi Territory and eastern part of Walikale Territory some of the least accessible areas in the Kivu provinces. Rough estimates suggest that in North Kivu, approximately 70% of those displaced in 2009 and 2010 are accessible and in receipt of humanitarian assistance, while the estimate is 60% for South Kivu. Humanitarian needs and response Despite various constraints and limited access to some areas, humanitarian activities continue, even during periods of particularly intense armed violence. In most areas where IDPs are present, existing social services such as health structures and educational facilities could not have coped with the latest arrivals, without the help of humanitarian assistance. The dependence on relief services is therefore very high for the majority of IDPs and recent returnees, as well as for many host communities. The humanitarian situation is of particularly high concern in the territories of Kalehe, Mwenga and Shabunda, in South Kivu, and the Lubero, Masisi and Walikale Territories in North Kivu. Limited funding to be used to improve access is one of the causes for limited access. Education Despite conflict, primary school attendance in the region is within the national average of 75%: it is 79% in Maniema, 72% in North Kivu, and 73% in South Kivu. The same applies for secondary school attendance: 32% in Maniema, 30% in North Kivu and 32% in South Kivu, against a national average of 32%. These relatively good figures are largely attributable to humanitarians, who work to ensure that education is available even in areas heavily affected by conflict. Key obstacles and challenges Due to their increased vulnerability, IDPs are often unable to send their children to school. Returnees and others, at the same time, face widespread poverty, and basic school enrolment is also difficult for them to achieve. In the majority of cases, IDPs live within host communities and when possible, send their children to local schools, which are unable to cope with the influx. Exacerbating this issue is the fact that prolonged conflict has also inflicted heavy damage on the educational system, physically in terms of infrastructure and qualitatively, knowing that teachers are themselves IDPs and that many of them have never seen the National Curriculum and have not received training on new teaching methodologies.
Despite that free education has been announced for grades one to three, and that a large number of children previously out of school have been (re)integrated, the problem of insufficient classrooms and teachers is exacerbated. The Government does not have the means to construct the number of classrooms required nor do they have the means to deploy extra teachers especially when there is already a large percentage of the existing teachers who are still not on the teacher payroll Learning outcomes are reportedly weak. A recent monitoring of learning achievements shows that average scores in French, arithmetic and culture were not more than 34%, 36% and 47% respectively. 1 The education of girls faces additional obstacles, such as early marriage, domestic chores, child labour, poverty, and a natural propensity of families to give priority to the education of boys rather than girls. Gender parity in access has so far received little attention from the Government of the DRC, as the persistent gender gap in school enrolment and the shortage of female teachers suggest. At the same time both boys and girls are vulnerable to recruitment in the various militia groups. There is also a lack of information and knowledge on social and health issues, including HIV/AIDS. Only 43% of women aged 15-49 years have knowledge on HIV/AIDS transmission from mother to child and 14% women of the same age have good attituds towards persons living with AIDS in South-Kivu. Henceforth, education is of essential importance in prevention and protection and provides the foundation for the development of the country s futuremain humanitarian activities The activities of humanitarian actors aim to: Ensure that the minimum standards for education are adhered to in all phases of a response. Involve the Government in all emergency and developmental activities in order to ensure a progressive appropriation of the sector by the Government. Reinforce the links between emergency and development, especially through the targeting of priority areas for activities. Ensure that sufficient quantities of teaching personnel, learning spaces, and teaching and learning materials, are available. Provide in-depth analysis of the most appropriate means for children and adolescents of both genders, and including IDPs as well as recent returnees, to access free, quality education. Reinforce the links with water and sanitation, health, and protection activities, aimed at the improvement and safety of learning spaces. Improve awareness among the population on social and health issues, including HIV/AIDS. Work in adherence with the Five Engagements for ensuring Gender Equality in Education as validated by the Education Cluster. Raise awareness among communities, parents, and leaders, on the importance of education for all children. In 2010, the Education Cluster was able to provide access to education for 122,821 children who would have otherwise been excluded. Around 240,000 received learning materials, and 607 classrooms were rehabilitated. UNICEF has supported the Government in developing and implementing a life skills curriculum designed to equip adolescents and young persons with skills in HIV/AIDS prevention, peace education, and conflict resolution. During 2010 160,000 students and 425,000 out-of-school adolescents have acquired life skills and more than 3 million have benefitted from awareness campaigns about HIV, STIs, reproductive health and citizenship/peace issues through mass media and social mobilization activities. Food Security and Livelihoods The Kivus significant potential for agricultural activities. However, during the last two decades, food production has dropped, and limited food access has affected the households. Agriculture remains the primary livelihood activity for 95% of the population, it is the main source of income for 76% of households, and it contributes to 67% of the food consumption. 