Upgrading Health Care in the Democratic Republic of Congo

Health Situation in the Congo

Health indicators in the Democratic Republic of Congo are among the worst in the world and it will be extremely challenging for the country to upgrade health care especially to provide access to qualified basic health care services.

Maternal and infant mortality rates are very high: 129 out of 1,000 infants die before the age of one and 205 children out of 1,000 die before the age of five. Maternal mortality rate is still very high. Up to now over 36,000 women die each year. In addition to the many children orphaned by maternal deaths, an increasing number become parentless each year due to HIV/AIDs. At least 16 percent of young children are severely malnourished.

Infectious diseases including malaria, acute respiratory infection and diarrhea are particularly severe incidents for children. To reduce child mortality is to tackle malaria which accounts for a third to a half of all child deaths representing 150,000 to 200,000 child-deaths annually. Other diseases contributing to poor health are HIV/Aids, tuberculosis, measles, poliomyelitis. 

Poverty and conflicts as factors

Poverty and conflicts are key factors affecting the health status of the population as well as inadequate health services. Often people are not satisfied with the service which is demonstrated in low utilization rates of health services. In many cases people are choosing to self-treat or to use practitioners of traditional medicine.

In the East Congo, about 70 percent of health care is offered by church-owned institutions. Government structures are weak and often inadequate.

DIFAEM-Projects in the Congo

DIFAEM main focus

  • Hospital care and service delivery
  • Care and rehabilitation for women suffering from sexual violence
  • HIV and AIDS care, treatment, prevention and support
  • Rehabilitation of health facilities
  • Community-based projects aimed at prevention of sexual violence within churches and communities
  • Maternal and child care

HIV prevention and support of people with HIV and Aids

Despite the high HIV and AIDS infection rate, this issue is still taboo in Congo. Those affected are ostracised, lose their jobs and often get into economic difficulties. They are frequently confronted with recriminations and abandoned by their partners.

The Catholic OLAME Centre in the eastern Congolese city of Bukavu is a contact point for socially disadvantaged people, especially women and children. DIFÄM supports the centre in HIV prevention and in the care of people living with HIV and AIDS.

 Focus on young people and students

OLAME staff provide information on HIV prevention at public events. "The measures are primarily aimed at leaders of youth and student groups," says Congolese therapist and OLAME director Thérèse Mema Mapenzi, explaining the programme. In addition to HIV and AIDS education, the centre offers training on how to peacefully deal with conflicts and develop resilience mechanisms. "This is where we address young people in particular." They make a kind of commitment to protect themselves against HIV. They also want to sensitise other young people and promote a positive attitude towards infected people. "There is a lot of ignorance about the virus, about prevention and transmission possibilities," says trauma expert Thérèse Mema. Young people in particular are at risk of contracting HIV because of their low level of knowledge.

Living with HIV and AIDS

The work with infected women and men aims to reduce their fear of stigmatisation. In confidential small groups led by OLAME staff, those affected learn to talk openly about HIV and AIDS and to accept their status. "This strengthens their will to maintain their health by taking medication regularly," explains Thérèse Mema. Ten pairs of parents found the courage to talk to their children about their illness.

All participants also receive training on how to get into employment and are supported in the relevant activities. In addition, OLAME staff go to the families of those affected and offer family mediation.

DIFÄM also finances the medical treatment of destitute women and men suffering from HIV and associated diseases.

Strengthen Maternal and Infant Health Care

One of our main objectives is to strengthen health services of mother and child care. Therefore we support the supervision of health services, assist in supplying basic equipment so the institutions are able to offer qualified basic care. Capacity building in management and administration as well as upgrading the service of lab technicians are a focus of our assistance.

Campaigns for surgical repair of vaginal fistulas are organized once a year by one of our partners. Up to 100 women are cared for. This means a great relief for women who have been marginalized and stigmatized. They come from isolated mountainous regions.

The challenges of HIV/AIDS

Assistance in HIV/AIDS prevention, training of peer voluntaries and voluntary testing as well as counseling has been given. In some areas village chiefs are asking to have programs started in their villages.

Slowly people are willing to discuss the challenges of HIV/Aids and once a person has openly declared to be affected by the virus others follow. This has a great impact. Support groups are started and it’s great to see how communities start to take up responsibilities. Members of the communities are now able to address the challenges and take measures to handle the problem.

Strengthening health Systems

Strengthening health systems is another key aspect of DIFAEMs interventions. Together with our Partners, we work to upgrade their administration and have necessary basic equipment to operate in their offices. This allows them to write reports, to collect proper statistics and analyze them and improve supervision.

In Bunia, DIFAEM supports a community-based health program. Today, it has over 3,000 members. Frequent diseases like malaria, diarrhea etc. are covered. Extension to neighboring health zones are in view. The health facilities in the catchment area have financial advantages, since the payment of the costs is garanteed by the health insurance. By this fact, the health systems are supported and strengthened.

Education for deaf-mute children

In Aru, a town in the North-East of the DR Kongo, hearing and deaf-mute children go to school together. The Centre d’Education et de Réhabilitation à Base Communutaire (CERBC) makes sure, as well, that students get sufficient information about HIV...



Dr. Gisela Schneider
Dr. Gisela Schneider Director of DIFAEM Merrit & Peter Renz Haus Im Rotbad 46, 72076 Tübingen Tel. +49/7071 206-811 schneider@difaem.de
Ms. Gabi Hettler
Ms. Gabi Hettler Consultant Health Services, Leader Team Education Mohlstraße 26 72074 Tübingen Tel. +49/7071 704 90 14 hettler@difaem.de