Refugees resort to harbor treatment because they do not access health centers in Goma DRCongo

Medical problems of refugees in Goma, the Democratic Republic of Congo

Responses towards refugee medical needs in North Kivu, DRCongo is within the context of the whole refugee issues. In terms of responsibility is not so clear who should be responsible for this but because we all know that for the last 30 years the Government of DRCongo has not been active in this part of the country due to wars and insecurity, the United Nations High Commissioner for Refugees (UNHCR) should have been more responsible to ensure each refugee has access to available medical treatment. Globally UNHCR accounts for the protection of refugees.

This is what we are trying to do by engaging UNHCR to be more active in the field of ensuring the protection of refugees and at the same time engaging the state to play a big role towards lasting solutions. We have collected cases and have shared them with UNHCR for potential interventions. Since February up to now we have observed progress in terms of policies. At first UNHCR medical interventions were limited to only urban refugees, however these days UNHCR has indicated that yes it can also look into the situation of others but support will be based on individual merit of each case.

On a positive note, UNHCR has paid medical bills to those who are not urban refugees especially some among those we referred to her, but the fact is that all refugees seem to be vulnerable, so the policy of individual merit may not apply and cannot be effective and should be encouraged to be changed in order to accommodate interventions that target all refugees.

Context of refugees

Refugees during our weekly meeting discussing challenges related to medical problems in Goma DRConngo

Since 1996 both the state and the International Community Represented by UNHCR deserted refugees in this part on their own and the consequences are too high. Refugees present more chances to die of curable diseases than people in the host communities, this is because refugees are economically more vulnerable than the host communities, as refugees do not have a stable source of income. Much as we all know people who are killed by wars or by armed groups, the Cameras have not yet been turned towards refugees who die every day in DRCongo especially in the east due to lack of medical treatment.

Mutuelle de Sante Programme

In north Kivu Province only around 3,000 refugees may have access to generic medical care where UNHCR pays 75% and refugees pay the 25% of the total treatment. This arrangement is limited only to refugees who are recognized by UNHCR as residents of Goma, and Karisimbi Divisions which are called urban refugees.

Even in these two urban Divisions we believe that many refugees do not have access to medical treatment because they are not identified and they are not registered as refugees, simply because the registration services do not exist. We estimate more than 7,000 refugees in Goma and Karisimbi who are not yet registered by UNHCR and by the Government.

Other parts of the Province

Refugees with local communities after the eruption of Nyiragongo Volcano which has caused many to get sick.

All the other parts of the province where a huge number of refugees are totally not a concern of UNHCR Goma and no medical intervention is specifically looking at the situation of refugees. This is also partly because in these areas UNHCR does not focus her attention on refugees but rather intervenes more on Internally Displaced Persons, and completely abandoned refugees. It is not yet clear why such a preference, who are behind it, how does it advance the mission of UNHCR and what are the real outcomes of such a move?

While we estimate that more than 700,000 refugees are in North Kivu Province, only more than 170,000 are registered and identified by UNHCR. This alone exposes all others to potential risks and exclusions which are observed.

The existing health services are generally set up to serve the local population, this does exclude refugees who have to camouflage themselves into the local population in order to access services. But still that does not help them too much because many refugees have challenges with the language, they are discriminated against by medical centers personnel, and many do fail to pay the medical bills which pushes the medical centers to generalize the situation to all refugees, by conditioning services with money first.

This refugee family we contacted indicated “we are here because we run away from our home in Masisi due to the lack of money to pay for the medical treatment of my daughter. She was raped, so we took her to the hospital where she was treated for two months, in the process we failed to pay, so they detained her there. Now we planned how to escape and since then we are hiding here. In case the hospital knows that we are here, they will come to arrest me”.  This family is part of many others who have moved from their usual place of residence because they lacked money to pay for the medical treatment.

This woman came at our office with her child who is sick and wanted us to help her, she told us “I do not have money to take this child to the hospital, she developed this problem two months back, and since then up now I have been using harbor medicine, but the situation of this child is deteriorating”.

In Nyiragongo Territory in North Kivu, almost 85% of refugees we talked to indicated that they only use harbor medicine because they do not have money which can take them to the hospital. This is one among the causes of the high rate of deaths among refugees in North Kivu. Unfortunately such deaths are attributed either to witchcraft or to the Devil or to the “will of God” for those who are Christians.

UNHCR ambiguous policies

As we said, UNHCR does intervene only for those identified as “urban” the criteria for someone to be an urban refugee remains unknown and creates various reactions because Goma is now beyond the Division of Goma and Karisimbi. But even those who are covered by UNHCR do only benefit from the basic medical treatment which leaves other refugees with critical sickness with no other option than to die. UNHCR also seems not to have in place alternatives for possible transfer of refugees to other places where they may be able to get specialized treatment, those with such demands are already sentenced to die.

In the rest of the other territories in North Kivu UNHCR does officially intervene only on Internally Displaced Persons and nothing is mentioned as “refugees”.


Inclusion of refugees in all health approaches in North Kivu Province DRCongo

It is very urgent to work on medical treatment of refugees in North Kivu in order to save their lives, this will stop this massacre against refugees who lose their lives to curable diseases. As per now the urgent actions we should all do is to engage UNHCR to recognize the legitimate needs of refugees in North Kivu and then put in place services which can address those urgent needs, but also engage UNHCR to appreciate the need to call upon other humanitarian actors to come in and address issues surrounding refugees.


Global Refugee Leaders Forum

Author: Kuliloshi Pecos