2 South Kivu is generally in a food deficit situation. The 2010 World Food Programme (WFP) food self reliance monitoring showed 37% of the population is severely or moderately food-insecure. The causes of food insecurity vary from structural problems such as generalised poverty, which limits access to food or agricultural inputs for a large number of households, to transitory problems including armed violence, lootings of crops and livestock, losing planting season, crops and animal diseases, climate change, high food prices. The protracted armed conflict with its massive population displacements has been identified as the main cause of food insecurity. The major achievements of Food Security Cluster members during 2010 can be summarised as follows: They delivered by road, rail, boat and air 12,206 metric tonnes (MT) of food; They provided food assistance to 493,527 people through WFP-led Relief and Recovery Operation; They equipped 250,000 households in need with seeds and tools; Key challenges foreseen for future Food Security Cluster operations include the following: Limitations on access for assessments and field monitoring, due to insecurity; Geographical access continues to be a challenge to transporting food to rural areas. In 2011, the Food Security Cluster plans to assist an estimated 290,000 beneficiaries through general food distribution, 5,500 through programmes for mother and child health as well as assistance to persons affected or infected by HIV/AIDS, 237,000 through the provision of school feeding, 50,000 through programmes for vulnerable groups including children formerly associated with armed forces and groups, and 59,000 through Food-For-Work programmes. 1 Enquête Nationale sur les acquis de base des élèves des écoles primaires et des apprenants des Centres de Rattrapage Scolaire, 2008. 2 Source: CFSVA 2008
Seeds and tools distribution for the 2011 planting seasons will continue to cover the needs of thousands of IDPs and host families, households with under-five malnourished children, and other vulnerable people. The Cluster will continue to assess the food security indicators, building the capacity of small farmers and continues to address the needs of spontaneous IDPs and recent returnees. Health Key indicators, priorities, and obstacles The latest available health indicators in eastern DRC are as follows: Vaccine coverage (as of December 2009): 89.2% for tuberculosis, 88.8% for hepatitis B, 83.4% for measles, 83.9% for yellow fever, 80.5% for tetanus. An estimated 90.3% of children aged under five has received at least one dose of Vitamin A. An estimated 36% of babies are exclusively breastfed. In 2009, 6% of children aged under five sleep under impregnated mosquito nets. In 2009, 5% of HIV-positive pregnant women have received relevant medication. In 2009, 15% of children born from HIV-positive women have received relevant medication. The major health concerns at present include limited access to health care, resulting in increased mortality, including maternal mortality during delivery; increased vulnerability to disease outbreaks including cholera, meningitis and malaria. Frequent population movements are a key reason for these problems, as they lead to a stretching of the health care system, and a significant decrease in access by the population to both preventive and curative health care. At the present time, the main priorities in the health sector are the following: Maintain disease and nutritional surveillance and early warning mechanisms, and support existing governmental mechanisms in these domains. Ensure rapid response to epidemics and nutritional emergencies. Provide support to the most vulnerable people, who suffer from temporary disruptions in the provision of health services. Reduce maternal mortality. Strengthen coordination, in order to improve response activities. The health system in eastern DRC is facing many challenges, which severely affect the provision of basic health care. In some areas, this is due to the high concentration of people, including IDPs. Major obstacles to addressing key concerns include shortages of medical supplies, poor training of health personnel, and lack or shortage of proper equipment for the management of medically complex cases. Responsibilities are gradually being handed over by humanitarian actors to the Host Government. For example, feeding centres, which were managed by NGOs during the war, are now being integrated into the national health system. Reproductive health Pregnant women are among the most affected by precarious health conditions, and have no access to emergency assistance or crucial obstetrical services. The rates of both maternal and infant mortality are high, estimated at 850 per 100,000 and 120 per 1,000 live births, respectively. In a context where IDPs are often victims of sexual violence, services for managing the consequences of such violence are available in some urban settings, but often lacking in rural areas. Reproductive health services for adolescent women are rarely available, leaving young women who are sexually active particularly vulnerable. The fight against HIV/AIDS continues to be a major priority, with emphasis on primary prevention programmes. However, lack of resources continues to prevent treatment being provided to all those in need. Main humanitarian activities The distribution of over 2 million impregnated mosquito nets started last January and it continued until last March and covered the Maniema Province. At a rate of three mosquito nets per household, this benefits 1.8 million households, or 11 million people, and is expected to have a significant effect against the prevalence of malaria and other insect-borne diseases. Logistics The United Nations Humanitarian Air Service (UNHAS), managed by WFP, began flying in May 2009. In 2009, more than 7,597 passengers flew with UNHAS in the DRC, while figures for 2010 are not yet available. Nutrition Indicators and obstacles The major obstacles are insufficient supply in therapeutic foods and essential drugs, as well as difficult access to beneficiaries in some insecure zones Major humanitarian activities In 2009, response activities focused on the management of acute malnutrition using the community-based approach, as recommended by DRC national protocol. In 2009, this approach was implemented in North Kivu, South Kivu, the Orientale Province, and in the Maniema Province, and was integrated into routine health activities. No information for 2010 is available. Out of 159 health zones in the eastern part of the country, 86 (over 50%) are currently implementing the community-based treatment of acute malnutrition. In 2009 more than 49,000 children affected by severe acute malnutrition were admitted for treatment, and more than 80% recovered. No information is available for 2010.
These activities were supported by several partners including the national nutrition programme (PRONANUT) and over 33 national and international NGOs. In 2009, management of acute malnutrition required more than US$ 4 million, including project implementation costs, project support costs, and supplies. No details for 2010 are available. Strategy The response of the nutrition cluster for 2010 is based on the following key elements: Scale up the community-based treatment of malnutrition. Integrate preventive activities and treatment, also through the promotion of exclusive breastfeeding and ageappropriate complementary feeding. Create and maintain a nutrition surveillance system in order to monitor the nutritional situation, anticipate potential deteriorations, and provide timely responses. Protection The Cluster supported the organization of several trainings and workshops over the year, including exchange of experiences and techniques among the provinces. Shelter and Non-food items (NFIs) Key Obstacles and Challenges During 2009 and early 2010, the continued context of protracted displacement in vulnerable host families, new displacement, displacement in collective sites and camps, pendulum and partial displacement, and in return have all created needs in essential household and personal Non-Food relief Items (NFI) and Shelter. Most NFI and emergency shelter actors are geared toward one-off distributions or NFI fairs (see below). The challenge is to design more targeted assistance in some of the items which can become unusable after extended use. While this has been easier to do in collective sites, it has been much more of a challenge to launch programmes to renew essential NFI in host communities where the majority of IDP s live. There are few shelter actors in the DRC. While there have been some interesting pilot initiatives, the humanitarian community has had limited success in mobilizing larger scale innovative, community-based, and appropriate solutions to address acute shelter needs particularly for saturated host communities and families returning to areas where long periods of absence and/or direct destruction of houses has created significant difficulties for return and recovery. Major Humanitarian Activities Since 2009, UNHCR and the Pooled Fund are funding shelter assistance to IDPs and host families in the Kivus. The main objective of the intervention is to prevent and mitigate protection risks. Main service providers are CARE in South Lubero, GTZ in Masisi, and ADRA in Fizi and Uvira Territories. In addition, shelter assistance is being provided to specific caseloads, such as pygmy populations, and to vulnerable people and returnees from Tanzania in South Kivu. NFIs are being distributed to IDPs leaving camps and sites in North Kivu once they have arrived in their areas of origin. The Rapid Response to Population Movements (RRMP) mechanism, managed by UNICEF distributes NFI to all segments of the society based on multi-sector assessments. Figures for the first quarter of 2010 are being compiled with the help of UNICEF s online activity and output tracking system, ActivityINFO designed and rolled out in 2009 to allow Cluster members and other UNICEF partners to easily enter and compile data from their activities. Figures for the rest of 2010 are not yet available. As is the case throughout the country, the NFI/Shelter cluster has supported partners to commit to standard inclusion of female hygiene kits to address the needs of menstruating women and girls in all NFI interventions. After successful and large-scale pilots in 2009 reaching tens of thousands of families, the NFI/Shelter cluster has made a strong commitment to continue training and accompanying partners in the appropriate use of cash-based response to meet the needs of affected families as they choose their own essential NFI and shelter materials and NFI/Shelter material fairs using cash-based vouchers at NFI/shelter fairs or in open voucher programmes. Dozens of fairs and have taken place in 2009 and 2010. Water and Sanitation Over one million persons affected by conflict and waterborne epidemics have benefited from emergency water and sanitation activities. Approximately 150,000 households received water and sanitation integrated assistance, through the construction or rehabilitation of more than 3,000 water points, and 20,000 latrines. These activities have contributed to mitigating cholera outbreaks in areas of displacement in the Kivu provinces. All activities are based on a gender approach, thereby ensuring priority consideration and representation of girls, women, boys and men in order to ensure their security and dignity. Humanitarian organizations working in this sector have developed and distributed female hygiene kits, and washing spaces for female personal hygiene were tested. More than 130,000 people were provided with chlorination, water trucking, and household treatment during 2009. No information for 2010 is available. For more information, please contact: Maurizio Giuliano, Advocacy and Public Information Manager, OCHA DRC, giuliano@un.org, tel. +243-81-9889195 Sylvestre Ntumba Mudingayi, Associate Public Information Officer, OCHA DRC, ntumbamudingayi@un.org tel. +243-99-8845386